Monthly Archives: October 2014

A (night) in the life of a night shift nurse

A few months ago, Nurse Eye Roll posted a post entitled A Day in the Life of a Nurse (all credit for this idea goes to her). Without further ado, here is the flip side of that, what happens in the wee hours of the night when day shift is off the clock, our patients are all “asleep”, and it’s always 7am somewhere.

Dedicated to all of you hard working night shift nurses who are reading this on your smart phones right now while trying to pass the time.

Wake up, wide awake, look at the clock, and realize it’s only 2pm

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Trying to go back to sleep… trying to go back to sleep…. trying to go back to sleep

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When I hear my neighbors kids getting off the bus, and the dog barking, and LAWNMOWERS.

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New plan for surviving tonight: COFFEE POP REDBULL

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About the time my alarm was set to go off

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Walk out my front door

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Get to work and discover I have three admissions, a discharge, and a transfer waiting for me, and we’re short-staffed

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Long-winded coworker takes half an hour to give report on three patients

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Okay day shift. You can go home now. 

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Going around, quickly meeting my patients, and asking if they need anything, which turns into thirty minutes of listening to a patient’s entire life story

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Discovering the previous nurse waited until right before shift change to give the Kayexelate and Milk of Mag cocktail ordered at 4pm 

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When my most time-consuming patient is watching that TV show that I was really upset about having to miss tonight

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Patient’s family comes to find me because my patient is coughing

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and because they think they have a fever

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and because they think they have Ebola

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One patient wants pain medication, another needs to be changed, a third one has a SBP in the 70’s, a family member is on the phone and I have to pee

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Oh, and you’re getting another admission

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Passing meds, handing out apple juices, driving my computer around like a boss and saving the world 

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Finally finish my med pass and assessments. Now it’s time to sit down and do some uninterrupted charting

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When I am FINALLY sitting down and my IV starts beeping

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Finish charting an entire assessment, only to realize I forgot tonight is scheduled system maintenance and the computer system went offline before I had a chance to save it.

seriously

Seriously.

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When my H&H comes back and I have a standing order to give blood if their hemoglobin is below 8… it’s 7.9

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It’s not even midnight yet?!?!

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Time for lunch break, dinner break, or whatever-I’m-supposed-to-call-my-middle-of-the-night-meal break

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Realize I left my lunchbox on the kitchen counter, it’s too late to call someone to bring me food, and the cafeteria just closed. So now, dinner is graham crackers and applesauce

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Ask my coworker to help me change my patient and they let one rip as we roll them

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Nope. Not just a fart after all

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When I tell my patient I’ll bring them a sleeping pill… then I realize there’s not one ordered

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Then I realize there’s not a hospitalist on their case

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So, have to call the surgeon for an order and get yelled at for waking him up

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I can’t give my patient an Ambien? Okay, that’s cool. What about a Restoril? No? I can’t even have a Benedryl? Really?

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Patient is finally asleep and I realize I left something in their room

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The time of the night when my “pleasantly confused” little old lady turns into the devil incarnate

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It must be 3am now

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Coworker misses their IV stick and calls me to try

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Accidentally wake up a grumpy patient while hanging their 4am Zosyn

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Home stretch… I’m awake… I’m awake… I’m awake

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5:30am. Time to wake everyone up for their Synthroid and Protonix, at which point they will also need to pee and want their Lortab

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Check a blood sugar and my patient doesn’t need coverage!

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Half an hour before report and my IVs all go bad and my patients all have to pee. again.

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Finally caught up and waiting for day shift to come

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Day shift shows up late and spends fifteen minutes chatting and fixing their coffee

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Oncoming nurse asks me 92830498234 irrelevant questions that I have no idea what the answer is and I also don’t care

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FINALLY GETTING OUT OF HERE

dead

I’M GONE

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DONE.

seep

(At least, until I have to go back in twelve hours) 

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To Nina, to Amber, and to nurses everywhere

I’m not one of those nurses who has spent thirty plus years riding the ebb and flow of this constantly changing profession. I don’t have the wit and written eloquence of Kati, known to most of you as Nurse Eye Roll. I don’t have the feisty presence of Katie Duke, my infamous nurse comrade featured on ABC’s best-show-ever NY MED. I don’t have the insight and wisdom of so many of the elite nurse bloggers. For the past two and a half years, I’ve been your run of the mill ICU nurse. I stick to expressing my thoughts in 140 characters or less (find my primary home on twitter at @RNMeetsWorld), I keep calm, and I carry on my way.

