So I feel like I'm using this blog as a venting ground but whatever. If I don't I'm going to snap at someone and put myself at risk of losing my career.
My day starts off with my supervisor asking me to come in early. Apparently one guy is targeting me and a handful of others and tattling that we have cell phones out in the department. He is also claiming my documentation isn't "up to par" and they have a lot of things to do when my shift is over and I've left. He's targeting me so much that I'm one step away from being written up and put on probation. He hasn't confronted me, he is spineless and would rather stab you in the back. I'm pretty close to telling him off (I'm probably never going to do it, I don't do well with confrontation).
I clock in and start my shift, already disheartened from the situation above. I get an ambulance in one of my rooms and this person is really ill. He has a pneumothorax (a collapsed lung) in addition to pneumonia and a shitty medical history. I've taken care of him before and he is really sick. He gets intubated because he can't tolerate Bipap (a breathing machine, puts positive pressure on the lungs, not a good idea for the pneumothorax) and he isn't doing well on his normal nasal cannula.
Long story short (too late) as the doctor is inserting the chest tube (he has received rocuronium and etomidate for the intubation process) he goes into PEA (pulseless electrical activity, the machine picks up on the heart rhythm but there is no heart beat). Start chest compressions and ACLS protocol. He goes into V-tach (ventricular tachycardia, not a good rhythm, needs to be shocked ASAP) and finally after 30 minutes of working him we get him back.
This person is 1:1, I need to be in there and I can't leave him alone. He gets an A-line (inserted into the artery to give us accurate blood pressures and instant changes), central line (IV access inserted by the doctor that goes deep into the larger veins), peripheral line, and intraosseous line (IV into the bone) by the time we're done. I end up working with this patient for almost 4 hours before I can do anything else.
While working with this patient someone else takes care of my other 3 patients. She discharges 2 of them. The charge nurse puts a sick person in one room and at 3pm she leaves. She never told me about my new patient. She never asked anyone to watch that patient. The person who cared for and discharged the other patients left at 3pm also. I have no clue what's going on outside of my 1:1. The next charge nurse puts another really sick patient in my other empty room. In my opinion those rooms either should have been closed or they should have received a different nurse to take care of them while I was with my sick patient. Nope.
Backtrack a little. I have a patient being admitted because she is having difficulty breathing. The patient is in no acute respiratory distress, she is actually able to complete sentences without struggling to breathe and she is stable. She is in room 32. While I'm literally doing chest compressions Someone asks me to answer the phone because the hospitalist needs to talk to me about room 32 and how she needs me to put orders to change her room assignment. I ask the messenger to tell the hospitalist to do her own fucking job (I'm not sure it was relayed in that manner). I continued to get requests from the hospitalist regarding room 32 like why didn't you change the bed request or can you administer meds or can you put in orders for me. Each time I had to explain I was in the middle of taking care of someone else and she would either have to do it herself or wait (guess what she did, if you guessed she did her job YOU'RE WRONG!). At one point I finally got some orders in for this lazy, incompetent POS hospitalist and I ask the lab to draw her blood because of everything going on. They come over and inform me the patient has a port and they can't access blood from a port. OK, well I didn't ask her to access the port so I assume the lab tech drew blood because she moved on. There are other ways to draw blood, just because a patient has a port doesn't mean you can't find a way. I guess that's my fault for assuming. She had walked off without drawing her blood, leaving me to do it for her.
While I'm still dealing with the aftermath of my sick (almost dead) patient they continue to give me ambulances and expect me to care for them as well.
Even though I'd never walk away from a job (I don't ever want to put my license at risk), I was about to snap. My usual mostly composed responses to frustrating questions were a little testy and snide (like room 32 asking for dinner even though her blood sugar was 700, my response to the messenger was "tell the fat fucker to stop eating like a pig so her sugar is more easily controlled and maybe I can give her a trough", hopefully room 32 didn't hear that).
This makes me wonder why it's OK for nurses to fix hospitalists problems. Why is it OK for them to fuck up and expect us not only to catch their mistake but correct it both in the computer and before it touches the patient? I don't get paid to do their job and they won't give me money to do so. So why do I have to put up with their incompetence while they expect us to fix their shit?
I need a mental day. Glad I don't return until Saturday for my next shift. Until then my job can just fuck off.
