Wednesday, April 28, 2004

A day in the life

Every once in a while I get those days that make me wonder if Mercury is in retrograde, the Moon is in Klutz, and the Universe just generally has it in for me. They're the sort of days that make old nurses cynical. The sort of days that make young nurses stare hollowly at the wall in the bar. The sort of days that, in short, I had two of this week.

Given that I've only worked two days so far this week, I'm not thinking this is a good thing.

I honestly don't remember much of Monday. It was busy--no busier than usual, really--but things got complicated by the one shining thing that stands out in my mind: a patient I got at 1645 from post-op.

Now, normally, people stay down in post-op recovery for several hours at a stretch. They're brought out of the OR to the recovery room, extubated there, and stay there until they're stable. It might be two or three hours before that happens, so there's plenty of time for the recovery nurses to get things done. It's SOP for a patient to arrive to me with a unit of blood hanging and one course of antibiotics finished--at a minimum.

Instead, I got somebody who hadn't had X-rays post-op. Nobody had ordered them. She didn't have any blood running, and no antibiotics. Nobody had gotten that stuff from the bank or pharmacy. She didn't have an ice pack on the operative extremity, anti-DVT booties on, nothing.

When I called the post-op nurse to ask what, exactly, she had done with the patient for almost four hours, she told me she had settled the woman in and then gone to lunch.

(Picture Nurse Jo with her head thrown back, silhouetted against the moon, howling.)

1645-1900 is the busiest time of day. I barely have time to breathe during those two-plus hours, let alone run blood, which requires close, hands-on monitoring. Nor do I have time to call the pharmacy and harass them about antibiotics.

Let's just say I was a Jo-shaped blur for two hours and leave it at that.

Yesterday was no better. I had one patient who couldn't move much and was incontinent, one who couldn't think much and was incontinent and trying to pull out her lines, one who was continent and could think but couldn't talk and couldn't walk, one who was breathing eight times a minute when I walked in to her room (you try it; it's not good), and one who was waiting for surgery and nervous.

Oh. Did I mention that these patients were spread out all over the floor (roomwise, I mean; I didn't just line them up in the hallway, much as I would've liked to), necessitating much walking?

And did I mention that the incontinent, non-moving patient also weighed over three hundred pounds?

So my day went a bit like this: Run down hall. Get Narcan. Administer Narcan to slow breather. Slow breather comes back. Run down hall. Get five other people for lift help. Change bed for 300-lb. non-moving patient. Run down hall. Try and fail to keep confused patient from pulling out her own catheter. Run down hall. Reassure nervous patient. Lather, rinse, repeat. Lather, rinse, repeat. Lather, get the idea.

Here's a tip for all you non-nurses out there: any time you meet a person who works in a hospital in direct patient care, whether they're a patient care tech or an LPN or an RN or whatever, thank them. Don't say, "Gee, you must make a lot of money." We don't, and anyway, it's never what we're worth. Buy that person a drink if you see them staring at the wall in the bar. Offer to rub their feet.

And for God's sake, if you happen to be talking to me, don't pee on yourself.

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