Saturday, October 20, 2012

Wednesday, October 17, 2012

Maybe I should have been a plumber.....

I'm all for chipping in, going above and beyond for the team, and working hard, but this was a little too much.  I arrived to work before 7 and eyed the patient board. We already had a full load of patients. Not a very good start to the day. My hospital recently decided, in all of its wisdom, that a normal load of nurses is not needed between the hours of 0700 and 1100. So, they have cut us back to a charge, triage and 2 other nurses to handle the entire department. Brilliant!

As I was getting my report from the night nurse, it didn't seem too bad. I had a new patient in one room - stable and pretty simple with regard to chief complaint. My trauma room had a post moderate sedation who should be discharged within an hour, maybe hour and a half. As I was getting the report, I heard the fire dispatcher on the radio send an ambulance to an unresponsive person. I start checking on my patients and doing the normal morning equipment checks.

10 minutes later, an ambulance comes in and fills my other room. After triaging this person, my charge comes to me and states that she will be using the other unassigned room for a code (the unresponsive person call).
Now, since we don't have enough nurses to cover the ER and run a code and watch my post sedation - we're in a pickle and have to get the trauma coordinator to leave her office and help.

Code comes in and its pretty much a done deal. As I was working that code, the triage nurse fills up all of my other rooms with not so stable patients. Next I discover that my charge has now assigned me the code. Although the patient is pretty much stable (dead), I still have to deal with paperwork, family, notifications, etc. Now I have 5 patients with all immediate needs. I wish I could have been there for the family members, but I couldn't. I had to delegate that to the pastor and administrators arrived to help. The post sedation patient was flippin' mad about not being able to go home yet, but the more she yelled - she had an airway and was coherent enough to understand her situation - she's stable. The other patient, threw some pillows at her and told her to elevate her limb and chucked the cast cutter in his room. Eyeballed the other patient and she looked like her bleeding was controlled a bit - not going to die in the next hour. Then I went to my new patient and started working on her - she could go down hill quicker than the other ones.

I'm whining, I know, but it's all a bit much when you can't actually do the job as well as you would like to do. In nursing school, they fill your head with all kinds of crap about therapeutic communication and nursing theories when in reality, you will never get to implement them because of all you have to do. You're set up to fail.

No one died, thank God (well, except the code, but that person was already dead). It's just there are many more days now that it just.....well, sucks.

Wednesday, October 3, 2012

100 and Counting...

I walked into my new patient's room while looking at her chart and prepared for the worst. She was a 100 year old lady with a chief complaint that I knew would warrant a hospital admission.
I was shocked when I walked into the room. The patient appeared to be in her late 60's. I looked down at her chart again to verify the age I thought I had read.

"Yes, I'm 100 years old dear. I don't think the people I spoke with earlier believed me."

Her daughter was bedside and I thought she was older than the patient. I started talking to the patient and began my assessment.
"When did you last eat?"
"I only had 2 cups of coffee this morning. I like my morning coffee."
"Me too, but I haven't had it yet."
"Oh sweetie, you really should get your coffee in the morning, it really perks me right up."

"What medications do you take?" I waited for pages of meds to list.
"Only 3....."  Really? Wow. I've had patients who were my age taking pages and pages of medications.

"When was the last time you were in the hospital?"
"Oh, not too long the late 1970s"
   "No Mom, it was in the 1980....I think 1988."
"Oh yes, that's right 1988. I can't believe I'm back here again."

My LOL (little old lady) was spunky, sharp as a tack and had a keen sense of humor that I took full advantage of.

As I was starting her IV, I asked her, "So, Mrs Soandso, would you tell me your secret to looking so young and being a vibrant 100 year old."
"Umm, I don't know."
"That's okay, don't tell me your secret then. You're keeping it to yourself. I see how you are."
She laughed and gently slapped my arm.

Then she asked, "Do you think the doctor is going to keep me here very long?"
"Well, I believe so. Your doctor wants you to be admitted to the hospital."
"Hmmm, what if I just jumped up and ran out of here?"
"If you're going to jump up and run out of here with all of these wires attached to you then let me know first. I want to get my cup of coffee and sit here and watch you do it."
"You want me to be your entertainment this morning? I'll oblige."
"Mrs. Soandso, you're already entertaining me!"

What a sweet, spunky lady. I have no doubt she'll live a lot longer than 100 years. It's so refreshing to have a patient like this. You have no idea.....