You know its going to be a bad shift when...

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Just as you're walking into the hospital for your shift, you hear "Code Blue" followed by your unit.

Eight of your patients have had 13 BM's, and it is not even the first hour. (Happened to me 3 weeks ago, wound up dealing with 27 bms that day)

All of your patients are restrainted and just happen to be related to Harry Hodieni.

Your coming on shift, and you see a patient from your unit making a break for the main entrance in their Birthday Suit followed by six nurses and two techs from your unit.

When the night shift (Or day shift) who doesn't smoke hands you a pack of cigarettes and says "Here, You'll need this."

During report on 605, night nurse laughs and refuses to tell you why.

When the night shift tells you good luck.

The night shift says it was quiet and hopes your day goes the same.

When the A/C breaks down and its 102 outside or the Heater goes and its -32 outside.

You only have one patient at report.

When you come into work, and everyone is bagging the vent patients, because of no power.

When you hear a doctor go "Oops."

The the Alheimers guy in 405 tries to climb into bed with Alheimers lady in 406, insisting they are married, let alone they live in two different states.

Five nurses call O/S for the 7 a to 7 p shift, and there are 30 total care patients with no techs.

When your patient has 72 different meds to be given during the day. (I have seen this one also.)

Feel free to add

Adam, RN

Passed my Boards 7/18/2005

You know it's a bad shift when you have 3 licensed staff and 2 unlicensed for 32 patients, the day shift says "by the way room 323 has IVP chemo to be given over 2 hours and we couldn't get to it", you are the only chemo certified nurse on the floor on top of being charge and you have 3 patients recieving blood products. Then the supervisor tells you that you need to rewrite the assignment because the "aides have too hard of an assignment", and then you have a patient go missing for over 2 hours, after a hospital wide search he was found returning to the floor smelling strongly of alcohol. Finally at the end of your shift, you are told you can't get overtime for staying over 2 hours to do your charting, but you can take comp time for it, the catch is you can only cash in your comp time "if we have enough staff to cover you". ( the floor I work on is understaffed by 5 RN's, 3 LVN's and 2 NA's by last count).

Specializes in Utilization Management.

You know it's gonna be a bad shift when you walk in and find, of your 8 patients, one is in SVT, one came up from ER c/o 10 out of 10 crushing substernal chest pain, and another is c/o 3 out of 10 chest discomfort--and he has a 90% block to the LAD. :uhoh3:

P.S. Everyone lived through it.

Specializes in Critical Care.

OK, round 2 here:

You know it's gonna be a bad shift when:

. . .they've called you for the 3rd time just to check that you really meant 'no!' the first 2 times they begged you to come in (but that's a bad shift you don't have to deal with if you stick to your guns!!!)

. . . the supervisor starts by asking 'how many empty beds do you have again?'

. . . your relief calls just when you finally get to the point to hope the shift is about over, and asks you if you had any plans for the next 2 hrs (cause I can't possibly get there until . . .)

. . . your supervisor states that the ban on working more than six shifts in a row 'is really just a guideline' . . .

. . . when three of your patient's four docs are in the room, all shouting verbal orders.

. . . when the crash cart is left in your pt's room, 'cause you're gonna need it'.

. . . when the off-going nurse says, 'the doc stated if the isuprel (to increase heart rates on 3rd degree blocks) doesn't kick in within 30 min, he'll come put in a trans venous pacer, and oh, that was 29 minutes ago with no luck yet'

. . .both your patients are 1. depressant overdosed suicide watches, or 2. DKA's w/ insulin drips and q1hr fingersticks, or 3. 'walkie-talkies' (it's a critical care thing).

. . . the off going nurse says 'the doc says don't call for v-tach unless it's more than a 30 beat run!'

. . . your pain management patient is allergic to 'codeine, vicodin, darvocet, nsaids, demerol, stadol, morphine, dilaudid, phenergan, you get the point'

. . .the off going nurse says 'Well, I told everybody it wouldn't happen on my shift, tag you're it' (this could apply to full codes or go-lytely - you pick).

. . . when the cardiologist and the CV surgeon are arguing over the patient about just what qualifies as a need for 'emergency surgery' (had this happen, the patient went into v-fib during the 'discussion', the CV doc says 'see what I mean', and walked off.)

