PNS

Post Nightshift Syndrome.

That restless nauseated low tolerance high irritabilty state of being that occurs after working a nightshift and then only sleeping for 5 hours so that you can try to get back on a more traditional sleep schedule and not screw up your natural circadian rhythms too badly.

Last night was my first shift as a Real Nurse. It was also my first nightshift after an unusual stretch of nine day shifts.
My old mentor was working and decided to try to make it as interesting (read: challenging) as possible for me.
Thanks a lot.

The third nurse says it was my fault because i had declared at the begining that we were not going to have any deliveries.
I also said NO ADMISSIONS, NO BARFING, NO CODES.

At the start of the shift i was talking to Dr. T, the doctor on call for the night.
Me: Dr. T, are you stressed?
Dr.T: Yes. Are you stressed, JV?
Me: No.
Dr.T: Are you married?
Me: No.
Dr.T: Ah, well. I am married.
Me: Well Dr.T, that was your choice. You are going to have to learn to cope with the decisions you make.
Dr.T: Yes.
Me: And i shall die a Happy Spinster!
Dr.T: ha ha ha!

This is what happened.
Agatha the frustrating aggravating bell-ringing patient with dementia had been tranferred to the long-term care unit in the basement before the start of my shift. We were all relieved.
I didnt have the 5 cardiac patients i had had on sunday. Well, 2 of them were still with me but they were my sweet old ladies so its ok. I also had two extremely hard of hearing men with dementia who kept coming out into the hall and insisting that it was time to eat. (It is 4 o'clock in the morning. GO BACK TO BED.) So far not too bad. But there was still one more patient. He wasnt being Specialed. But he was still in the ICU room. We dont put people in there without really good reasons. Damn.
My mentor had a very nice woman come into the ER about to have her third child. We called in the Obstetrician On-Call who tried to convince Cranbrook to take her but they wouldnt so then we got to call in the OR staff and the back-up doctors for an emergency c-section.
The Third Nurse took care of the maternity patient and baby so while she was down in the OR and my Old Mentor was in Emerg, i was in charge of the whole ward. Great. It wasnt bad because we only had 11 patients instead of 20. But my patient in ICU was keeping me busy and i had to pee the whole time. Surgery never felt so long.

The mom and baby came out of surgery just fine and the Third Nurse took back her patients and i was left with my 2 cardiacs, my 2 patients with dementia, and a man in ICU.
I was so tired. That "its painful to be awake. its painful to not be horizontal" sort of tired. I spent the whole night praying that i wouldnt have to call a code. I would put my head down on the desk to rest and then jump up every time the cardiac monitor made the bad beeping sound. And that happened rather frequently. One of my ladies had a very low heartrate (in the 30's). My gentleman in ICU also was having a very low heartrate. And he was also having a low blood pressure. As part of the cardiac protocol, if the heartrate is below 50 (which it was) and the systolic BP is below 90 (which it was), atropine has to be given as a cardiac stimulant and a code has to be called.
Every time the bad beeping happened, i would look at the monitor to see if it was ICU man or Cardiac Lady and run into their room to see what they were doing. I was in and out of ICU all night. And every time my ICU man would open his eyes and say he felt fine and wasn't having any chest pain.
I called Dr.T at 3am (boy did he sound out of it) to tell him what was going on with ICU man. I really thought we should have been doing something. Like shipping him out someplace. The Dr wasn't that worried. My Old Mentor wasn't impressed. She made sure i charted everything the Dr said to cover my arse because she said he hadn't really been on the ball so far that night.

A short while later i put my head back down on the desk.
And jumped up when the bad beeping went off and the monitor said my ICU man was in ASYSTOLE! (flat lining).
Beat heart! Beat!
I ran into his room and stood over him.
Suddenly
He grabbed my hand, opened his eyes, and said "good morning".
Freaky.

The other problem with ICU man, besides his slow heart and low BP, was something called sinus pauses. He would have these pauses where heart beats normally would be but weren't. When the computer said that he was in asystole, it was because, technically, he had been. For 4.2 seconds. My ICU guy had a 4.2 second pause. The guy totally needs a pacemaker.
CAN WE PLEASE SHIP HIM OUT?!

In the morning, at the end of my long long shift, i went in to see how ICU man was doing. I was curious to see how he was feeling after being woken up randomly all night and having funny heart things happen.
He said he had an excellent sleep.