And What Is Your Profession?

I have discovered a new answer to this question
Seriously some nights I feel as if all I do is pass out pain medications like it is candy.
The other night I had two pts that had pain medications due q2h. Now they couldn’t have made my life simple…no instead, they had to be on separate schedules…so yes…I was passing pain medications every HOUR. It makes it very difficult to get anything done or focus on anything…when your pts call out on the dot every hour of the night.
I understand that you are in pain…but sometimes I catch myself wondering if you are really in as much pain as you say…I know it’s horrible…especially since I learned in school that pain is… “what the PATIENT says it is”…
But really, if I have given you 4-8 mg of morphine (and of course always the 8mg) q2h and 1-2 percocet (of course 2 tablets) q4h…and on top of that…since that isn’t working…how about 2-4 mg of dilaudid prn for break through pain…it is very surprising to me…that you are STILL alert and coherent enough to keep demanding your pain meds…especially since you asked for 10mg of ambient on top of all the pain meds…I mean really!!!???? How in the world are you NOT sleeping???!!!!!
And it is especially frustrating when I am trying to control your pain, and I see that you are beginning to experience side effects that include: falling asleep in the middle of having a conversation, seeing things that aren’t there, and saying things completely out of your mind…While these may all be a little entertaining…to me they are in actuality a sign that…guess what…I may need to hold off on the pain meds, the next time around…
And while it may be hard for your family members to understand…this does not mean I that I need to be belittled, yelled at or overhear a conversation including…”She is not a very good nurse…She does not care that you are in pain…she just doesn’t care about you at all!!!”…when I hear this…it makes me want to just turn around and walk back out the door and not give you any more pain meds or help with the pain!!!!
Believe me when I say that I do in fact care…I care so much that I am only trying to protect you as the patient…and I would rather keep you alive then have you die from overdosing!!!
Yes…one of the things I spend most of my time at work doing is passing pain medications…and next time you ask me what I do for a living…I swear I’m going to tell you “I’m a LEGAL DRUG DEALER”…now if only I got paid like one ;)

Some vs All Nights

Recently I have been having second thoughts about my career choice…actually to be truthful…they go a little more like… “What in the world was I thinking???!!! Why did I ever become a nurse???!!! AGHHHH!!!!”
Some nights, I wonder why I was ever foolish enough to become a nurse… Some nights I wish I would have become a doctor so I didn’t have to deal with all the craziness…Some nights I know that I made the biggest mistake of my life…Some days I dread the afternoon, because I know it means I have to spend another night at work and be a part of the crazy.
I arrived on the floor ready to have another night of caring for my patients. I knew it would be the usual busy…I just didn’t expect it to be outrageously hectic. I was already tired as working the night shift really messes up a person’s body and sleep schedule.
As I was receiving report, I noticed that one of my pts was not doing well and had deteriorated quite a bit from the night before. The pt was on 7 liters of oxygen via nasal cannula (which is not a good thing, since 6 liters is the maximum that a nasal cannula should be set at) and only having oxygen saturation of 85-89%. As if this wasn’t bad enough, the pt was also having a rough time coughing up mucus plugs. In other words, this particular patient was not doing very well at all.
For a brief second, I had a freak out moment… “I have no idea of what to do…my pt is going to die on me and I still don’t know what to do…WHAT AM I GOING TO DO!!!???” Now when I say brief…I mean very brief…I took a deep breath and collected myself.
And I did the only thing I knew to do…
I went and found a more experienced nurse and begged for some of their very valuable insight.
After I explained the situation, the other nurse amusingly raised her eyebrows at me… “Oh gosh, I thought…here it comes…she’s totally going to make fun of me…because I should know what to do…She’s thinking I’m a complete idiot”. As I waited for the taunting to commence, she quietly advised that I call the doctors and also Rapid Response so they would have a “heads up” on the patient’s condition. “Oh yeah…what a novel idea…why didn’t I think of that in the beginning!!!!”
As I was calling the pt’s medical team, a different set of doctors showed up…they were called in to consult on the case…(sometimes I swear pts have more doctors than they know what to do with)…
They began to question me about the pt and why she was still on a nasal cannula…
“um…I guess that would be…because I just got here and that’s how she got handed to me and um…I don’t know what to do” is what was running through my head…but heaven forbid I say that out loud to a team of doctors…wouldn’t want them to get the wrong idea and have them think they are smarter than me ;)
They suggested that we change the nasal cannula to a face mask to increase the oxygen getting to the pt…I went to grab the face mask…but of course I had to find all the equipment necessary first. I finally made it back to the pt’s room, only to hear the doctors change their minds about the face mask (of course they would)…instead they wanted to try something else. A little frustrated, I only smiled and went off to follow the new orders…and of course to call Rapid Response.
Within 5-10 minutes Rapid had arrived on the floor and once again I found myself giving report on the pt. They decided the patient ABSOLUTELY had to be moved to a different floor, where more adequate monitoring could be done. However, that’s not as easy done as said…after 2 or 3 more hours…I finally was able to transfer the pt off of the unit and the night finally slowed down for the most part.
Some nights I sure don’t want to be in the hospital…and DEFINITELY would rather be at home or hanging with friends…Some nights I hate my job…Some nights I get so frustrated…but I would never trade my job for all the nights in the world.

