An Hour of a Nurse’s Life — True Story written 20 years ago when I was a graduate nurse.
My shift had started routinely enough; I was on afternoons on the med-surge unit and I had just gotten released from shift report. Coming from the staff room, I recognized one of my patients being transported down the hall on a stretcher. “Where is he going?”, I asked. The transporter replied, “To x-ray”. I waved goodbye to him and then began to plan my day. I looked at my profile cards, my medication sheets, and then intended to begin my patient assessment rounds.
First, I decided to go see the new admission in room 10. I’d heard in report that the day nurse, anticipating change of shift, had let the patient and family wait in the room for over an hour and the family was eager leave. When I arrived at the room, I found that the family was not only eager to go home, they were downright angry that they had been made to wait so long. The patient I was admitting had Alzheimer’s and the family had to stay to give necessary information. I apologized for the wait and promptly decided to get down to business and begin the admission paperwork. They were a wonderful group of people who were very concerned for their father’s safety. They told me many stories about how he liked to wander off and get lost and into trouble. “You’ll need to use a posey vest on him,” they said, “He’s had to have one on before and it’s okay by us to use one, we understand.” I assured them that we were experienced at handling wanderers and his safety issue would be a priority. I spent about 30 minutes in the room listening to them talk about their father, they had many fond memories to share.
I still had five other patients to see and we were getting nowhere on this admission. I tried to steer the daughter of my patient in the direction of admitting Q&A when I heard an announcement, “Sally, you have a telephone call.” I paged the front desk, “Can I call them back?” “No”, replied the secretary, “X-ray says it’s urgent!” I excused myself, apologizing. When I got to the phone the panicked x-ray tech said, “Your patient is down here having a seizure! You need to come sedate him!” “Wonderful”, I thought sarcastically to myself but felt very concerned. This patient was one of my regular patients with a history of seizures and mental retardation. He was like a child and I felt very protective. I started to draw up Ativan thinking of the poor family waiting for me in room 10. All of the other nurses were busy with their assessments, too, and I couldn’t ask one to run down to radiology or finish my admission.
“Who has room 25?”, I heard. “I do. Why?”, I asked and felt guilty because I hadn’t seen this particular patient yet either. A lab tech was talking to me, “Her blood sugar is 29”. “Twenty-nine! Are you sure?”, I asked. She was, and I dropped the syringe of Ativan into my pocket. I ran into room 25 and found my patient, a middle aged diabetic woman, pasty, stiff, and obtunded. Our secretary was already calling the doctor for me while I grabbed an ampule of D50 and ran back to the room. I arrived to find my patient’s IV infiltrated and her arm swollen with a knot the size of a baseball. “There is no way this happened on my shift already”, I grumbled in my head. With a huge sigh and waves of panic I quickly ran for the IV tray. Two other nurses noticing my frustration and haste ran to help.
In the meantime, the daughter of my newly almost admitted patient in room 10 had stepped out into the hall. She stood outside of room 25 where we were trying to stabilize the other patient. She peered into the room and began shifting her weight back and forth, arms akimbo. She loudly cleared her throat, obviously upset and impatient. I apologized and closed the door. She began yelling and and I heard her stomp back down to her father’s room. “Sally, X-ray is on the phone!”, I heard overhead again. I started to feel overwhelmed.
Our supervisor, luckily, had shown up in the nick of time and had gotten a second IV started. The first amp of D50 was in. I was finally intent on heading in the direction of my patient who was seizing in radiology when the secretary interrupted, “The doctor’s on the phone!” I notified him of the low blood glucose and got orders. I ran past room 10 quickly. I didn’t dare look in the direction of the room or make eye contact with the family that was waiting. I thought, “They must think I am the most unorganized nurse and that I don’t care about them.” I could understand the anger and frustration they must have felt having been demoted on the priority list.
I found my mentally retarded patient scowling with his arms folded across his chest, wide awake. He had obviously not had a seizure, he was just not cooperating with the tech. I was very upset. “Well, he just had a little seizure,” she said. I stayed with him until the x-rays were done, accompanied him up to the floor, got him settled into his bed.
By this time, my patient in room 25 had pinked up and was drinking orange juice. I thanked everyone for their help and headed back to room 10. The family was livid. They asked for the charge nurse or the supervisor. I was accused of irresponsibly ignoring them and blatantly slamming a door in the daughter’s face. I was told that I was the worst nurse for having left them alone. “I can’t believe how lazy nurses are these days” the daughter spouted. My supervisor, who was present for the alleged door slamming incident, knew that what I had done was appropriate. With a red face, and suppressed emotion, I finally got the whole situation and the admission straightened out.
I was off schedule, behind on afternoon medication rounds, and I was angry. I was angry that I could not tell the daughter what I really thought of her behavior; I couldn’t tell the x-ray tech what I thought of her behavior; I had to be polite and politically correct; in doing my duty as a nurse I was called lazy; in having responded to urgent circumstances beyond my control with poise I was called irresponsible. I glanced at the clock and saw that it was only 4:40pm. I had left shift report at 3:30pm. This one hour of my shift would induce work nightmares, I knew. With seven hours left and all the potential chaos that could have ensued, the Ativan got wasted and my wanderer thankfully stayed in his room all night.