. . . both your patients are in reverse-trendelenburg when you get there. . .

. . . report: diprivan through this peripheral iv (PIV), dopamine and epi in that one, and TPN in the third PIV, the doc felt they were too unstable to drop a central line. DUH! - that's why you need one!!!!!!!!!!!

. . . CV surgeon tells you as you are walking in and he is walking out "I'm not on call, so if they need an emergency chest re-crack, call my partner - oh, and he already knows about the 350 ml of blood in the CTs in the last 2 hrs - so don't call him unless it gets worse."

. . . Same CV surgeon, different night: "She has an art line, do ABGs q1hr so we can get the HGB from the ABG and call me every hour so I can give enough blood products to keep up - you have a central line, a cordis and a VIP line on the swan, so you should have enough lines to give what we need".

~faith,

Timothy.

I know it's going to be a bad shift for everybody (especially nurses), when I walk in (see user name) & the first nurse I see says, in a tired voice, "Oh man, are we glad you're here". Something like this, being said as the shift is just starting, is a sign things will be just a TRIFLE busy. If I have to sit & rest after 4-5 hours as a volunteer, before I actually leave, I don't even know how nurses make it through 12 hours!

A skunk sprays the AC unit outside and fills the entire

second floor of the hospital with scent, including the sleep study bedroom. LOVELY at 2am. This happened to my husband last week. He was not impressed.

:chuckle

Specializes in MDS coordinator, hospice, ortho/ neuro.

.............when they served saurkraut/ weenies for dinner. I once told my administrator that this was not a good way to save on the cost of laxatives.

Specializes in floor to ICU.

Your report goes like this...

1) a nursing home patient w/ PEG feedings who was unresponsive and contracted, stage III decub on coccyx. She smelled like she was rotting away- MD has been trying to discuss hospice w/ family but they are resistant

2) a legally blind 80's gent who has HTN, ESRD, DM and such severe neuropathy that some of his fingers had to be amputated- now his wounds aren't healing and they are oozing. He also refuses to follow the sliding scale for insulin and instead dictates to the nurses how much insulin he will take.

3) a woman who has been in the hospital 25 days and had a colon resection for colon CA. She had 2 PR drains that were constantly leaking. She had a NGT and was on TPN ,lipids, IVF's, several antibiotics and her K+ was low so she was getting K+ runs. She was unable to move herself. She kept having the urge to have a BM so getting her OOB was very tedious

4) a post op total knee replacement patient in a CPM who had a bladder the size of a pea and needed much assistance to get OOB to the BSC.

5) and (thankfully) walkie-talkie with cellulitis

Specializes in Emergency & Trauma/Adult ICU.

Bad night when the first thing I hear as I'm walking around the hallway corner into the main part of the ER is a nurse asking a pt., "so when was the last time you took your methadone?" :smackingf

you walk in and the cna is beating her head against the front desk.

melissa

Specializes in Med Surg, Hospice, Home Health.

one day I had a complete meltdown, thanks to a 25 year old coming off of GHB...

he was "snapping" off his restraints...the weird thing was, he was compliant until about 3pm, when he started to get paranoid...he had been compliant up to that point...

found out after discharge, another nurse saw him up in buckhead DRIVING!!!!

scarrrrrrrryyyyyy

atlantarn

one day I had a complete meltdown, thanks to a 25 year old coming off of GHB...

he was "snapping" off his restraints...the weird thing was, he was compliant until about 3pm, when he started to get paranoid...he had been compliant up to that point...

found out after discharge, another nurse saw him up in buckhead DRIVING!!!!

scarrrrrrrryyyyyy

atlantarn

I used to live in Vinings. I can see this guy flying towards downtown in a BMW.

melissa

you know it IS a bad shift when

a) it's your first non-supernumary day and you don't see your preceptor for the first 2 hours

b) you find yourself sending sms messages to your best friend saying things like 'tell me again why i wanted to be a nurse' and 'i'm so out of my depth'

c) you're hyperventilating

d) you ask the other grad on your ward if you can cry and she replies 'no, because then i will too

e) among other things, you have a lady to admit who speaks limited english, and you don't understand what's wrong with her because half her paperwork is AWOL

i survived and returned the next day

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