When the overdose wakes up from his weekend bender and demands to sign out AMA
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@cajunnursing
When the overdose wakes up from his weekend bender and demands to sign out AMA
My intubated patient keeps banging on the side rails whenever they want something...
When the call bell goes off 65 times in an hour.
*rearrange face, step into room with a smile* "Can I help you?"
Thanks for spending 30 mintues explaining in great detail everything that's happened and what the plan is. Now, when will we be able to speak to the doctor?
When the resident says something rude to the ICU nurse and the attending puts him in his place
When we push Ketamine for RSI
When the creepy patient hits on you before you even give him any of the good meds
When the cute old man comments on "all these pretty nurses"
Dear Burned-out Nurse,
I am with you my friend. Work has been rough lately, right? Leaving it at the hospital isn’t always possible. It stays with you, keeps you up at night, as you replay “what ifs” and “I should haves.”
You’re dreading the next time you have to walk into that hospital. You’re tired of getting the sickest patients, or the ones with the angriest families. Because you’re great at your job and you’re nice, you get the difficult assignments. Part of you wishes you could quit caring and then maybe you’d have the easy patients for a change, then you could sit there on your phone, laughing with the rest of the group. But, you won’t do that, because you’d have to live knowing you didn’t do your best and that would feel worse than this.
You’re a good coworker. You are the one that helps everybody, the one other nurses get excited to see as a neighbor. Even when it’s 6 hours into your shift, you haven’t sat down, and you have hours of charting to do, when that coworker asks something of you, you say “Yes,” without hesitation. Do not change that either. It’s worth it to be the one the baby nurse goes to, just to give her a bit of confidence. It’s worth it to help that mama nurse and hear some of her wisdom.
Maybe this job has broken your heart lately, like it has mine. Today was the first time I set foot into bed eight since she died in there one week week ago. I entered the room and the flashback of her husband crying at the bedside, her laying there unresponsive, knocked the breath from my lungs. I paused, coming back to reality, before I could address the new patient in front of me. Caring hurts sometimes, but don’t give up you sense of empathy and compassion.
It’s hard to find people at home to listen, to explain the horrors you went through. Even when you don’t want to talk about it, what you saw at work is still playing in your mind. Your family doesn’t really understand, or they don’t want to hear gory details of someone else’s tragedy. They do not understand that it’s your tragedy too.
I hope you have some good days at work, sweet nurse. I hope you take care of yourself at home. I hope you’re reminded in little ways why you do this job.
Love, J-
Yesterday I overheard a nursing student snark, "yeah, this is why I'm in nursing school - so I can pass trays."
And if I hadn’t been up to my eyeballs in other things to do for my patients, I would have stopped and said: You’ve already missed the point entirely. I’m not sure why you DO think you’re here. If you hope to be a good nurse (or coworker, or person with a heart), you’re going to spend the majority of your working life doing things you SO mistakenly think are beneath you. You are going to pass trays with a smile - excitement even, when your patient finally gets to try clear liquids. You will even open the milk and butter the toast and cut the meat. You will feed full-grown adults from those trays, bite by tedious, hard-to-swallow bite. You will, at times, get your own vital signs or glucoscans, empty Foley bags and bedside commodes without thinking twice. You will reposition the same person, move the same three pillows, 27 times in one shift because they can’t get comfortable. You will not only help bathe patients, but wash and dry between the toes they can’t reach. Lotion and apply deodorant. Scratch backs. Nystatin powder skin folds. Comb hair. Carefully brush teeth and dentures. Shave an old man’s wrinkled face. Because these things make them feel more human again. You will NOT delegate every “code brown,” and you will handle them with a mix of grace and humor so as not to humiliate someone who already feels quite small. You will change ostomy appliances and redress infected and necrotic wounds and smell smells that stay with you, and you will work hard not to show how disgusted you may feel because you will remember that this person can’t walk away from what you have only to face for a few moments. You will fetch ice and tissues and an extra blanket and hunt down an applesauce when you know you don’t have time to. You will listen sincerely to your patient vent when you know you don’t have time to. You will hug a family member, hear them out, encourage them, bring them coffee the way they like it, answer what you may feel are “stupid” questions - twice even - when you don’t have time to. You won’t always eat when you’re hungry or pee when you need to because there’s usually something more important to do. You’ll be aggravated by Q2 narcotic pushes, but keenly aware that the person who requires them is far more put