Monday, January 21, 2008

what's the point?

i had another long, annoying, frustrating weekend at work.

we get five patients and 4 of my 5 had issues going on.

patient one refuses to do anything for themselves, i mean won't hold a cup of water, reposistion themselves in bed, sit up, stand up, nothing. even though they walk at home. and when pushed by the doc, was able to stand ( with assistance) and sit in a chair.

two came in with nausea vomiting and abd pain, but it had cleared up on it's own, and the pt was pretty much fine but being monitered. very bored, walking the halls.

three has been in the hospital a long time, is quite elderly, and does not look anywhere near their age. but keeps having complications.

four is withdrawing from alcohol, hard.

five is odered for insane doses of pain medication every two hours, i'd be giving too much away to say why, lets just they have a tolerance noone should have, and it would be enough to kill most people, so anyway - due every two hours but calling every hour and half, and then every five minutes until i get there.

on saturday patient three who has been on our floor for a while is not acting like themselves and will not wake up, call to md, every kind of lab work and culture you can think of, then wait for results. deal with nervous family, several calls to doctor.

patient one is complaining of pain no matter where you touch them, and refusing to do anything at all. deal with family who is waiting on them hand and foot, but none of them speak english.

patient four is needing medication every hour to control their symptoms (which are getting worse) every hour. deal with family who doesn't believe they are withdrawing.

patient five is calling non-stop, i get about two people done for my morning med pass, three to go, and they are already calling me back for more pain medicine. the whole day goes on like this, by the end of the day i don't even like my patients anymore, and i am all set with giving five medicine, but the doc has been in and increased his dose!!!

i come in sunday to a worse situation then i left. patient four really got into the dt's last night, wanted to leave against medical advice, called their family something like 20 times in the middle of the night, hallucinating, had to be restrained, got out of restraints and into the hallway, called 911 from their room. right now they are snowed(given enough meds to make them sleep) and now has a sitter in the room ( since they have proven they are not safe to leave alone someone is sitting with them at all times)

patient five is still calling constantly for medication

patient three is doing great today, awake alert visiting with family

patient two is bored and wants to chat with me in the hallway

patient one has a heart rate in the 150's, several calls to doctors, primary comes in and writes orders, teaching intern writes orders, they finally speak to each other, i push lopressor, heart rate comes down some.

pt five called constantly for meds the entire time this was going on, and is pissed by the time i get to the room, but called every five minutes the entire time i was busy. i am now giving 8am meds after 10am.

pt four is waking up, but their iv access is no good so i can't get meds into them, the iv nurse comes and puts in a new iv, i go to use it, it isn't good either, we have to wait for the iv nurse to come back(poor access). finally get access, pt is awake but ok.

did i mention my husbands grandmother is a patient on my floor right now? so in between this i'm trying to go check on her.

i finally catch up by late afternoon, i'm trying to get charting done, but it just isn't happening, now its time for afternoon meds, i have to find 20 mins to go pump because i last fed ben at 5 am, it's now 4pm.

i finally get my afternoon meds out i head to patient 5's room to tell him that i'm coming, as they has been calling me for an hour. the patient is not in the room, or the halls, or the family room, or the kitchen, not on the floor at all. this patient has disappeared before and knows they can't leave the floor, due to what is wrong with them and the meds they are taking. call the doctor to report it, call security to find them.

meanwhile pt 4 is losing it, wants to leave against medical advise, wants to walk home since the spouse won't come get them, it's sub-zero outside and now dark, i try hitting them with meds every hour to get him calm, it isn't working. i call the doctor who comes and says the patient shouldn't leave, not stable yet, pt calls spouse repeatedly, saying that they can't trust their spouse.

we find patient 5, in the cafeteria using a computer, ( a long walk through hospital tunnels in a different building) security sends them back right before we can discharge them for elopement. the patient walks back onto the floor and is not in his room an entire minute and calls for pain med. funny though how the pain went away so they could leave the floor.

it sucked, the entire weekend. and i left thinking what is the point? keeping druggies drugged up, killing myself for 24 hours in two days, for what? what did i accomplish? so not worth 26.00 an hour, i would gladly have told them to keep the money so i wouldn' t have to deal with all this.

i need to work, we need the money and benefits, i don't know another job that i could work two twelve hour days and be home the other 5 with my boys, and still have a decent paycheck. i'm grateful i have this option and i know plenty of moms are out there busting their hump for a lot less. i'm not going to leave my job-it's just a really good think i have days off in between to forget how bad the last shift was.

i just keep going back to bigger question what's the point? what does a nurse really accomplish?

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