But today, as news spreads about not just one, but now TWO of our fellow nurses being diagnosed with this enigmatic virus, I want my voice to be heard just as loudly as those criticizing, finger-pointing, and blaming. Fears over Ebola are sweeping across the world in exponential form. My family is panicking, my friends are panicking, and even my medically-trained coworkers are panicking. I went to the optometrist this morning, healthy as a horse, and the first question they asked me was about recent travel history. Flipping through the channels this afternoon, I saw an advertisement for N-95 masks in the context of Ebola, and I couldn’t help but groan. I ask my patients, or at least the conscious ones, if they have been out of the country simply because I want to be certain that nothing gets missed, and even worse, that I’m the one who missed it. I am being vigilant.

With that said, I am getting tired. I am tired of being asked how I feel about these two young ladies who share my passion contracting the disease while on the clock. I plead the fifth when it comes to just how many acquaintances I have unfollowed or unfriended on social media due to posts that I find offensive, derogatory, or flat-out ignorant when it comes to my profession. I have now perfected a monologue to offer when someone raises an eyebrow and takes a figurative step back as I introduce myself in public as a nurse. I’m sick of pretending to laugh off jokes about “You haven’t caught Ebola, have you?” I’m tired being asked if I am scared, or even if I regret my decision to become a nurse.

Not for one second.

I’ve been watching the news today, and I’ve come to an alarming realization. I could be Nina Pham. I could be Amber Vinson. I could be any one of the many other nurses who willingly put their lives on the line ensure Thomas Duncan received the best care possible. I work in a suburban ICU, an Ebola patient would never show up here. It won’t happen to me. Right?

Wrong. Texas Presbyterian wasn’t expecting to become ground zero either. Had Mr. Duncan shown up at my hospital instead, I very well could have been the one taking care of him. He wasn’t transferred to a specialized isolation facility like Emory or Nebraska, although CDC officials are now admitting that, in hindsight, he should have been. He was cared for in a generic intensive care unit in a hospital just like mine, by nurses who have been trained just like me.

Would I volunteer to take care of an Ebola patient should one darken the door of my own Emergency Department? I like to think I would accept the call with no hesitation. I’d like to think I would be courageous in the face of the unknown. That I would have enough confidence in my gowning and gloving and masking to feel armed enough to handle a disease of this virulence. That I would stay true to the commitment I made, before my perception of nursing was muddied by incessant charting and The Joint Comission and the politics of healthcare, that mantra of I will care for people when they can’t care for themselves.

To Nina Pham and to Amber Vinson, I am sorry. I am sorry that you have to be the butt of criticism over whether it’s you who is at fault, or your hospital, or Obama, or the CDC, or whoever happens to be the scapegoat of the day. I hope you’re getting to Skype with your families, and your friends, and your dogs. I hope that you are fighting hard, and feeling better. If you have a foley, I hope you were groggy enough when your coworkers put it in that you’ll never remember it. I hope you’re shielded from the criticism being directed at you, and that you are not watching the news right now to hear your character and your unspeakable bravery slandered by the uneducated public and the media frenzy. You took a risk that few would be willing to take, and I commend you for it. Thank you. 

Amber, I hope you are settling in well at Emory Hospital. Atlanta is a great city, I promise. I spent quite a bit of my childhood there. I wish you were getting to visit the Coke museum and catch a Braves game and sightsee at Centennial Park instead of staring at the bleak walls of an isolation unit in a strange city, far away from your loved ones. Nina, I hope being able to see the faces of your coworkers brightens your situation just a little bit, and that you know they are hurting with you.

You are both heroes, and I only hope that I would be as brave as you if I was walking in your bright yellow, rubber-soled hospital socks right now.

My life is defined by a belief in God, in prayer, and in the words of Romans 8:28 and Jeremiah 29:11 – That God has a plan, and that in all things he works for ultimate good. I don’t say this to get into an argument of why a good God would allow such a tragic thing to overtake Africa and now infiltrate the borders of Europe and America. I am wrestling with those questions myself. But I say this because, regardless of what anyone may or may not believe, I try to look for evidences of good speckled in with immense tragedy. I see the bravery and good spirits of Nina and Amber shining through all of the negativity. I see the selflessness of staff at Texas Presbyterian Hospital who continue to treat one of their own in the midst of fears that they will be the next to have their face plastered on CNN while they fight for their life in isolation. I see Dr. Kent Brantly, who has recovered from Ebola and is now offering anything he can to help others fight, being proactive in donating his own plasma again and again. I see the thankless work of a countless number of volunteers who have willingly chosen to put their lives on the line to treat the least of these in West Africa in conditions far less advanced than those here. The good is hard to find, and it’s dim, but it’s waiting on the horizon. It may get darker before the dawn, but keep fighting for it. 

And so, to my brothers and sisters in white, or ceil blue, or jade green, or whatever rainbow your hospital’s policy dictates: Live in caution, not in fear, and always remember why you do what you do and the heart behind it.

And please, please, please. Wash your hands.