Tuesday, November 21, 2006

Inside a whirlwind day of a Travel RN!

Well...hard to believe, my contract in San Diego has finally finished. The last 2 days were the most crazy and hectic of my whole three + months, I think. My mom says I just had to finish with a "blaze of glory." It was a "blaze" of something, though I'm not sure it was glory! :-)

The "blaze" went something like this:

6:30am - Report from off-going nurses, narcotic counts, and organization of patient loads

7:15 am - Start assessments and then organizing my first doses of am meds for my 5 patients. Usually don't finish this process til after 9am due to emergencies and needs, but this day, I was
still giving 8 o'clock routine meds at 10am!

7:30 am - Breakfast trays arrive, help CNA's pass out trays and smiles to patients. Some don't have what they requested, so I walk/run down to the Cafe personally to get the missing items since it would be 2 hours before the Cafe brought it up if I just called. (Whew - at least I got some extra exercise!)

8:00 am - Pt 4 had dressing coming off and needed to be changed. Long ordeal.

8:15 am - Request for Pain Meds IV push for Pt 1

8:20 am - Request for Pain Med IV Push for Pt 2

8:25 am - Pt request more coffee/drink...not good at making coffee (ha ha) so I put in too much mix in the coffee maker and about kill off all the coffee drinkers.... But how am I suppose to know, since I never make coffee!!! :-)

8:30 am - Request for Pain Med Oral for Pt 3
(Whoa....slow down, can't keep up with all these request!)

9:00 am - Still haven't finished all my assessments (I know, this is rediculous, but if you'd have been there, you'd have understood!)

9:10 am - Answer questions from irate family member that just missed seeing the doctor and is unhappy with what doctor is doing. Page doctor to discuss issue, doctor gets mad because he was just there and the family member wasn't there to talk....work to placify both parties!

9:15 am - Pain Med request IV for Pt 4

9:30 am - Cleaned up large BM for Pt 1....(Hey, at least I don't have to give that one a laxative!)

9:40 am - went to change another leaky bandage and wound Vac, but no supplies in supply room. Had to take elevator to Supply Dept on lower level to get supplies.

9:50 am - Spend few minutes visiting and praying with a discouraged pt - wish I had hours to do just this, but no....they are calling for me again!

10:00 am - Answered some phone calls from anxious family members....talked to more doctors, finished assessment on Pt 5 - thankfully, they were patient, and thankfully they weren't screaming for their IV narcotics every 2 hours.

10:15 - Request again from Pt. 1 for more IV Morphine....

10:20 - go looking for normal saline syringes and needles (since I've about depleted the supply with all my Narcotic IV's) but none are to be found. Run to unit on other wing to get supplies!

10:30 - Request from Pt 2 for more IV dilaudid (yep, I'm serious! Chronic pain issues, and the doc said she could have 1mg q 2 hours! Now isn't that a knock-out?!)

10:35 - Helped CNA bathe and clean up total care pt 3

10:45 - Request from pt 1 for more pain meds. (Sorry ma'm, you've already had your dose for the next 2 hours! What else could we do to help your pain?)

10:50 - I love being a nurse....but I just can't keep up with all the request, haven't even started charting! And now I need to start thinking about 11am med doses.

11:30 - Answer call lights...other nurses are ignoring them thinking a CNA will get them, but no CNA in sight. I think they are still giving bathes. I take my blood sugars. One is off the scale, a whopping 350, I give the Insulin and notify the doctor. He gives no orders and seems iritated that I called. Pt is on steriods and tube feeding, which doesn't help.

11:45 - More Pain med request - Trays arrive....pass out trays, deal with more food issues.

12:15 - Run for a quick lunch break....(It's required, or I'd skip!) Still have done no charting. Just giving pain meds or answering call lights or emergencies.

12:40 - Back from lunch...Pt 1 screaming for Pain Meds again, and Pts 2 & 3 soon follow suite.

And so the day continued...As it turned out, I gave over 25 Narcotic medications this shift (which is an unearthly number) and cleaned up about a dozen BM's. (One pt was obviously have diarrhea!) And I didn't start charting till 6:00 pm. We give report at 6:30 pm, so I ended up staying over a good hour and a half to get all my charting up to date!

How do I remember all the wonderful details??? Well, because I'm a nurse...and God gave Nurses an excellent memory! So good in fact, that it will wake me up at 2am in the morning! "Oh no! I forgot to chart the heparin flushes I gave Pt 2 & 3...or the feeding that Pt 4 received." I sigh and roll over. "At least I know I made a difference in a couple patient's lives, even if I didn't get every detail charted. But God, I don't know if I could handle one more day..."

And God softly replies... "My grace is sufficient..." I go back to sleep!

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