Sweet Mother of Mary.

When I decided to update my links over there off to the right, I did not realize that I would be adding sixteen more nurse blogs. Nurse blogs have really taken off! I couldn’t be happier – the more people that can read about what nursing is really like, the better. And the chance to get to know other specialties (ER nursing, Psych nursing, Labor & Delivery… the list goes on…) without actually having to float to them is intensely interesting to me. I started this blog over 4 years ago (December 2002!) and at the time, I found several doctor blogs, but only one other blog written by a nurse. Now there are so many, it’s hard to keep up with them. My sidebar has a sprinkling of the ones I read most often, but there are many, many, many more to discover here.

Anyway, I recently went back to work after 5 months off. It was a nice break, but I was ready to go back. One of my patients was a very sweet elderly man and the other was a very funny elderly man. My two favorite flavors! They were relatively easy but I soon found myself “in the weeds.”

Here’s why.

All shifts are busy on any unit, and I have worked all shifts, but flame me if you like – day shift, in my experience, is usually the busiest. There are daily labs to address, most procedures are done on days, most tests (CT’s, ultrasounds) are done, docs are making their daily rounds (which means they’re changing orders), and there are all of the daily meds to give.

Let me tell you something about the “give once daily” meds. 99% of them are scheduled for 8 or 9am. And some of our patients are on a lot of medications. Do you know how long it takes to give 10-15 pills to a patient who can only take them one … at … a … time? It can take awhile.

I’m used to this, of course. I’m pretty good at time management. But all the old frustrations came flooding back when I couldn’t get my patient’s EKG tracing to pick up. Fixing equipment is my #1 frustration. I hate when gadgets don’t work right. My job is difficult enough without having to take forever to troubleshoot and replace faulty equipment. I tried giving all the electrodes a little turn… sometimes that makes the tracing better and can at least pinpoint the EKG patch that’s not picking up. The tracing wasn’t affected at all. So then I went about changing all of the patches, which involved me having to take the old ones off (not even 24 hours old) of unshaved skin. Either it was an emergency, or the person who applied them is a sadist.

Meanwhile, the patient’s doctors are rounding on him and I don’t feel that it’s very nice to be putzing around under a patient’s gown while they’re trying to talk to their doctor – the one who only comes ’round once a day. I finally got all the electrode patches changed (having shaved parts of his chest so that when they came off they wouldn’t cause so much pain). Didn’t change the tracing AT ALL.

The mental commentary of the list of things I needed to get done was becoming increasingly louder, which added to my frustration level.

Finally I decided to just change the EKG cable. Of course, to do this, I had to hunt down a cable to replace it with. I don’t take cables from other rooms because who wants to go to admit a patient and find that they’re missing an EKG cable? I finally found a cable and had to go through the whole process of untangling the wires, rehooking the patient up, etc, etc. Bingo – perfect tracing. Which is all well and good, I’m glad it worked, but faulty cables seem to be appearing more and more. The really frustrating thing? For kicks, I decided to see how long his tracing had been virtually unreadable, and found that it had been like that long before I came on shift. Argh.

And then there was the old “Insufficient quantity of this medication currently loaded” on the pyxis. Even though Mr. Pyxis is supposed to alert the pharmacy when it gets low so someone will come fill it. Bah, who knows… maybe it had run out 5 minutes before, maybe 5 hours. Maybe they hadn’t had a chance to fill it yet, and I understand that… but again, it just adds more work for me when I have to send pharmacy a message and keep checking for the med.

They’re small little things, but they can really add up over the course of a shift. Is it like this everywhere?