Careful...They are Everywhere!

There is a  million dollar question that seems to hang in the air on my unit…How in the world did I end up working in a psychiatric hospital and not know it…Did I sign myself up for this?” Apparently the answer is…um…yeah…Duh!!!!
Working on a med-surge unit is just asking for a crazy busy night…however when there is a full moon that craziness and busyness takes on a whole new meaning. Believe me when I say…”It really is true that full moons make the craziest night in a hospital”. I don’t know why or what makes it happen but it is inevitable.
Tonight, I got a new admission. I was already tired because the shift had been plenty busy…but that doesn’t really make much of a difference. So I grabbed my paperwork (I thought I was going to be efficient and get my paperwork and assessment done all at once) and entered the patient’s room.
As I entered the room, I quickly saw this was going to be an extremely tough patient. She was lying in the bed screaming…”Don’t let them get me…they can’t have me…get away from me!!!” In addition there was a lot of inappropriate and explicit language being yelled in my direction. I took a deep breath and walked closer, wishing the whole time, I didn’t really have to.
The pt was in a lot of pain…with no pain medication ordered (why does that not surprise me)…I paged the doctors, but to no avail. Finally one of the doctors called back and informed me they were not going to give any pain meds because of concerns of mental issues. I so badly wanted to tell the doctor… “Fine…then you can come care for the patient all night since you will not give adequate pain control!!”…but I held my tongue and decided I would do everything I could to help the pt.
I re-entered the room hoping to get my pt profile and paperwork done…however the pt had other ideas. The pt was sitting up in bed, screaming and crazy out of the head. The pt was attempting to throw the stuff in the room and herself out of the bed onto the ground, with every movement creating more and more unbearable pain, causing the craziness to escalate even more. I knew I had to protect the pt from harm. I called for a nursing tech to come help me…and ran to keep the pt from harming itself.
As I got within arm reach of the pt, I bent over the bed to help move the pt back onto the bed…but before I could get to the pt…the pt grabbed ahold of my arm…
I have absolutely no idea where the pt was getting her insane strength from…but I seriously thought my arm was going to be broken. Just as the tech was arriving in the room…the pt had gotten my arm in between the bed frame and her body. However the tech and I were able to wrestle my arm away from the pt.
Of course for the rest of the night…I made sure to stay a safe distance away as much as I could. Finally the doctors ordered some pain meds and the pt was able to calm down enough to get some sleep and allow the rest of the night to be uneventful.
I definitely feel like I work in a psych hospital…but then again I WAS warned in school… “There are psych patients everywhere”.