October 6, 2009

Fun day

They put me on the intensive care unit.  Let's see...

  • We had the delusional patient who spent the day walking up and down the hallways giving oratories.  Some were really good speeches, especially when the nursing students were on the floor and he had an audience.  Others, not so good--apparently we're all not qualified staff in his opinion and he wanted a court hearing to discuss his rights.  This was before he got into a 30-minute long heated argument with the security camera.

  • There's the one that was refusing their meds PO...but they were legally mandated, so had to get them IM.  He was not happy about it--in fact he was verbally abusive and his agitation was escalating, so along with the charge nurse, they called in 5 male staff to help me give it.   Talk about a show of force:  they managed to pull up the burliest staff we have for this.  After a lot of cursing, swearing, and threats to come after us if anything happens because of this--much of this directed at me as I was the one with the needles--he got his shots and within an hour was sleeping.  It was all I could do to keep my knees from knocking the entire time. 

  • The other mandatory IM was rather cooperative.  I also outweighed him by 100 lbs (seriously, he was skin and bones).  I still brought a male counselor because I had to...but after that first experience, this was easy.

  • Bad news:  my first needle stick.  Good news:  it was a sterile needle--it happened as I was drawing up the meds for the preceeding patients.  I know why it happened--I was nervous about having to give the first patient described the shots.  After taking a minute to refocus, I started over with a new syringe.

  • One patient went south on his new meds, and I had to play track down the doctor while we scrounged for more male staff to help him in the bathroom.

  • Several patients were seeing and/or hearing things that weren't there.   Fortunately, most took the haloperidol I offered.   One didn't want it, but that was because the voices were only playing music and he was down with it.

  • And it must have been national No-Shower day. 

Overall, I think I met the challenges pretty well.  I definitely can't say it was a dull day....I hope I don't have another day like it for a while.  And FYI to the nursing students who may read this:  if, when taking vital signs, you get abnormal results...retake them.  Then if they are still abnormal, tell a staff member about them.  Don't let us find out a couple of hours later from the vital sign sheet that someone's Stage 2 HTN but who shouldn't be.

In other news,  week 1 of Weight Watchers is complete, and I lost 5lb.  I'm still following up with the endocrinologist though because of the abnormal labs.

No comments: