Wednesday, September 2, 2009

I worked my first (and last) double on Tuesday

Oh what an interesting experience.

I'd been having a really good day on Tuesday. I was Resource (along with L, another not-so-new grad). It was pretty busy, and I had to jump in feet first to get a patient discharged. His family said that if he was not ready to go by 1600 they were not going to be able to get him and he'd have to stay another day.

After that had all gotten settled, it was a pretty smooth shift. Gave people their breaks, helped with fingersticks, did other Resource-y stuff. Nothing eventful enough that I remember it.

But near the end of shift we get word that 2 or 3 of our night shift nurses have called in sick, and they need people to stay double.

Now, I have to say that it's a running gag at this point to ask me to work a double. The Ass.Man. (teehee. thanks to J for the abbreviation) still asks anyway, with a huge grin on his face, knowing I'm going to say no. I'll be the *first* to volunteer to go home early, but I'll be damned if I work anymore than my contract says I have to.

But today I'm thinking, "Well, things are going pretty well. We have 24/26 beds filled, and 6 RNs (we have a 1:4 ratio) so we're full. I guess I'll stick around just to see what it's like."

So I shock the whole world by agreeing to stay double.

I give the boyfriend a call and let him know I won't be coming home as previously discussed, and that if he really loved me he would bring me Starbucks and a salad from Jack-in-the-Box. Not only did he come through for me, he drove miles to find a Starbucks open at midnight, and he got food for L as well. He's so sweet lol.

The first part of my second shift was cake. Potter came a little after midnight, and I took a 15 to show him around the unit and hang out a bit. We ended the tour when one of the pts became confused and his nurse was too busy to re-orient him.

He was a sweet guy who "just felt disorganized" and couldn't figure out where he was. I reminded him he was in the hospital for a bowel obstruction, and that the NG tube was to keep his stomach from filling up with gunk (technical term). He said he knew all that but just couldn't figure out where he was. So I got him up out of bed and walked him to the doorway. Pointed out the main station down one way and the big window down the other. Eventually he got it and was content to try to sleep.

After that, I asked the 3 nurses on my side (there are 2 stations on the unit) when they wanted to take their dinner breaks, offered to help out with anything they needed, and mostly just sat on my butt, slightly bored.

Heck, one of my nurses didn't even tell me when he was going on dinner, or give me his phone or anything. Very different from on PM shift.

Then we found out that ED was OMGFULL and that one of the resources (me, apparently) was going to take an admission. Ok, not a huge problem.

So at about 0330 I decide to take my dinner (mmm southwest chicken salad without the chicken) and relax before I got report. I also have an insane urge to brush my teeth, because this is about the time I go to bed normally. Thank god I keep a toothbrush in my backpack :)

At 0355 L pops her head in and says, "Did you get report yet on 54?" "No, why?"

"Because he's here"

WTF?! Seriously ED. That is *NOT* cool. You do not bring a patient up to the floor without giving report or warning. I understand it sucks being full, but blindsiding a nurse is just not fair.

And this is where the clusterfuck began.

If we had gotten report we would've known that the pt was on droplet precautions (ie, he was coughing and may have something communicable) and we would not have assigned him to one of our 4 double rooms (the rest are singles).

So at 0415 we have to start playing the bed-shuffle game. One patient got transferred to another unit, and then about 5 different patients had to get switched around to accommodate the nursing assignments, because it would suck to have a patient moved all the way across the unit halfway through your shift.

Finally get everyone settled and I try to do my admission the best I can with the few remaining hours of shift. Also trying to be helpful to the other nurses, as I only have 1 pt to their 4.

As the sun came up through the windows I started feeling really exhausted. And when the day shift nurses started streaming in I got the most surreal feeling. It was like I was on the wrong end of time. It was funny watching all the Day RNs' faces register the fact that I was there at start of shift, not end. Barely concealed surprise and shock, and quite a few laughs and "What are you *doing* here?"s

I give report to whoever was taking my patient, then try to give report to the Resource whose side I was on earlier that night.

Got out of there about 0745 and headed out. Immediately, I was confronted with something I hadn't expected to deal with: traffic.

"Oh god. I don't think I can deal with this" I felt the strangest kind of awful driving home, realizing that I had about 6 hours to get home, sleep, and get ready and leave for my normal shift at 1500.

I honestly don't remember much about my regular shift. I responded to frequent statements like "You honestly stayed double? You never stay over! What made you change your mind?" I know that my Resource saved my exhausted ass on a couple occasions. I made promises to patients that I forgot to keep. One of my patients was a retired L&D nurse, and she was very understanding about my situation. Didn't make me feel any better about it, though.

Near the end of my shift I realized that I was getting paid time-and-a-half (or double?) to be a *terrible* nurse. And as much as I'm sure my paycheck will be nice this time around, I can't do that to myself or my patients again. It's not fair to anyone.

At around that point, the Ass.Man (who is becoming cooler these days) comes around and asks people for their Starbucks orders, as he is going on a run and apparently won the lottery. I put in a request for a nonfat vanilla latte (mmm) and go about finishing up my to-do's. I felt a little bad, as I think J may have been trying to just get stuff for the people who were staying double but no questions were asked and, hell, I feel like I deserve free coffee on occasion. And man was it good. Who cares that I was drinking that much caffeine so close to midnight lol.

So I guess if I were to evaluate everything, the only situation I'd work another double is if we were *full* (26/26 beds taken) *and* I was Resource *and* I wasn't working the next day. Because I have better things to do with my life than work myself to death.

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