Shift 46, 47, 48, and 49

Sorry, with three straight days of work in a row, and then one day off before I work one more day, I didn't have much time for blogging.  So, I saved it for after today.  

Shift 46:

Not so bad when I first got in, but started picking up pretty good.  I ended up taking 4 hallway patients within a couple of hours before shift change because the day nurses were overloaded.  Then at shift change, I went to relieve the 11am nurse for her lunch break and then I took my lunch break and went to triage.  Pretty uneventful day overall.  It did finally start to slow down and it was a pretty decent night part of my shift.  

Shift 47:

Again, not bad when I first get there, but then the flood gates opened!  I'm not even exaggerating when I say that we literally had 3 fire rescues walk in the door at the exact same time.  There was a line where they check in (I've never seen that before!!).  And then while they were lined up, there was another fire rescue calling on the radio.  We had patients waiting by the ton in the waiting room.  It was so bad we had 4 nurses on the floor yet we had to call for another nurse to come in, and she came at 4:30pm to help, and we had to call our director, who also came in to help.  It was insane.  At shift change, the nurse who came in at 4:30pm covered my patients for my lunch break and I went.  When I got back, she left, and it was somewhere around 8 or 8:30pm by that point (I didn't go right at shift change and then while on my break, I had to take a call from a doctor, so I got a few extra minutes on my break).  When I got back., things finally started to slow down.  Patients got discharged or admitted so rooms opened up, and we didn't have as many people coming in as fast as they did, so we were catching up.  By 12:30am, I no longer had patients in any of my rooms.  Other than being busy, it was really an uneventful day otherwise.

Shift 48:

Seems to be a pattern.....not so bad when I first get there.  Even our fast track area was closed.  But it started to pick up for sure.  I had 3 rooms when I first got in, and at shift change I ended up getting 1 more (we had less nurses to split the rooms at night).  At one point (after shift change) I had 8 patients!  Thank goodness we had the fast track area closed because that nurse was able to float to help.  It was steady all night.  When I left, I had just discharged 2 of my 4 patients, and 2 more came in.  The charge nurse had to take my patients because we only had 2 other nurses working that night.  It was crazy.  

I did have one pretty interesting patient-  the patient was having a severe allergic reaction to cleaner fumes that were sprayed in the bathroom.  Patient went in right after the bathroom was cleaned to take a shower and started having trouble breathing, was coughing and headed right over to the ER.  Good thing.  When he got there, he was having trouble breathing, his throat was swelling, his eyes were swelling, his eyes were watering like crazy.  His oxygen saturation was at 94% in the waiting room, and then went down to 92% in his room in the ER.  We gave him Epinephrine, Benadryl and a steroid to help decrease the swelling, and we put him on oxygen.  Within minutes, his lungs were fully moving air again and his oxygen saturation was back up to 100%.  Scary for him I am sure.

Long day (or 2 days I should say), and when I got home, my head pounded, my feet ached (they still do!) and I was exhausted.  One day off and then I have to work again (thank goodness its only for one day, then I have two off).

Shift 49:

When I got it in, it was busy, but not crazy.  It stayed steady all day.  Around shift change, it started slowing down. It really was a decent night, but we had a ton of fire rescues coming in constantly throughout the night.  Not much to really say about tonight, except I had one patient who came in from a nursing home who just had a foley catheter put in earlier yesterday and there was no urine draining from it. So, the nursing home sends him to us.  First, I tried flushing it, which means I just disconnect the tube from the bag and take a big syringe with sterile water and flush it in.  Nothing drained out.  Next I tried deflating the balloon on the foley- at the very tip of the cath, there is balloon that is inflated once the cath is fully in to keep the cath from coming out.  This is how is stays in.  So I deflated the balloon, pushed the cath in further, and then reinflated it, and voila!  The urine started to drain.  Seems like the nursing home could have saved time (and this guy's insurance money, and fire rescue resources) by troubleshooting the problem first.

Anyway, I am going to enjoy my 2 days off, especially with this surprise cool front that came through.  Its 1pm and its 72 out.  I just love it!!!