Wednesday, March 2, 2011

the "typical" day

0700: Report from night shift.
0800: assessment. I've given up on the head-to-toe thing. I'm a little ADD for that. I've resorted to "around the bed".
0900: meds. sounds so simple--and it should be! Yet it still takes me so much time. checking and rechecking the MAR. Drawing up the right doses, crushing the pills, getting another nurse to check my heparin/insulin/narc gtts, gathering the syringes/needles/infusion pumps/alcohol wipes/etc. etc. For two patients, it often takes me over an hour!
1000: turning patients. hopefully there's a tech available to help boost, check skin, clean surprises. trach care, dressing changes, bath, oral care, etc etc. The doctors are also coming in at this point. So, through the curtain comes "what was his potassium today? did we replace it? how long has the versed been off? where is the levo? has he had an echo done?" and through my mask and the curtain, as I'm packing sterile guaze between staples in the abdomen, "3.3 and yes. 4am--still no response to verbal stimuli. 8mcg--going down. i don't know." (I'm coming to terms with that last answer.  it's very often the sad but honest truth.)
1100: more doctors. more questions. more "i don't know"s. and more orders.
1130: assessment again.
1200: meds.
1300: entering the doctor's orders.
1400: I open my paperwork. aaahhhhhh! Seriously? all blank? maybe I'll go to lunch instead...
1430: back from lunch. open my paperwork. really? still blank. maybe I'll talk to my pod-partner for just a little bit...
1500: open my paperwork. Blank? I could have sworn I started something! I start scribbling....
1600: assessments again. last one. phew. and meds.
1700: more charting, and some late doctors straggling through.
1800: more meds. empty drains, I/Os, clear pumps, clean rooms, etc.
1900: night shift here! Report.
Mixed in with that is the q2 hr oral care/patient repositioning/restraint check, hourly vitals, the line for the pyxis, waiting for the facilities guy to come fix the pyxis after it's broken down for the 8th time today, answering family member's questions, helping my pod-mate with his/her patients, and the phone calls! oh the phone calls! and, what i didn't understand until I was a nurse, there's always the unofficial assessment. his heart-rate is up--why? should I call the doc? what meds can I give for that? he's not peeing as much as he was--why? she seems more confuse than before. I wonder what her paCO2 is. that's racing through my mind all the time...
even on easy days, I still feel pretty tired by the end!

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