Monday, October 26, 2009

A tiring day

My job runs the gamut from stultifyingly boring (very rare) to excruciatingly tense (way less rare.) I way prefer the latter. It is rewarding to recognize an impending crisis, and avert it before it happens, or deal with it before it becomes a disaster. This is gratifying in many ways. The most obvious is that one has saved someone’s life or limb. And then, there is the yummy adrenalin. One can become addicted to it. And there is the interaction with the many disciplines all working together to solve a sometimes critical problem. It is wonderful. On a less exciting, but still rewarding level, one just makes life easier for one’s patients, supports them in their concerns, pains, infections, etc., advocates for them with the sometimes less than congenial medical bureaucracy.
And then there are evenings with uninspiring little mini-crises, one after another, that just take time to deal with. Last evening when I arrived, I got report and found that I had four patients who were “due to void” at times not too distant. Great! My heart sank. I knew this would be a lousy evening. Lots of work with a real problem that sounded so plebeian to everyone except the person with the too full bladder which they were unable to empty. The first two patients had no problem going potty. The problem was getting them to the potty as frequently as they then wanted to be there. They were both hefty and had joint replacements. Plus, the aide I had this evening was from another unit and not one of the wonders we have on our unit’s staff. She was no ball of fire, and I ended up doing a lot of her work myself, which seemed easier than chasing her down. Our usual crew get everything done before one even thinks to ask them. They are a component of Nurse Heaven.
One patient just could not go, and I kept asking the physician if I should put a catheter in as she had not urinated in a loooooong time. The doctor kept saying “Let’s just wait.” We waited until it was nearly time for me to go home. I pointed out that the patient hadn’t urinated for nearly twelve hours and had almost a liter of fluid in her bladder. Great! Just when I am finally nearly ready to go. For some reason, placing a urinary catheter is something that all nursing students are eager to do and are thrilled if they get the opportunity. The summer when I was a senior nursing student, the nurses on my unit let me put in every one that needed to be done. I thought they were so generous and kind. Little did I know. This is a task that very quickly loses its charm!
There were other uninteresting problems ( which required one or more calls to the physician) with every single patient. I had no breaks and got out an hour and a half late. I was so knackered that I slept for over ten hours, and then this morning, just sat around stupefied for several more. I did finish the NYT Sunday crossword, and that was gratifying, but then I considered the time I had wasted on it (it took me quite a while as it was a hardie) and felt ungratified. Now it is dinner time and I am just coming to full consciousness. What a life! (Don’t get me wrong—I love it and wouldn’t trade with anyone!)

And the relevance of these pictures? One is fluid based, as was my evening, and the other is the cuddly thing that snuggled and comforted me when I finally got home.


Samos said...

One of the great benefits to working in ICU is not having to get people up out of bed to pee... If a doctor asks for a catheter to be taken out I say "sure, just right the transfer orders and I'll do it right after I've given them my report!" I remember that as being the greatest agony of ortho...

Barb said...

Having just gotten out of the hospital where I sat with Coop for days, I have a whole new appreciation for the hospital nurses. Coop also could NOT void that first day but a catheter for a man is nothing remotely fun. We were lucky that the staff let us let nature (finally) take its course. I am writing a letter to the hospital about the fantastic nurse we had on the first day and second day. I hope one of your patients does the same for you!