LOL maybe I'll turn this into a Blog.
Today I was assigned two patients on the med/surg floor. At 7:15 a.m. I was told I had until 9 a.m. in which to be ready for my instructor to get back to supervise me passing meds. In that time I was supposed to get verbal shift reports on both patients from the charge nurse (15 mins), do a head-to-toe physical assessment on each patient (supposed to take about 15 mins each but actually takes me around 20-30 mins each) take vitals on both patients (5 mins each) and look up all the meds my patient is getting (11 meds) and know the nursing interventions for each med, check for interactions and contraindications, and check lab values if they pertain to a med (like checking a patient's past potassium value before they get their potassium pill)
Now I'm pretty fast at this and only have to do this on one patient usually takes about 15 mins.
Now someone grab a calculator and tell me how long it was SUPPOSED to take me to do these things to be ready? (Long pause as I attempt to do math)
I had 1:45 to get every thing done. I was prepared to do my assesments at lightening speed so I can have extra time for med look ups because we always get quizzed and need to know our shit.
Instructor: What does Medcine X do to the heart? Me: <bright smile as I confidently reply> "It slows the heart rate so you need to check the pulse and not give it if the pulse is below 60 or you will have drug induced bradycardia in your patient" .. stuff like that...
So I decide to start with vitals, since the nurse I'm supposed to get the report from is on the phone, but I can't find the equipment I need. (Remember this is my first day on the med/surg floor at this particular hospital, so I don't know where a damn thing is.) After asking several nurses, I find out there is only one working rig (sphygmomenometer<probably spelled that wrong>, electric thermometer, pulse ox machine on a little wheelie pole) on the floor and the patient care tech has it. So I hunt down the patient care tech not knowing her name or what she looks like. I finally find her chatting with a housekeeper at the end of the hall. I grab the wheelie thingy before she can say a word and sprint down to my patient's room and get my vitals, record them, then to be nice, run the rig back down to the patient care tech who is still chatting with the housekeeper. Elapsed time 20 mins.
Okay so now the nurse is off the phone so I can get the report on my patients. This doesn't take long and I jot down pertinent info in my trusty notebook. Elapsed time 10 mins.
By now the three cups of coffee I consumed at 5 am have completely recycled, so I run to pee. Elapsed Time: Peeing 4 mins, handwashing 2 mins.
Okay now it's time to do head-to-toe assessments on my patients. The first one goes off without a hitch except for the fact that my patient is completely uncooperative, when I asked him to remove his gown he growls "Why?" <sigh> Most men tear their clothes off when they see me but this guy was completely unimpressed. Dispite some resistance from my patient I am still able to gather most of the assessment data I need. Elapsed time 20 mins.
I move on to my second patient, a frown creasing my delicate face before I get within six feet of him. I know that smell. That smell is bad news! Ever the optimist, I smile at him and tell him I'm back to do his assessment and that I have to remove his gown for a few moments. Knowing that I don't want to know what's under there, I still have to pull the gown back, to find my patient's bed not only wet but also very very dirty. To top it off he has dried balls of feces stuck in his pubic hairs. (Yes, dingle berries.) The patient complains that he is cold and I know that I can't leave him till later. His dignity is being comprimised and he is experiencing discomfort. Since he is wired up to several machines, a bed bath is the only option. Time for my second treasure hunt of the day. <sigh>
The first nurse I ask gives me a blank look when I ask where the supply room is. The patient care tech overhears me and actually shows me where to go. I grab a basin, soap, shampoo, washcloths, towels, fresh linens. Can you guess what I forgot to get? If you guess dirty laundry biohazard bag you would be right. I also forgot to ask where the soiled utility room is. So I dash back to the patient's room, strip him down, clean him up and change his bed with him still in it. All that took me about 30 mins, because he was very dirty.
Okay...so now I have a pile of wet, shitty laundry with no bag to put it in and no idea where to to take it onced bagged. I know better than to leave it on the floor, I also know that it is against OSHA rules for me to walk down a hall with it unbagged. I might have made a dash for it, but I had no clue where to take it.
Obviously, it is time to call for reinforcements. I stand by the door for about five minutes waiting for a sympathetic soul to pass by. I can't ask one of the nurses because painting myself into a corner is something that the day shift will find hilarious. They would laugh and make fun of me after I left, probably for days. Finally a fellow student passes by and I flag her down, and she agrees to help me. (We end up covering each other's asses alot)
She finds a biohazard bag so I can bag the browned bedding, then after removing my gloves and washing my hands I find the soiled utility on my own. Total elapsed time 40 mins.
Okay, now it's panic time. I got most of my assessment info on patient #2 (lol punny) while I was cleaning him up so all I had to do was write it down and ask him a few questions. I've got like 9 mins to do that AND research all my meds. So of course the instructor shows up five mins early and asks me if I'm prepared to pass meds. Now I have two options, admit that I was too slow and look stupid, or get called out for not knowing the meds I'm trying to pass to a patient, and look stupider. I pick stupid and tell her I'm not ready yet. I manage to finish my med research by the time she is done with the other student on my floor but I still get graded down for bad prioritizing and poor time management. I knew my drugs though, and the floor nurses were happy with my work. I end up pulling a B for the day. And just remember, that was my day for TWO hours.. I have another six hours on the floor and I'm already physically and mentally pooped.
OMG how did this thing get so long? If you read this far.. you deserve a medal, because I probably would have stopped reading about the time the story started talking about poo. SUCKER!!!!
