i picked up a nightshift last night. i thought it would be ok because when i left in the morning yesterday, we had a good census (low number of patients) and some of them were scheduled to go home. And my friend C-A was the LPN on duty and i hadnt worked with her in forever and she plays games with me so we were both excited.
i forgot about the friday factor.
there always seems to be a whole whack load of admissions on fridays during the day. its extra work because pharmacy is gone so they dont have their own meds poured and we have to be the pharmacist and there arent regular Dr rounds in the morning so everything is messy and make-do.
my side of the ward wasnt full but it was full enough. and i had a patient in isolation. such an inconvenience. and things kept coming up (like the incubator for the premie with jaundice kept alarming) so it was 10pm before i had given my 8pm meds. and one of my patients wouldnt come out of the bathroom.
but we were managing.
and then.
a nurse called from home to say she heard an ambulance go screaming past her house. this is not a good sign.
and then the ER nurse called down to ask the other RN for backup because the ambulance was bringing in an MVA (motor vehical accident).
and that left me with the whole ward. i hate when this happens. especially when there are people with bad hearts.
but we were managing.
the RN came back from ER after a rather short time and i started grilling her for info. i'd never had an MVA or any sort of trauma patient come in before. why dont you go down and look? she said.
friday nights are extra paper work nights and i was far behind. but all my patients were in bed and medicated so i passed them off to C-A and went to see my first MVA!
I've come to help, i said.
Great! The RN put me to work right away. Besides the MVA, she had a lady with a possible broken leg and the doctor, Dr. Chicken Legs, was in the process of draining blood from around her knee. i was a little sad that i had missed it. I always miss the cool things, like the night before when the doctor pulled a piece of metal out of someone's eye.
but then i got to assist with the MVA and that was very educational because he had a severely dislocated elbow and Dr. C-L used this crazy contraption from the OR to freeze his arm and then he pulled it back into place!
It was a good thing it was Dr. C-L last night because things got busier and he's a pretty calm guy (unlike the Dr. on dayshift who's highstrung and admits everyone. Because of him i had a patient in with a slight fever!! Who does that?!) and he's very resourceful and he was in a teaching mood so he patiently explained to me the different layers visible in the MVA's head laceration as he sutured it up. And that was cool. And very nice of him. I didnt like when he kept asking me to get him things. It was nice that he knows my name and doesnt ignore me because i'm the newest nurse, but not nice because i dont know where anything is in the trauma room. i've never been in there before. i dont know what he means when he says he wants some 2%. you want some milk? or when he says he wants some 2% without. Without what? But my mentor says this is how you learn. and she's right. i should be grateful. he never yelled at me or lost his patience and i did experience quite a lot.
The MVA was a drunk driver. I had no sympathy for him or his injuries. Does this make me a bad nurse? The ER nurse says no. I'd like to agree. I mean, i'll still treat him to the best of my abilities but there will always be a little part of me thinking that he brought it upon himself. Maybe the loss of his finger will be a motivator to clean up.
A momma called to warn us that she was bringing in her 5 month-old with breathing problems. She's all yours, the ER nurse said. (she doesnt like babies). The baby was super sweet and she seemed to be breathing ok to me. I liked that it was my responsibility to triage her. And the next child that came in. He sliced open his finger trying to cut a mango by himself. He wasnt supposed to be using knives alone. After seeing his finger wide open, i think he'll think twice about doing things without parental supervision.
I never realized that the ER nurse didnt like the ER. She had always seemed like a very competent and capable individual to me. Mind you, she also gets rather anxious. And doesnt like babies. She wont touch them at all. Categorically refuses. And bloody things like gaping head wounds make her ill. But she doesnt like the ER. And neither do i (come on! I've only been an RN for a week and a half! Does it really seem like a good idea to stick me in my obivious green-ness out there?! Critical thinking, people!).
But we managed.
Essentially what neither of us like about the ER is that they stick you out there ALL. BY. YOUR. SELF. And this just seems like a really bad idea, no matter how skilled you are. But since i was there, that made two nurses in the ER so it ended up being ok. And she didnt baby me. She trusted me to attend to new patients as they walked in and trusted my judgment to ask for help when needed. And she's right. I can do that. I dont need her supervision for someone coming in for a pre-scheduled IV antibiotic treatment. I do those all the time on the ward independently.
i returned to the ward and my paperwork several hours later. i was tired and headachy from dehydration and low glucose. but i was excited for all the new things i had experienced and the patience of my colleagues.
it was 2am. the doctor had just gone home. C-A informed me that one of my patients wanted a sleeping pill. I am not calling a doctor at 2am for a sleeping pill. no. no. no. But the other ward RN had just called him about insulin and told me he was still awake. i gave in and paged him.
Dr: yes?
me: oh hello doctor. are you sleeping?
Dr: no
me: oh good. can we get a sleeping pill for my patient in with pneumonia? (actually, this was the patient that was admitted with a fever. Its beause Dr.A.P had been on. The "a" is for admission.)
Dr: no.
me: NO?
Dr: fine. What's he like? Is he a big man? A little man?
me: uh... well... (shoot! shoot! shoot! how do i describe someone i've seen once briefly several hours ago and i'm too tired to think of how to even spell my own name?) well, he is shorter than you, but wider than you!
RN standing behind me: ha ha ha ha ha!
Dr: tell her i heard that! ha ha ha!
it became the best joke of the night. He's shorter than you, but wider than you!
and then i did all my paperwork and C-A and i played crib. she cheated.
you know it has been a busy night when you go home and then have strange anxiety dreams that you are still at work.
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