Remember to Breathe

There are some nights as a nurse that you just want to throw up your hands and quit.  You are pushed to the edge of your emotional cliff, and then just for the fun of it you are pushed off to see if you land on your face.  Guess what, for new orientees and new students we call this harsh training.   Unfortunately it seems all of the people that I preceptor end up getting in crises and finding trouble…what can I say…I guess I’m a good teacher. ;)

One night the new nurse I had taught had a patient that was going to have a liver biopsy done the next morning.  The doctors thought his liver might be destroyed by Hep C.  Since his liver was possibly destroyed, his risk of bleeding was increased.  The doctors had ordered 6 units of fresh frozen plasma and one unit of platelets to be started at 0400, so it would be done before his biopsy at 0800. 

The nurse called the blood bank at 0400 to request the first unit of plasma.  The blood bank lady told her she needed prior approval from the resident pathologist.  She tried to explain to her that the attending was the one who placed the order and this is common procedure for a liver biopsy but with no luck.  The nurse called the resident pathologist who said she had to speak with her attending about the matter.  The return call to the blood bank to verify that she had spoken with the resident pathologist, resulted in the blood bank technician telling her she couldn’t give her the plasma yet but she could get the platelets.  Ten minutes later the nurse called the blood bank to see if the platelets were ready and the lady told her she needed prior approval for the platelets too and that she had told her that.  But the plasma was now approved and they could release two units and then she would have to redraw his morning INR lab before the rest was released. 

The nurse went up to the blood bank to get the plasma.  She was gone for a while and when she returned, it was obvious she was very upset.  I asked her what was wrong.  She told me that the lady had totally went off on her and called her rude and unprofessional and refused to give her the plasma until after she was done yelling at her. 

After the nurse had calmed down, I spoke with the blood bank and we decided that the nurse would not go back up to the blood bank. 

When that first unit of plasma was done, another nurse went up for the second unit.  While she was up there, the blood bank technicians were discussing the other nurse and about how she didn’t have a clue of what was going on and she had messed it all up.  The nurse just received the plasma and didn’t say anything. 

When I went up and asked for the third unit, the lady sarcastically said “I’m glad you guys have it all figured out now.”  I very nicely looked past her and asked the other lady to help me. 

Unfortunately, there are always going to be moments at work that are tough and they usually happen when everything else isn’t going right, and the stress is already high.  But we just need to remember “All we really have to do is breathe and take life one moment at a time.”