Tuesday, April 21, 2020

I've still got a lot of fight left in me

This last week has been exhausting as I ended up working three days in a row, one of them being Saturday (and we all know everywhere is staffed less on the weekends)...but week two down and now on to week three.

I have been spending some time on the PICU unit which is not actually pediatric now, but more young adults. With this being said, the nurses have been taking some time to explain the ICU things to me. I was eagerly soaking it all up: ventilators, arterial lines, 7-10 drips at a time.... the whole thing. Unfortunately, I also was pulled to another unit at 10:30am. This is all too common here, but has not yet been me who was pulled. Walking onto the other unit, I have never seen such chaos.... let me paint a picture for you so you can try to imagine this

  • Charge nurse pacing back and forth stating this is not safe. 
  • Patient lying calmly on stretcher in hallway near nurses station, Charge RN notices the patient and walks over asking the name and who the patient was. (this happened again later....and turned out to be an admission that I was chosen to receive)
  • Charge RN handed me a stack of paper handouts on my 5 patients and said he had passed meds on the one he had, then walked away. No other report was provided......these patients are 2 in a room, most if not all on some amount of oxygen some on non-rebreather.....solid wooden doors which must be closed at all times block any view of patients. No monitors in patient rooms, no way to have continuous pulse ox monitoring on any patient. Only way to check their O2 saturation is to wheel in a vitals cart and then wheel back out and wipe down. (most units only have 2 carts for 30 some patients give or take). 
  • He didn't ask my name or tell me his. Didn't tell me the codes to get into clean supply or nutrition rooms.
  • I log into the computer and begin to view medications due. 2 patients had 8am insulin that had yet to be given along with BP meds etc. It was almost 1pm before I could even lay eyes on my last patient, at which time my 6th patient was found in the hall on the stretcher (as I mentioned before) determined to be the admission for one of my rooms and wheeled into the room. No one told me or the charge the patient was on their way, no one told us the patient was left/dropped off in the hall. 
  • There was one nurse aid one one side of the unit and two army nurses who tag teemed acting as nurse aids on the other side of the unit. There were no depends....anywhere.... patients get abd pads if they're incontinent without a foley.
  • One of my patients left against medical advice. 
  • I got another admission.....inappropriate to the unit and my poor charge spent over an hour calling bed board, doctors and nursing director trying to get the patient moved.
  • In the back of my mind I was praying I would not walk in and find a patient had removed oxygen and had stopped breathing. 
  • I am a type a person who likes to be on top of things, I felt I started out behind and couldn't get caught up with my tasks. 
  • Patient needed hand fed and I swear they took 2 minutes to chew one bite, but they needed to eat. If I didn't do it, no one else would. I dripped sweat and thought of my other 6 patients as I sat there and waited on the patient to chew, trying my best to appear calm and not hurried.
  • A doctor approached me and stated IV was removed on a patient but pt is dehydrated so could I just hand patient the cup every time I walk in the room. I politely stated that I have 7 patients and will not be in this room often, can we just replace patient IV? MD told me no its not necessary but he will hand patient water when he is in room and could I do the same. I tried my best. 
  • A patient passed away on the unit, not mine but on my unit. 
  • Seemingly never ending CAC (cardiac arrest code) and RRT (rapid response team) being paged overhead. 

On another note, I received something akin to gold this week! What we called a "bunny suit" at my previous jobs. A one time wear disposable zip up suit with a hood. Unfortunately, these are not one time suits during the crisis, below is a photo of my suit, one of me getting all garbed to go into a room, and one of me wiping down a colleagues suit so the suit could be folded and placed into a bag to wear tomorrow and the next day, and the next day.

Oh yes and please note the IV pumps outside the room in icu settings to decrease need for entering room due to IV beeping etc. They came up with a way to use lots of extension tubing and keep lines outside the room as much as possible.

Moving towards the more encouraging things from the week, the travel RN below had no cloth masks to wear when not providing patient care or at work, so I offered one donated by a classmate of mine. You can't see her smile, but it was huge!

Pin by Laurie McCullough on Note to self... (or this is me) (With ...
Finally, to end on a good, but emotional note, this last week the hospital began playing overhead a short clip of Fight Song by Rachel Platten whenever a patient is extubated. This brought tears to my eyes almost every time this clip played. Staff would often stop what they were doing and start clapping. The emotion that swept the unit was tangible. I had goosebumps. Go listen to this song and her voice and her statement "I've still got a lot of fight left in me."

1 comment:

  1. Having spent way to long in the NICU with my son, too much of what you describe and are showing is all to familiar. I applaud you for your courage and strength through this and Simone and I are absolutely praying for you. Keep up the amazing work, and keep the perspective positive! If you need anything please don’t hesitate to reach out!