I have to make a note of my deadest day at work today as I feel like every patients were out of control here.
I started my work at 7:30 a.m so I had to get up at 6, unfortunately I fall asleep at 2a.m.. With lacking sleep mode, I still dragged my dead body to the ward. Simply greeted to my patients after hang over
Then I took a deep breath, before I stepped out of the nursing station.
“It will be a crazy day again. ” I murmured in my mind.
Day time nurses are normally in charge with 7 patients a day. Here is my patient list today.
1 patient was discharged
1 patient was transferred to the rehabilitation ward
1 patient was suffering from low pressure headache with hardly seen vein and she still had to be NPO for the gastroscopy and colonscopy in the morning and nerve biopsy in the afternoon.
1 patient is diagnosed with ALS and admitted for sort of breath, she refused BiPAP.
1 patient with BAO who is underlying heart failure. The completed EKG showed frequent VPC and the blood pressure unfortunately fluctuated during my shift. We also found out her urine culture was full with dirty enterococuus bacteria, resulted in changing a new ICD for her.
1 patient with seizure under controlled, however her Hb dropped down a lot which I suppose it should be related to her poor renal function.Anyway, the initial treatment for her was blood transfusion. Unfortunately, she looked a bit more drowsy and complained powerlessness with mild fever before everything started. So we decided to do the fever work up first. Again, due to her poor renal function with regular hemodialysis. One arm is prohibited for invasive treatment. With her poor vein, I really have no comment. Wasted about another 30 minuted there on my busy day. She then magically be alive after fever work up, I suppose maybe the needle shots were too painful. She turned back to her annoying mode sadly, but I rather her be this than being sick.
1 patient was the angle for today who is ready for discharged recently. Free from any illness. I suppose I only spent less than 15 minutes on him today.
Ideally, my typical day starts at 7:30, finish treatment and administration just till noon then admitting new patient in the afternoon.
The annoying news was my new patient showed up at 8a.m when I hadn’t settled down my old patients, so I had to put him on the side and wish he will be fine before I have time for him.
When I got a little gap, I found out he had serious postural hypotension, I had to immediately monitor his postural blood pressure which took me another 15 minutes to do so. As we all suspect he has an issue of autonomic dysfunction, checking residential urine is another task during my little shift.
I had to run to the ICU for bladder echo machine and give it back on time. Soon and later, I received a call from the operation room for another patient for her nerve biopsy.
I don’t know somehow that patient’s intravenous catheter who was going to the OR was out and her arm was as big as an elephant. Sadly, another 15 minutes was gone.
Finally, everyone calm down. VPC patient’s blood pressure went back her baseline, Nerve biopsy patient was in the OR, ALS patient has smooth breath, HD patient got up and finished her blood transfusion, new patient has settled down and old patients were safely discharged.
My crazy day has finally ended.
Wish I good luck tomorrow.