Thursday, March 01, 2007


It's 3 p.m. and you haven't taken a break yet because "it's been busy." Lunch seems like a really good idea but the moment you report off to your buddy two of your patients come back from procedures and they both require frequent vital signs monitoring every 15 minutes then tapering off.

A quickie assessment tells you that they're both fine, but rules is rules, so instead of skipping off to eat for the first time since you arrived at 7 a.m. you stick around and do vitals on each and assess their groins for hematoma/bruising/whatever.

On hourly rounds you discover that a patient has been incontinent so you freshen them up and replace soiled DuoDerm dressings on their decubitus ulcers. Same for the next patient.

You see a call light on from one of the patients whose nurse has actually escaped to the lunch room and for whom you are covering. Their bed is full of shit and they've pulled out their IV so you get the CNA to help clean them and restart their IV which you cover with yards of gauze wrap hoping that they will not pull it out again soon.

While you chart these events a patient family member approaches the nurse's desk to say that their "mother has to go to the bathroom" and knowing that she's non-ambulatory your heart sinks lower than the gonads of a snake.

She's covered in loose stool from neck to toes. Yes. She is.

The CNA is busy so by yourself you cleanse the patient and put up fresh linens. But... her arm is puffy because her IV has infiltrated so you get a new one in after a bad try.

The other nurse comes back from lunch and just as you are reporting off to her the monitor technicians call to say that your patient in room 14 "isn't satting well," and you go there to find that he's wheezing and has his oxygen off. You call Respiratory Therapy to give him an albuterol treatment and his oxygen saturations climb to 92% and you're happy with that.

Your bladder is filled to bursting.

Then the monitor techs call to say that your patient in room 11 has gone into rapid atrial fibrillation, so you get a set of vitals, which are fine but a little tachy, call the doctor, and start a Cardizem drip.

All is well. Time to eat lunch.

Or dinner. Whatever.


GingerJar said...

UHUMMMMMMMMMD! And then the *powers* still automatically deduct 30 minute from your check for the mandated lunch break...and remind you that there are also 2 15 minute breaks on a 8 hr shift...since going to 12 hour shifts I have never had a 15 minute break...and a lunch break...well bringing your own lunch gurantee's that if you go empty the bladder, wash the paws and dash past the fridge you can gobble that sandwich before you out the door of the employee break room....5 minutes tops...then back to all that butt wiping..........*sigh*

anne said...

Well, then. I see what I have to look forward to! At least I have some practice from my years as a vet tech, and before that as a worker bee at my dad's prosthodontic practice. Yes, I know those things are worlds different from nursing, but at least I won't be *completely* gobsmacked come job time.

I absolutely love reading what you nurses write. Thank you for putting it out there.

Kookaloomoo said...

Ohhhh... thank you, thank you, thank you for reminding me of why I chose to leave hospital nursing and enter the (incredibly boring) world of the Day Hab. nurse. Yes, I remember now! It was the constant setting aside of my own physical needs (water! food! my own bowel/bladder!) in order to meet the physical needs of everyone else. As much as I sometimes miss the hospital, I definitely don't miss that dehydrated/hypoglycemic feeling.

Me said...

Sounds like someone's place of work has a crappy nurse to patient ratio.

Yay for the snowbird rush, eh?

shrimplate said...

I may have inadvertently suggested that the nurse -patient ratio here wasn't so good, but it's only four-to-one, even on the night shift, which as good as it gets. It's he accuities that kill us.

Some day I'll blog an entry about one of the easy days.