You know the shift is gonna be a hot mess when ...

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You know your shift will be a hot mess when your patient is on a PEEP of 25, Fio2 100, PaO2 50, febrile @ 40 degrees Celsius, maxed pressors, white count

Glad I had a cup of joe.

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"You know your shift will be a hot mess when..."

So true....

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Specializes in Haem/Onc.

Several of mine have been said, such as:

- When certain charge nurses are taking the shift, and you know it means you will be trying to balance the drama on your own unit plus patients from general paeds no matter how good their own staffing is.

- You walk on to increased noise and no-one visible by the nurses' station.

- You don't even make it to handover before being told to just go straight to your part of the unit and get nurse to nurse handover instead.

- Handover starts late.

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Specializes in neonatal.

I work in NICU. Somethings bad when all the lights are on and the crash cart is outside the door. Hoping that's not your assignment for the day.

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When you are work acute dialysis and assigned ICU for the day. You have an assignment of 3 patients on CVVHD, have 3 add ons, your tech is sitting a 8 hour SLED on an acidotic vented patient. You get told that there is a tylenol OD that needs a 12 hour SLED stat. A coworker assigned med surg dialysis gets that started ( leaving med surg dialysis short), and then find out that life flight is bringing in an cardiovascularly unstable pt with a potassium of 7.5 that needs a SLED, but every dialysis machine in the hospital has a patient on it, and the ED has a patient in volume overload on Bipap who needs urgent dialysis also.

You win! We have 2 machines that can do CRRT and one of those is in the unit for the non's.

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I walk on the unit and all 14 trauma/neuro beds are filled, 2 call outs, a couple 1:1 patients and I'm in charge with 3 vented patients, all with pressors maxed out and these are the most stable patients on the unit! Plus, I have to carry the RRT beeper and respond. Manager not answering her phone and there is no one qualified to float to the unit. It was a long night and no, my charting was not what it should have been! And also, at that time, we were told that if a patient or family member asked if we were short staffed, we were to say no. What a crock!!!

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.

When the nurse you are getting report from starts off with "okay I am going to apologize ahead of time."

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I am happy and quite proud that my training and experience kicked in and held up in one of the most stressful situations that I have ever been in. I don't think I have EVER had to Critically think so hard in my professional life or in my life at all for that matter. Especially when my attending and fellow were inserting the cannulations and needed to concentrate on the task at hand. I took over managing the patient's oxygenation via the vent, and hemodynamics via drips, fluid, and blood administration.

I am certain that the trauma bay and ED had never seen an ICU RN calling the shots and managing the patient while an attending was performing surgery. I am not sure if I ruffled any of the ED MD's feathers since I basically took the reins from them (basically what I saw when I came in was the ED MDs telling other MDs and RNs to titrate and change things and then my attending telling them "no" but not explaining the reason since he did not have time to explain the physiology of what was happening and was getting visibly annoyed). Whether or not the ED MDs/RNs were annoyed or impressed, I have no idea, but I made all of the right calls, and none of them were contested.

My mind was so racked from all of the critical thinking that I could barely speak English at the end of the shift......and yes it is my first language :wacky: haha. I freaking love my job!!!

they may have been grateful. They likely knew that they were out of their element.

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When the nurse you are getting report from starts off with "okay I am going to apologize ahead of time."

This is the one I get the most.

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Specializes in Med-surg, telemetry, oncology.

When you walk on the floor and the charge says: so-and-so (RN) called in, and we're down two CNAs. No staffing pool tonight. You're your own CNA tonight. :no:

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Specializes in Med-surg, telemetry, oncology.
When the nurse you are getting report from starts off with "okay I am going to apologize ahead of time."

I get that a lot (and I've said it myself plenty of times), along with:

"Wait until I tell you about this guy." or

"You're not going to believe this, but..."

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You know your shift will be a hot mess when...

-Before you even woke up there was a text message sent by management begging for extra help because we're holding admissions in the ED

-You are down the street from the hospital and see EMS fly by you with lights and sirens

-The nearest trauma center's helicopter is landing on your helipad while you are looking for parking

-You walk up the the ambulance bay and you see at least 3 ambulances

-The charge nurse says there is no pre shift meeting today, go to the floor and find your assignment on the board

-Your report consists of, "I haven't even met the other 3 patients yet"

-You read the MD line up and ask yourself if its too late to call out

-By the time you get caught up on those other 3 patients, your coffee is cold

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Specializes in Stepdown telemetry, vascular nursing..

When as a novice nurse you crossed your name off from the assignment and you return to see you have been assigned to that patient, floor nurse that gets along with charge says "I think since you know the patient and all, you'll be fine. Why are you scared, just because he is a DNR?"

It did end up being my worst shift yet.

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