Tuesday, April 28, 2009

The Magic Words

I'm back....wondering why I'm posting a new post so soon? Because I got sent home early from work tonight...due to the census dropping. Swine flu? What swine flu? Nah, it seems our ER was quite packed with people thinking/overreacting about any symptoms they might have, but not many were being admitted tonight for anything.

The night before wasn't that great...I was a patient care tech. Why am I always patient care tech when our floor is full? Never when there's only 8 or 9 patients...noooo, always when there is 15 or 18 patients. And of course there is always one that is incontinent & can barely move that is drinking Golytely...always! I don't think I've changed so many diaper/briefs in my life like I did Sunday night. It's not fun...trust me!

Monday night I got to work & the day nurse immediately says to me...the magic words...."you have two discharges." Which I immediately reply "Nooooo, YOU have two discharges." She should know me by now....I don't put up with slacker nurses that try to push their afternoon discharges off on me at shift change. She tried to tell me that the order was justttttt written. Ok, show me. Ummmm 4:25 in the afternoon is not the same as 7 pm. It's your discharge.

The other one didn't have a time when the discharge order was written, but I know it wasn't 7 pm. Luckily we had a discharge nurse on duty.....of which the day nurse tries to tell me she's tried calling her but can't reach her. Huh? I thought you just got these discharge orders at 7, how could you have already attempted numerous times to reach the discharge nurse?? Uh huh...it's a lot easier to tell the truth than to have to keep lying to cover up the lies...right? I wanted to say that, but I didn't. So I pick up the phone & wow...guess who answers on the first ring...the discharge nurse. So I tell her there are 2 patients to be discharged & she tells me she'll be there as soon as possible. Cool.

Then I find out my second discharge is actually going to a skilled nursing facility. So I ask...has case management arranged this? The reply: "I called case management but they aren't calling me back." Are you kidding me? Case management is probably the easiest group of people to get in touch with because they want to discharge people as quickly as possible. So again, I pick up the phone & amazingly get case management....who arranges the SNF placement so quickly...that I tell the day nurse she may as well just call report over to the SNF herself.

I sound bossy, but I'm really not. I actually make my requests sound more like great suggestions than orders. Usually it works.....the one patient was discharged before we were even done with report. See how nice that works....within 30 minutes of me getting there...the patient was being wheeled out the door. This is the reason day shift stalls....because if they get rid of a patient...they worry they'll get another one right away. I can't blame them for stalling....but if it's 6 pm...you're not going to get another patient...so discharge then instead of piling it onto the night shifts work. That's not asking much, is it?

I had another patient that came in with some unknown strange disease. A small portion of me wonders if it could be the swine flu......fever, dehydration, purpura. They were working him up for Rocky Mountain Spotted Fever, Syphillis and Pneumococcal Meningitis. They had him in a semi-private room with no precautions....even though he had a rash & was itching everywhere. I didn't want to go near him or touch him or even breathe the same air as him. As luck had it...a private room opened up on the other end of the unit, so I quickly transferred him over there. Ugh, now I'm feeling itchy. Just kidding...I think....yeah.

So that left me with one patient. Add in the other 5 or 6 discharges we had at shift change (grrrrr) & one of us had to go home. No one volunteered because we're all scheduled to work again Tuesday night. So the clinical leader looked at the list & said I was next to be called off. Oh well...that's the way it goes sometimes. I ended up going to Wal-Mart for food & then the gas station. Exciting, right? Try to keep up with me.

And now it's 4:38 in the morning & I'm still wide awake. Guess I'll go watch tv & try to fall asleep. Only one more night of work to go for this week...yay! Movie with a guy friend Wednesday night, hanging out with my best friend Thursday night (hi Maria) & then Friday is Shay's birthday.....my puppy dog will be 2 years old already!

Ok, off to go watch Dancing with the Stars...bye everyone!


Julie said...

Why do bowel preps always come in 3's. And why do they always prep people who are incontinent in the first place.

We just went self staffed so I imagine we will be getting sent home in the middle of the night also. Sigh.

newnurseinthehood said...

You should probably hold a seminar on how to tactfully tell someone "hell no". I haven't quite mastered that one yet. I generally feel sorry for day shift, but that is just freaking ridiculous when you can call someone to do part of your job for you and you still don't. Goodness.