Unpredactibility is the Name of the Game

One aspect of nursing I will never get used to is the unpredictability of the profession.  It’s normal to receive report and to make a plan of how your evening is going to go…including which patients you are going to see first, what order you are going to do your tasks in, and what time you are going to do what.  But the one sure thing about nursing is that as soon as you make a plan…your night is destined to do anything but abide by that plan.  Hahaha
Another thing is the unpredictability of the patients.  You may think you know how a patient is going to react or respond during the shift…but in reality they are just as much of an enigma as ever. 
One night I had a patient who had an EMV of 8 or 9 (this pretty much means he was non-responsive and lethargic) .  Until about 1 or 2 in the morning, he was sleeping and non-responsive to what we were doing around him.
The tech and I went in to clean him up and to change his dressing.  In order to clean him and his bed completely, we had to roll him onto his side.  As we rolled him, he became more alert and began shouting, “NO!!!! NO!!! Put me back down!!!!  Leave me Alone!!!”   The whole time he was fighting to roll back over…
I finished with his dressing and changing his sheets.  We placed him back in his original position, and he began to fidget all over the place and began mumbling.  Then he managed to sit up and get halfway out of the bed…It took three of us to keep him in the bed.  When he was safely back in the bed,  I went to get him some pain meds, because I thought he may be in pain.  As I was checking the MAR to figure out when his meds were due…I heard the techs yell out “Alicia we need you in here now!!!!”.  I grabbed the pain medicine and went to the room…as I entered the room, I noticed blood everywhere.  Then I noticed the IV had been pulled out.  We had to change the sheets and clean the patient up again.  The patient continued to fight and managed to get in a couple of punches toward me and the tech…he also managed to get my arm within his grasp…I thought for sure he was going to snap it in half…I have no idea where he got all his energy from.  I managed to get my arm free and once he was clean, I gave him his pain medications, which made him sleepy and he was back to sleeping like a dead person for the rest of the shift.
The next night when I came in, an order had been placed for restraints because he had managed to pull his dialysis port out. 
It just goes to show that you can never know how your patients are going to act or what they are going to do…you have to be prepared for anything.