“Nurse, Nurse!”

“It is 1500, I haven’t even peed today and I am so thirsty. Yes! I have an expired granola bar in my backpack, I will hide in the med room and devour it quick. Should I chug a red bull?“

EntrepRNooer

Shift Start: 0700

Report from night shift 0715

Report taken from night shift: Nurse, nurse! The patient in room 45H (hallway bed) is vomiting blood and is not making sense, are they confused? Room 48 is asking for a warm blanket, 56H (hallway bed) wants to eat and says they have been having chest pain for 30 minutes, and room 59’s ventilator is alarming and IV pump is beeping.

Okay, we can do this. Let’s ask the tech to do an EKG for 56H, oh wait we don’t have a tech, okay let’s at least just throw them on the monitor really quickly. Finally find portable monitor, battery is dead and there is no power cord. Okay forget it, they look fine right now, I will come back, I mean they came in for abdominal pain, probably just heartburn. They are 30 years old, they will be fine for now.

Nurse, nurse! 45H is still vomiting blood and 48 is yelling for a warm blanket, 56H is yelling because you did not bring them a sandwich, oh and the family is coming out of 59 worried about all the beeping.

Okay, let’s go check on 59, they’re obviously our sickest patient. Sedation drip is running dry and patient is breathing over the ventilator. Okay I will just hang some more Propofol, blood pressure is too low, let’s ask the MD if they want to add a pressor *pages ICU MD, pending response*. Okay now I will page Respiratory Therapy (RT), oh no RT is covering the inpatient units too, they will be down in 30 minutes. Great, should be fine. Oh no. Patient only has 2 IV’s, one looks like it is leaking. Let me just put another two in really quickly, hopefully the ICU MD will insert a central line. Okay, the patient is fine for now, family reassured that RT and MD paged, patient should get an ICU bed soon.

Nurse, nurse! “Hello, we are here with The Joint Commission, can we speak with you a minute?” Uhh I am a little busy at the moment. “Oh, that is okay it will only take a minute. Can you tell us how long Glucometer strips are good for? Also, where we would find the Safety Data Sheets for the department? Oh and are you scanning patient’s medications and labs at the bedside?” All questions answered to the best of my ability, okay now where were we? Oh, right, 45H has been vomiting blood. So glad I could answer nonsense questions for 15 minutes.

Okay, let’s go see 45H. Shit, the ICU doc is on the phone for 59. Hey doc, I think this patient needs some pressors for blood pressure support, their MAP is 63, and if you could they should probably have a central line put in due to poor access and all the meds they have ordered. Sure, okay nurse. We will get to it when we can, just start some Levophed. Okay, let’s just hang the Levophed really quickly then go see 45H. Oh shit, we never got an EKG for 56H. Student, could you go start the EKG and I will help you once I leave 59. You have never done an EKG? Okay, no worries just stay with me then we will do the EKG then go see 56H.

Nurse, nurse! 48 just ripped out their IV and they are yelling. Okay let’s stop by 48. “YOU FUCKING FAGGOT! YOU ARE A TERRIBLE NURSE, YOU DON’T CARE ABOUT YOUR PATIENTS!” Okay sir, I apologize for not coming sooner, I have been tied up in really sick patient’s room, also your language is not appropriate and I would appreciate if you stop yelling. “FUCK YOU!” Patient proceeds to walk toward exit, spits at the nurse on the way out, all while dripping blood down the hall from the IV self removed. Well okay at least that is one less patient. 59 still needs the Levophed, their BP is dropping, we really need to do the EKG for 56H and stop by 45H who has been vomiting blood since we got here.

Nurse, nurse! There is an ambulance coming to 40H, the EMS crew is there waiting to give you report. Okay great, 90 year old nana who fell at nursing facility and hit her head, takes blood thinners daily, seems confused but unsure if that is her baseline. Get her settled, quick set of vital signs and neuro exam, then come back to get her and IV and to CT scan, hopefully she does not have a brain bleed. Alright, let’s run to 59 now. Levophed hung, RT stopped by, great, still no central line, but it is fine for now.

