Worked today, usual chaos. My shift is usually 7a-7p, but then needed someone to stay an extra few hours because of a call-out and the only nurse who could come in couldn't come in until 9. I volunteered, since I'm off for 3 days and, to be honest, I'm usually there finishing up all of my documentation anyway.
6pm rolls around and the shit hits the fan -- which is to say, there was all the usual bullshit, but new, crazier bullshit heaped on top of that.
I had a patient, a homeless guy, cut his hand and let it go for a few days before coming to the hospital. It became infected, they had to cut out the abscessed portion, pack it and dress it. He's supposed to keep his arm elevated to reduce swelling, and is on scheduled antibiotics.
That is, of course, the least of his concerns. I basically played waitress for him all day -- "Can you get me a coffee, plenty of sugar?", "Can I get a cold beverage?" One of those patients that seems incapable of asking anyone else but the nurse for anything, just comes out to the nurses' station to ask you directly, regardless of whether the tech was just in the room ("Can you tie my gown?"). (To make matters worse, he has MRSA, so I have to gown up everytime I go in the room.)
So, 6pm rolls around, he is due for his IV antibiotics, which take 2 hours to infuse. I hook him up to the pump. 15-20 minutes later, he's asking if he can be disconnected so he can go off the floor to smoke. I try to explain to him that it's important that his antibiotics are given at the time they are ordered, because we have a protocol as for when we draw labs and monitor the levels of the meds in his bloodstream, to ensure he is getting the most effective dosage of medication. He just doesn't care, what's the big deal, he'll be gone for 15 minutes and then he'll be back. (My manager is sitting at the nurses' station at this time, and she also tried to explain to him.) I tell him finally that I need to call the doctor first so he's aware that when we do draw his labs, they won't be accurate.
I'm on the phone with the doc, and the guy starts getting agitated, yelling, saying he'll leave AMA if we don't let him go, goes to try to disconnect himself from the IV.
The doc comes up and basically gives into the demands of an overgrown toddler throwing a temper tantrum. Tells him he can go off the floor and get the meds when he's done. He starts to walk away and my manager actually says to him, "Are you kidding me? You're letting him stay? I'm tired of the patients running the floor -- you give them what they want, but you get to leave and don't have to deal with the patient all day."
It's just the usual bullshit of running a hotel/diner, where the patients can come and go as they please, nevermind the fact that they could be god-knows-where and we have to chase them down to give them their fucking meds and do our job.
Security had to be called because he was getting so unruly.
Then, less than an hour later, I've got another ordeal on my hands. One of my patients had a fall and has some lasting neuro effects -- he's expressively aphasic, so he has difficulty finding the right words and expressing what he wants to say. He's rather loud, says "NO" very loud and emphatically. He's another patient on isolation for MRSA, so they're ideally supposed to stay in their rooms (MRSA patients are cohorted, and we gown up and everything to decrease the risks of transmitting from one patient to the other, even if it's more so transferred via direct contact with some kind of fluid or whatever). It's of course peak time for me and I'm trying to get all my meds off to my 6 patients, so I try to keep redirecting him.
I'm in another patient's room and I hear our secretary call my name and tell me to look where my patient is -- he's sitting behind the desk of the nurse's station, trying to use one of our computers. I ask him to go back to his room, try to explain that we need patients to be in their rooms so we know where they are and can give them their meds, etc., etc.
Keeps wandering (the night before he apparently wandered and got on the elevator and they had to call security). Next time I catch him in the computer lab that the docs go to, again, trying to use the computer. I can't understand him, he's visibly frustrated. Again, I try to walk him back to his room, but he overshoots it and goes the other way.
Then things get ugly. Increasinly agitated, he basically tells me the "fuck off" -- not as well put together, but there was a clear "you" and a clear "fucking" directed very loudly and angrily towards me. He refuses to go to his room.
Call security again, and this time 3 guys come up. I have to get them to hold him down while I give him Haldol to calm him down.
This angered him. Fractured our relationship very much. I had to give him some insulin later, and THIS time, he tells me (again, very loudly, very pointedly -- think of the POTW in the House ep "Failure to Communicate," only louder, and he can't write stuff down):
"You. Need. Sex."
Then, under his breath, I'm fairly certain he called me a whore.
Hey, I won't argue with the first point. I don't know if he thinks I'm taking out my frustration on him, if I'm doing it all to attract the handsome security guards, if it's some sort of power thing -- who knows.
I just... ugh. This job. These people. I think I've had ONE day I can truly say went fairly well and I got out on time.
On top of it all, I had a shitty tech who can't be bothered to do her fucking job, and management does nothing about it -- we get the standard line, "Well, ultimately, it's the nurse's responsibility to [insert task/function here]." Like no one gives a fuck that we're doing everyone's job.
Other than that, I've been sick lately. I went to the ER 5 times between 9/2 and 10/15(ish) for severe abdominal pain, nausea and vomiting, and everytime I walked out with a different diagnosis. In the process, they found a endometrial polyp, which is more commonly found in women over the ages of 30-40. My GYN recommended I have a D&C, but, I got some recommendations at work for a different doc that deals strictly with GYN-related surgery, and is actually like an in-vetro practice. It's something that, if not done carefully, could result in scarring, or not getting the whole thing and having to have subsequent procedures, and all of that could also effect my fertility. I already missed a lot of work dealing with the gastritis thing, so it's going to be something I have to try to squeeze in and schedule creatively.
I'm just so over everything. This job. People.
To make up for all of the complaining, I will say that I do truly love the nurses on my floor. There's really not a single nurse who isn't willing to help if it's needed, and that's really valuable as a new(er) nurse. Particularly when all through nursing school, they keep repeating the whole "Nurses eat their young" theory.