Why have your guys' breaks been interrupted? Tonight mine got interrupted because my patient had a green bm and the nurse that was covering me freaked out and wanted me to clean it
Honestly for the most part I like my unit, but the last two shifts I had were back to back awful. First night I had a patient come up from the ED around midnight and start seizing almost as soon as he got to the floor, had to call rapid/provider. Had about an hour of him just seizing, coming out of it for about a minute, then starting another seizure, they had to intubate and take him to the ICU, the previous nurse had not done any of his CIWA scales so providers were also pissed about that. Then went to check on my other patients and one of my others was desatting in the 70s, had to throw oxygen on and sit her all the way up to get her to 80s before provider and respiratory arrived and we got her back in 90s. I pushed for her to go to ICU as well since this was new but they said it was managed so she could stay on our floor.
I come into work the next night and before I even got report on one of my patients the PCA came to tell me he was desatting in the 70s, called provider to floor, got oxygen on him, day nurse was arguing with me that he was fine since he wasn't in pain and "he's probably just developing a little COPD, he just runs low." Patient was still same level of mentation as when he came in, no distress, provider said have respiratory do a breathing treatment. Called respiratory, once I got his O2 sat in the 90s with the oxygen went to check on my other people, one whom was the desatting patient from the night before. Unresponsive except to sternal rub. Called rapid on her, providers argue with me that "that might just be her baseline now" but I was able to say she was able to tell me her name last night and the night before she was yelling at anyone around according to the nurse who had her then. Plus new facial droop and sluggish pupils. Rapid nurses took her to CT then ICU. Provider for a 3rd patient with scabies calls me every 20 minutes to ask how his pain is. I just gave tylenol, I'll reassess when it's had time to kick in. I go to start an antibiotic on him, both his IVs went bad, have to start a new one. One of the other nurses passed a med to my 4th patient so I could catch up a little, and 5th patient needed a new sitter sheet and personal sitter alarm because they're in for homicidal and suicidal command hallucinations and they have to have suction tubing in the room still because they had a seizure earlier in the day. Keep bouncing around, call respiratory for update on first guy, "Well HONEY, I wouldn't do a breathing treatment on a patient with crackles, he just needs to cough. I told him to cough. You should know crackles aren't an indication for a breathing treatment." I go check on him, he is satting better and coughing on command, productive cough, update provider. New admission bringing me back to 5 patients, go check on desat guy and now he's combative. Had to call provider for mentation change and by the time she got there a couple minutes later he was lethargic but having visibly increased work of breathing. Draw vbg, call rapid, rapid nurses comment "oh we keep seeing you!" Provider says "never listen to respiratory for anything but bipap/cpap settings." We suction the patient, thick plugs, they think he has aspiration pneumonia. He also started a nose bleed from the nasal suctioning but starts breathing better. We put in an dhoff tube, provider puts in order for xray to confirm placement, they decide he's stable for the floor for now. I go check on my people, it's like 5: 30am, find out the PCAs I delegated blood draws to (within our policy) did not do them and didn't ask anyone else to help. I draw blood on 3 patients, provider trickles orders for the new admit so I had to draw like 3 times from her. Come out of her room, PCA for dhoff guy tells me she thinks he might've pulled it. I go in, it's sitting in his lap. I go to message provider, portable xray is there to get the placement xray. Had to message provider still, she had me pass along to ICU provider that had come up to see if he was sick enough for their floor that he pulled the dhoff. Had to give report on them all, then had to stay about half an hour late to write my notes.
The first night I felt like things were better because we had our charge nurse that's been working for like 20 years on this unit, the next night it was a nurse that's been here about 2 years and had 4 patients as charge so she couldn't even help out much. I feel like quitting but I work tomorrow night too unless I call in, I just want to not have people who are all one emergency/urgency after another for my entire shift
IDK, probably will delete tomorrow but it was just a horrible couple of nights and I'm dreading going back