Nurse, nurse! 56H said their chest pain is getting much worse and now they are feeling sweaty. Okay lets go see them, we will just walk by 45H on the way to make sure they are okay. Yikes, they vomited all over the bed, they need to be cleaned up, but at least they stopped vomiting. We will come back and clean them after we do the EKG for 56H. Oh, this EKG does not look good, go give this to the doc now, I am going to get another IV in them and get them changed into a gown. So sorry you are in the hallway, I will do my best to keep you covered but I need you to change into this gown.

Nurse, nurse! Code STEMI (urgent heart attack), 56 Hallway! Get them to Cath Lab stat. Okay, grab the travel monitor, make sure report is called to the cath lab RN, let’s go. Wow I am thirsty, oh right no water at the nurses station, I will have to grab some later. Okay, great, patient to cath lab, hope they are okay they are so young, but one less patient for now.

Nurse, nurse! The family for 45H is here. They are upset that their family is covered in vomit. Hi, I am so sorry. We have been very short staffed and busy this morning, we will be in to clean them and make them comfortable. “Do you even care about your patients? This is so ridiculous, it looks like a murder scene in here. I would like to speak to your supervisor. Why are they not getting a bed upstairs? Are you new here? Would you treat your family this way?”

Nurse, nurse! Your patient in 40H has a head bleed, we need you to monitor their neuro status every hour to monitor for any changes, we will follow up with another CT scan in 4 hours to make sure it is not worsening before we admit them. She is trying to climb out of the bed and appears very confused. We don’t have any staff to sit with her, so just leave her in the hallway so we can all see her. Mhm okay, great. Hopefully nana doesn’t fall again. Oh my gosh my dog walker text me, they can’t get into my apartment. Shit. My dogs will be alone for 14 hours without a potty break. Terrible dog dad. Okay anyway, student go to lunch and take your time. I need to sit down and chart, I haven’t documented a single thing yet today. It is 1500, I haven’t even peed today and I am so thirsty. Yes! I have an expired granola bar in my backpack, I will hide in the med room and devour it quick. Should I chug a red bull?

Nurse, nurse! Your patient in 59 got a bed in the ICU. What is taking you so long to get them upstairs? Okay, grab a travel monitor. Call RT. Request a transporter. Make sure we won’t run out of sedation or pressors on the way up. Transporter won’t be able to come for 45 minutes? Okay I will just drive the stretcher and push the IV pole myself, RT can handle the ventilator. RT thinks they know how to get from ER to floor 12D. I think we have to go down the elevator, through the tunnels, five rights then three lefts, then take the Y Elevators to floor 7, get off there and transfer to the elevators down the hall, up to floor 12. Great, let’s go. Hey other nurse, please watch nana in 40H. She doesn’t look well, docs don’t want to do any intervention right now, she has a head bleed, I will be right back, I am taking my ICU patient to 12D. My other patients should be fine.

Nurse, nurse! Finally, you are back from the ICU. Quick, clean 59 we have a Code coming in, EMS intubated in the field, CPR in progress. Oh, don’t forget! You have 5 modules due by tomorrow or you have to come off the schedule. By the way, can you pick up extra hours tomorrow? We are so short staffed, I don’t know how we are going to operate. Oh and your student isn’t coming back, they went home sick. Finally, it is 1855. Shift is almost over. I will give report, help start the code and be out by 1930. Shit, my relief is going to be 30 minutes late. Oh my gosh, I had no water today. Good thing I had that granola bar to hold me over for 12 hours. Hope my dogs are okay. Shit I have to stay after to finish my modules so I don’t get taken off the schedule. Should I pick up overtime tomorrow? I could use the money, I have vacation coming up. Ya, today wasn’t so bad. Could always be worse, right? Just gotta finish those modules.

-Colton Lord, EntrepRNooer