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

blondy2061h, MSN, RN · Sep 4, 2016

The census is low and there are at least 8 surgeries scheduled and you aren't staffed appropriately

Worse yet- start day full, 8 scheduled surgeries, but 8 discharges too. Happy marry go beds!

blondy2061h, MSN, RN · Sep 4, 2016

Your manager calls you at home on her personal cell phone, hoping that you won't recognize the number to plead that you come in.

Oldest trick in the book! I trust no numbers.

MYSTICOOKIEBEAR · Sep 4, 2016

Think I peed reading this....

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!!!

blondy2061h, MSN, RN · Sep 4, 2016

You know your thread is gonna be a hot mess when Hannah starts posting in it.

Cricket183, BSN, RN · Sep 4, 2016

When you walk in to your inpatient oncology unit (normal patient ratio 1:4-5 depending on acuity) and find out one of your patients is a 1:1 and you are not an ICU. Patient was young, beautiful inside & out and had a rare form of leukemia. Family (mom a RN, dad part of hospital admin) has requested you as the primary nurse. (Ended up working 8 days straight until the patient was no longer 1:1.) Great family but very scary situation.

futuresctRN · Sep 4, 2016

When the charge nurse literally comes up to you and says "It's a sh*t show, sorry."

NursesRmofun, ASN, RN · Sep 4, 2016

The census is low and there are at least 8 surgeries scheduled and you aren't staffed appropriately
When you do bedside rounds and 3 out of 5 patients are confused/fall risks with no family
When "person who shall not be named" is the charge nurse for your shift
When "other person" is the CNA assigned to your patients
When you get report on a patient who doesn't look great and they say "They've been like that all day".....those tend to go bad
When you start getting report and get called overhead because the assignment needs to be re-done..somebody put "Shannon" on the schedule but she's on vacation

These made me laugh a little....so true

NursesRmofun, ASN, RN · Sep 4, 2016

The nurse you are relieving is furiously trying to "finish" some things.

There were several admits at change of shift with lots of stuff undone as of report time.

Patient has H&H teetering on transfusion time and you just got there and have 5 more patients that are also no cake walk.

You just got a patient and they are already close to critical and you are not in ICU and have other patients that are also not doing great.

The nurse before you is hurrying report like she needs to leave now "for some reason"....like she knows something is about to happen.

FurBabyMom, MSN, RN · Sep 4, 2016

1. You realize you're on call - and look to see which of the residents/attendings you are on call with. Welcome to the "black cloud" club. AKA you're getting called in at some point in time this call shift.

2. You walk in, haven't changed or clocked in and they're already talking about bumping the first case in rooms to accommodate an emergency coming from ICU.

3. You walk into two emergencies on the same service line, of the same etiology, at the same time.

4. The other trauma centers / tertiary referral centers in your region are on diversion. YAY. Not. Buckle up, welcome to a rough day.

5. The trauma pager goes off with "Mass casualty standby: plane crash, casualties unknown, ETA unknown". So, um, about that, which airport is it at (or was the flight intended for) and what size plane? 'Cause a 2-6 seater or crop duster is a different story than, say, a 747?

Nature_walker, ASN, BSN, RN · Sep 4, 2016

When you walk and see 6 public safety officers in the nursing station and they start apologizing for you upcoming shift....

Editorial Team / Admin · Sep 4, 2016

1. You realize you're on call - and look to see which of the residents/attendings you are on call with. Welcome to the "black cloud" club. AKA you're getting called in at some point in time this call shift.

Not necessarily. I mean, you have to be able to leave first for them to call you in...

2. You walk in, haven't changed or clocked in and they're already talking about bumping the first case in rooms to accommodate an emergency coming from ICU.

Or they see you and tell you to go somewhere and do something because you came in a few minutes early and the call team (who got called to come in at what would actually be the normal start time) isn't there yet. Bedside ICU chest cracking, anyone?

3. You walk into two emergencies on the same service line, of the same etiology, at the same time.

Do we work at the same place? I'm having some flashbacks here.

4. The other trauma centers / tertiary referral centers in your region are on diversion. YAY. Not. Buckle up, welcome to a rough day.

At least you have other centers in your region. We don't, and the one time we had to divert all ER and possible OR patients elsewhere, they either overwhelmed the rinky dink hospitals or had to be lifeflighted several hours away.

5. The trauma pager goes off with "Mass casualty standby: plane crash, casualties unknown, ETA unknown". So, um, about that, which airport is it at (or was the flight intended for) and what size plane? 'Cause a 2-6 seater or crop duster is a different story than, say, a 747?

Wait, you mean we actually need more resources if it's a 747? C'mon, now, a plane crash is a plane crash. Not.

EllaBella1, BSN · Sep 4, 2016

When you walk in and the nurse you gave report to 12 hours earlier/are getting report back from looks at you and says "Oh my god I am so happy to see you."