Thursday, July 7, 2005

I just have to laugh!

What a night it was last night.  I got to work early (as I usually do) in hopes of getting a quick report about my patients that I had the night before.  Things never seem to go as planned though.  It is so frustrating getting a not so great report from a (let's face it)...not so great nurse.  It throws everything off. 

Anyways, I am in the middle of report regarding a new admit from earlier in the day.  The day nurse is telling me about how this patient's brother is a lawyer & also power of attorney & he is already threatening to sue if things don't go right.  I don't like those kind of family members!  During report, the cardiologist shows up to make rounds & he goes in to see this patient.  While he's assessing this patient, the patient starts to vomit in a bath basin.  Next all we hear is yelling.  I don't know if it's the patient yelling at the doctor or what.  Turns out the patient was demanding that the doctor clean out the bath basin & the doctor was yelling at him saying "I don't do that, I don't touch that stuff."  Then he comes out of the room, calls the admitting doctor to inform him that he will not take this patient.  I just have to laugh at his reaction to a little bit of vomit & the patient's request for this highly-paid cardiologist to clean up his mess.  I go in there to see what's going on, the patient in the other bed (mine also) is already dressed & pretty much fleeing from the room as fast as he can.  I said "Where are you going?"  He replied "Home."  I said "Wait, I have to get the approval from your admitting doctor."  The cardiologist had already cleared him for discharge, but I still had to get an order from the primary doctor.  He said "I cannot be in a room with that guy any longer!!!!!!"  I totally understood.  If you ask me, ALL hospital rooms should be private rooms.  So I let this patient wait in the waiting room while I worked quickly on getting him discharged.

Meanwhile, the admitting doctor of the first patient calls in an order to the day nurse to consult with the patient's original cardiologist knowing full well that this cardiologist not only "doesn't" come to our hospital, he has no priviledges here - so even if he wanted to, he can't do anything.  I call back to inform him of this - fully expecting orders to consult another cardiologist, but instead I get an order to send the patient to ICU.  Ummm, ok!  I don't mind one bit - between his nausea & vomiting and a threatening brother/lawyer, I'll be happy to move this patient elsewhere. 

So I prioritized - get my discharge wrapped up so he can  go home.  (I hadn't received the ICU order until after this patient had been discharged.)  So next on the list was getting this patient off of PCU & into ICU.  He was continuing to vomit, even after giving him Phenergan.  His heart rate was jumping up from 95 to the high 130's.  I delivered him safely to ICU.  The nurse was not happy about getting this patient, but sorry - I'm just following doctor's orders. 

I get back to my floor at about 10 pm & I am told to call ER - that I have a new admit.  I take report & they have him delivered to the room about 5 minutes later - nothing like giving me a little bit of time to get situated.  Luckily he was an easy to care for patient.  I'm not even sure why he was admitted.  He came into the ER complaining of chest pain & rated it as a "1" on a scale of 1-10 with 10 being the worst pain you've ever felt.  By the time he got a bed in the ER, his pain was gone.  All of his labs were normal, tests were all normal, no further chest pain, vital signs stable.  Yet they admit him.  Like I said, he was easy to care for.  After I assessed him, he went right to sleep & slept through the night without any further complaints.

Luckily my other 3 patients were all doing pretty well while I was running all around.  I had one patient who came in with what they thought was bacterial meningitis.  I remember the night he was admitted back in June & wondering if he was going to survive. Turns out he had viral encephalitis.  I read multiple times that he was aphasic, but he was able to follow commands.  He definitely isn't a man of many words, plus he speaks primarly spanish - but last night he says to me out of the blue "You are a very nice nurse."  I was shocked that he said a full sentence.  So perhaps he is able to talk but only talks when he feels like it.  Who knows?  It's nice to be appreciated.

I somehow managed to only have 4 patients.  Everyone else had 5.  They were pushing to give me an admit, but the only beds open were in semi-private rooms & the patient they were trying to give me had a WBC of 2.1 due to chemotherapy.  He definitely should not be sharing a room.  Luckily my clinical leader was on top of it & delayed the admission until we could get a private room - therefore bypassing me for a new admit.  Gina says to her "Do you pity Jennifer?  Is that why she only had 4 patients?"  My clinical leader replied "No, she worked her butt off tonight, she deserved a break & that's why I kept her at 4."  Yep, yep - worked my butt off & still had all of my paperwork done over an hour before the change of shift.  I must say I handled it all pretty well.(So much for my med-surg nursing instructor emphasizing while I was in school that I needed to work on time management!!!!!!!!)  It just makes me laugh to think about how crazy the night began & how smoothly it ended. 

Ok, time for me to get some sleep.  One more night of work - then two days off - then three days on.  Sweet dreams!

No comments: