Friday, December 14, 2012

Worst day ever

          I hate floating.  I always drown.  And no, I'm not talking about swimming.  Or anything to do with water really.  No, I am talking about the dreaded practice of working on a different hospital unit than your own when your home unit is overstaffed.  Thankfully it didn't happen too often, but after this one particular experience, I dreaded it with every fiber of my being.
          Let us go back a few years to a time when I was a newer nurse with a year of working by myself under my belt.  In those days we were trained to work both ICU and the General Care floor, which was a nice variation, but meant we had the training to float to almost any unit in the hospital.  On this day I went to a general medicine unit which basically means your disease isn't specialized enough to go anywhere else.
           Here was a breakdown of my patients: a woman who was deaf and blind and in isolation because of a communicable disease, but she was there for a serious case of constipation.  Side note: constipation can actually kill, so drink your prune juice.  My next patient was a Spanish speaking only gentleman who had high blood pressure needing to be monitored to see if his new meds were working.  Then I had a patient who had a bad infection and needed tons of IV antibiotics, but had no IVs to give them in.  He was also a former IV drug abuser, thus his veins were in rough shape.  And last but not least was a gentleman who I was told was recovering from pneumonia and would be discharged home that day.  Now, from the superficial look of things, not a bad group, right?  So, I gather my meds for my first lady and get gowned, gloved and masked to enter her room.  I was probably in there for an hour because she communicated by writing on a dry erase board and touch.  So it took forever to get anything communicated.  And then there was a lot of commode sitting and enema giving. 
              That done, I raced to my blood pressure guy.  Again, he wasn't that sick and there wasn't a lot to do, but since my Spanish speaking skills are zero, everything took twice as long while we tried to interpret each other's miming skills.  Then I had to schedule a time with an interpreter to go over some education about high blood pressure and new meds.  Let me interject here and also say that since this was not my home unit, I did not know where anything was located, which caused everything else to take twice as long too.
              Then I find the drug abuser antibiotic guy has IV meds that have been due since two in the morning but not given because of no IVs, and the previous shift had done nothing about it.  I realize I'm not going to have time to poke this guy to death, so I call the IV team to come do it.  I give him his oral pills and do a quick assessment and he's looking good.  Then I go see my last guy.  I saw him last because he was being discharged that day, so he should be the most stable, right? 
              I enter, he's sleeping.  I turn on a light and go to gently shake him awake.  No rest and relaxation at the hospital.  He's breathing like a marathon runner who completed the race and then is lying on the asphalt gasping for air.  Not cool.  When I talk with him he says he's fine but just wants to sleep.  I listen to his lungs.  I can barely hear anything in his entire right lobe.  I take his heart rate.  It's going at a pace of 150 beatsperminute.  His blood pressure is holding, but not looking great.  I have a full blown emergency on my hands... with a lady still on the commode, antibiotics still to be given and a dude who doesn't really know why his nurse was gesturing so wildly at him.
To be continued....