yuck...

This past weekend I got the call. Yup, the dreaded evil call to tell me where I could be working and this particular day they were sending me to the very pit of hell. That is right the wicked vile step-down unit where nurses go to die.

I woke up listened to my voice mail and as I heard the coordinator give the assignment a cold chill went up and down my spine and a sudden sickness came over me. It was not to be a glorious day.

I tried to tell myself, "it won't be that bad." I am pretty on top of things and I can go with the flow - famous last words.

So I go to work and get my assignment - not bad. The within an hour everything begins to unravel. I have three of five patients leaving the floor all at the same time. The techs are playing hide n seek (once again) so I am getting patients out of bed and to stretchers and verifying they can go without monitors. Finally the last one is gone.

Next comes the slew of residents as far as the eye can see and they are all chasing me down to as some stupid questions. One tries to explain that the patient has the wrong size cuff. I tell the pinhead I have been here two hours and have not made it to the room but would be happy to look into that at a more appropriate time. It was freaking nuts!

Then swoosh all my patients that had been off the floor come back within seconds of one another. Still cannot locate the tech, is one working? I go back help the patients back to bed, help set them up to eat. Two of the need to use the bedpan (hello where is the tech). In the next hour I manage to give meds to three patients and I still have not seen the other two on the other hall.

I finally escape the front hall, walk into room number four and the first thing from the patient's mouth is, "I need relief immediately". I am like - what? She goes on to tell me she has not had a bowel movement in 10 days (the prior nurse gave a more realistic time frame). She insisted that I "fetch the doctor" so this could be addressed at once. I explained the residents were rounding and promised it would be handled today, however, she felt this delicate issue should not be handled by a resident. It must be addressed my an attending. By this time I am so over this argument so I put her meds in front of her tell her to take them and I head out the door.

It is now very close to 11 am and I still have one more patient to see. However, her daughter found me first and she was CRAZED! It seems mama had been transferred to the step-down from the other step-down during the night via a stroke alert. Mama was found on midnight rounds with right sided paralysis and facial droop with very slurred speech. Mama walked into the hospital a few days earlier with minor rectal bleeding, history of chronic a-fib. So, they stop her coumadin and scope her up and down and find nothing - now this!

Anyway, the daughter was not informed of the big changes upon transfer. A resident did call her at night and explained a "minor change" but nothing for her to worry about. Well, the daughter disagreed with the MINOR change and proceeded to freak out right in front of me. So, for the next hour or so I tracked down this doctor and that doctor and had them come to the room to explain in greater detail to this worried dtr what the fuck was going on.

The daughter was also freaked out because now mother was incontinent and needed changing.

Let me tell you...over the next six hours I cleaned this woman 9 times and still no tech anywhere in site!

So at about 1400 I had had enough! I tracked down the charge and told her she either find the missing techs or she start turning, feeding and cleaning my patients because I was about to walk out the door.

Every once in a while it feels really good to throw down a girl-scout-hissy-fit! They didn't see it coming from me, but it was well overdue!

Waalaa missing tech arrives and looks as if she just woke up. She tells me she has been in the patient's room who I have cleaned 9 times. So I bring her into the room and ask the daughter and patient if they have ever seen this woman and both state they have not. Hmmmm.

So, I get the tech to change the patient and place a foley (praise baby jebus). Then, the gaggle of residents decide this stroke woman needs a slew of stat orders. I love how the little resident tracks me down to inform me that there are stat orders. I walk over to the chart, that is laying on the secretaries desk with a pink post-it saying "stat". I had to chuckle as there were no less that 12 charts piled at the desk and the secretary was out smoking, eating or sleeping - who knows?

I read through the orders and there are stat MRA/MRI orders. I attempt to call MRI and after multiple rings. I call radiology and am informed that MRIs don't happen on weekends. I explain this is stat and am told they do not care, they WILL NOT be performed on weekends. So, backup plan..the gaggle of residents order another stat CT to see how the stroke has progressed.

This time the patient will be leaving the floor monitored. I tell the monitor tech I need the patient taken on monitor to CT stat. He says, "I am going to lunch." WTF!!!
It is like 1630 the fat bastard has been on 5 breaks and been stuffing his face all fucking day and now when I need something the idiot is rushing off to lunch?? I track down the charge yet again and explain how this is unacceptable. She then helps me take the patient to CT and back.

Finally, after two enemas a few feeds and some iv starts the day is settling down and it is only 1800 just one more hour to go. I decided to dash down to the cafe to grab a soda since I have not had a lunch and I am sorta hungry and exhausted. I am in line and who do I see? The fat-assed monitor tech with more food. I could have punched him in his fat face!

I hate step-down! There is a reason I am a critical care nurse! I do not ever want to go back there again!!