upon. You will navigate unbelievably messy family dramas, and you will be griped at for things you have no control over, and be talked down to, and you will remain calm and respectful (even though you’ll surely say what you really felt to your coworkers later), because you will try your best to stay mindful of the fact that while this is your everyday, it’s this patient or family’s high-stress situation, a potential tragedy in the making. Many days you won’t feel like doing any of these things, but you’ll shelve your own feelings and do them the best you can anyway. HIPAA will prevent you from telling friends, family, and Facebook what your work is really like. They’ll guess based off what ridiculousness Gray’s Anatomy and the like make of it, and you’ll just have to haha at the poop and puke jokes. But your coworkers will get it, the way this work of nursing fills and breaks, fills and breaks your heart. Fellow nurses, doctors, NPs and PAs, CNAs and PCAs, unit clerks, phlebotomists, respiratory therapists, physical and occupational therapists, speech therapists, transport, radiology, telemetry, pharmacy techs, lab, even dietary and housekeeping – it’s a team sport. And you’re not set above the rest as captain. You will see you need each other, not just to complete the obvious tasks but to laugh and cry and laugh again about these things only someone else who’s really been there can understand. You will see clearly that critical thinking about and careful delivery of medications are only part of the very necessary care you must provide. Blood gushing adrenaline-pumping code blue ribs breaking beneath your CPR hands moments are also part, but they’re not what it’s all about. The “little” stuff is rarely small. It’s heavy and you can’t carry it by yourself. So yes, little nursling, you are here to pass trays. <3
By Deborah Hoffman
When MRI is backed up and you get to pawn it off to the next shift
When a surgeon tapes down a drain and tells us it's to make it "nurse proof"
It’s my home...until it isn’t
I started my career in ICU. I’ve been there over ten years. It is my home. These people are my family. Until I realize that it’s literally destroying me one patient at a time.
Too many times to count I’ve:
held the hand of a dying patient with no family at the bedside (or no family at all)
skirted around an order by a physician who was overworked and wasn’t paying attention (or those very few who just don’t know or care)
watched my coworkers be abused by confused or just asshole patients
gotten hit, punched, kicked, elbowed, or spit on while I’m busy trying to save your life
worked my ass off my entire twelve hour shift but managed to keep my patient alive just to come back to work in the morning to an empty bed
tried until I was red in the face to explain to family that their loved one was not going to make it through this and further treatment would only prolong their pain
continued to treat a patient even though I knew it was useless because the family (and me, sometimes) wasn’t ready to stop
had to put up with whiney, not-so-critical patients while at the same time juggling my actually dying patient’s needs
been reprimanded for lack of charting when I barely had time to inhale a protein bar so that I could make it through the day
There just comes a point where it’s no longer a positive, growing environment for me. Burnout is real, people. Maybe I just need to take a step back for awhile. Do something else to gain perspective. Spend time with my four year old who still sees life as this beautiful, magical place.
But then I think about all the things I love about my job. And I do LOVE my job. The people who are genuinely grateful for everything I do (even if their outcomes aren’t good). The gifts that I’ve received that let me know just how much my job really matters. In my house right now, I have a handmade baby blanket, a plant, a cross on my mantle, a nurse angel next to it, and a nurse figurine. Not to mention all the cards and enough food to make even the most disciplined bodybuilder fat.
Those countless times that I did have to stop care and turn healing into supporting a dignified death are on my mind all the time. It’s those times that even the most difficult family member turns into the most appreciative. The time that the children were on the way but not quite at the hospital so I sat with a distraught wife with my hand on her back as she watched her husband take his last breaths. Those times I walked out to the waiting room several times to update families because it was too chaotic to let them stay at the bedside but I wanted them to know that I hadn’t forgotten about them. That time I tried to call the family back because I saw the downhill crawl coming but they just didn’t make it in time. So I sat next to the bed and held his hand. Because no one deserves to die alone. There are so many more. Enough memories to fill ten pages. Good and bad.
But for now, a sabbatical. Critical care, how I love you. You are my home. But for now, we need a vacation from each other. For my sanity. For my not quite yet hardened heart. For my child who probably gets a stressed out Momma more often than he deserves. For me. And for my patients.
When your patient has 6 kids, 3 siblings, a wife, and an ex who all hate each other
NSTEMI, Vented, 2 pressors, now GI bleeding. GI asks "Is he stable enough for a bleeding scan?"
ICU nurses...