Friday, October 30, 2009

It Happens in Threes

This past week was a strange one at work. And also a sad one. Tuesday night started out extremely rough. My orientee & I had 4 patients. 4 patients that were total cares. I was so thankful to have an experienced nurse as an orientee. I could not imagine how stressed I would have been had those 4 patients been all mine with no help. Wow...ok, don't want to imagine that scenario anymore.

The orientee took 3 of them as her own, I took 1 & would take the future admission. We worked as a team though...both helping each patient & each other. My patient was in some extreme pain in his lower extremities. He was all swollen. I thought for sure it was going to be DVT's (blood clots) in his legs...but the ultrasound ruled that out. He was getting 4 mg of Morphine every 4 hours. It's a decent dose...with Lortab inbetween. I felt bad that I couldn't take the pain away completely. I don't think anything we had could do that short of putting him into a coma.

We made it through that shift & for some odd orientee & I went to the day charge nurse & volunteered to be floated that night....if they needed someone to do that. She looked shocked that someone was volunteering, but we assured her it would be no problem. Partly because we didn't want that group of patients back & partly because it's easier to float to somewhere new when you have a partner to go with you.

Our wish was granted...we came back the next night & we were floated to another PCU floor. Before we left my usual floor, the day nurse of one of our patients informed us that he died that afternoon. We were shocked as he had been very alert & active all night long. She said physical therapy took him for a walk, then he came back, said he was tired, laid down & never woke up. He was a DNR, but still. Although ideally that is the way I want to go. No pain, no discomfort...just sleeping when your heart decides to stop.

So we leave my floor & go to the other floor. It was a piece of cake. We only had 4 patients the entire night & they were all pleasant people. With 2 of us being there, we could attend to their every need within seconds. This really should be how nursing should be done if the hospitals/Medicare really care about patient satisfaction. I'll save that topic for another day.

We're sitting there charting when we hear "Code Blue, room such & such." Gasp...that was my patient from the night before that was having the pain in his legs. O.M.G. He's coding. Part of me is wanting to know what happened & the other part is thanking God & the stars above for floating me tonight. I'm not a new nurse, but I still panic during stressful situations such as when my patients heart stops working. I didn't want to call up there as I knew they were all busy. I also didn't want to be an onlooker either. A little while later an oncology doctor we knew came to our floor & told us he was at the code & the patient did not make it. Wow....that makes 2 of our patients from the night before gone. This has never happened in my nursing career. Even though I wasn't present when either of them passed, I still felt weird inside.

My orientee then reminds me "You know this death stuff always happens in threes." Ugh, that's's usually true. So we waited & hoped none of our patients coded. At shift change, we hear a code blue called for my usual floor...again. My orientee turned & looked at me & said "see!!!!" However, that code was cancelled within a couple of minutes, so it wasn't a true code.

We came back Thursday night & did not get to float this time. We were a little on edge, but we did have an entirely new group of patients. My 2 were wonderful....walkie talkies....didn't need much. Her 2 were so so, but not bad. My orientee then got a call from her usual floor telling her that the patient that fell on our floor last week just passed away within the last hour. She had been my orientee's patient last week the night she fell. There was our third.

I am weirded out...if that makes any sense. I don't believe the fall caused her death or speeded up her death. She was in congestive heart failure and she had an aortic valve that needed to be replaced....for the second time since it wasn't working properly. Because of her poor health (prior to this hospitalization), there wasn't a cardiologist in the area that would agree to do this procedure. She was in respiratory failure when she was admitted & it steadily got worse. I feel bad for her husband. He is such a sweet man. I'm sad for all of these patients lose someone that you love....there are no proper words to describe the grief.

I'm sure there will be a lawsuit in regards to the fall even though she was alert & oriented. We've already been advised to write down what happened & keep it somewhere safe...because it could be 2 or 3 years before anyone asks us anything. This is the part of health care that I don't like. You give your all & you can still be sued even if it's not your fault.

No comments: