Had a terrible night at work last night.
My patients were all high acuity patients. It was a night full tubes, drains, fall risks, confusion, decubitus ulcer, vascular wounds, PICC lines, central lines, shunts, stents, pacers, OG tubes, family conflicts, blood transfusions, fresh post ops, spina bifida, and sadness. In addition to the loads of problems the fact that nearly all of my patients required constant attention and management made for a very busy, and emotionally trying evening.
I had a 21 year old spina bifida, dialysis dependent, dead leg, total dependent who didn’t care is she lived or died. Also, a 41 year old who lost over 300lbs after a gastric bypass (years ago) along with his entire stomach and now was vomiting up toilet bowels full of blood. Even after all that, he said he’d do the bypass again, because he said he thinks he would be dead without it. An 87 year old who was begging me to take her OG tube out. A 41 year old whose leg cellulitus was so bad it looked like someone had cooked it an over and was so confused she was playing in her own feces. And one 83 year old fresh post op from an exploratory lap.
My my admission, the post op, was my easiest patient.
The patient who would have usually took the most time, energy, and effort. The patient who I should have been able to spend the most time with, was the one I spent the least with. I am thankful that she had a wonderful family who were both very helpful and understanding. I am thankful that she was strong, and had a wonderful first night.
The rest of my patients required so many interventions, help, pain management, nausea management, emotional support, education, cleaning, changing, dressing, ext, that I was unable to chart the first note until 0700. I didn’t even begin to check my charts until 0600, in a mad rush to beat the doctors to them.
It took hours to chart. I didn’t leave until 9:30am, and I can only hope I charted everything I should have. I am honestly not 100% sure, and I hate that. But I can honestly say that I did my very best, I took good care of my patients, and I honestly fell I made at least some small difference in a few of their lives.
My biggest success story of the evening including removing an OG tube from a patient who told her family and doctor that she was ready to go to her `eternal home and see her mother. The patient thanked me. Smile at me, and had a very restful night. IT was a lot of hard work, a family conflict, and a very compassionate doctor who took time away from his busy evenings to discuss end of life decisions, DNR/DNI with the patient and her family.
There were many moments yesterday that I cried with my patients. I did my best to be supportive, but I couldn’t help but feel their pain, their stress, their despair.
I did my best to care for them in a way that delivered them the dignity and respect that they often did not receive. I cared for them as the physicians ordered and as they requested. I kept their pain manageable and their linens clean. I obtained all of the information requested of me and the patients to the best of my abilities. I really just hope I documented well enough to prove it.
It will probably never be something I even have to see or worry about again. But every day I put my license, my livelihood, and my families safety and prosperity on the line. Nights like last night cause me stress because even though I know I cared for my patients the best I could, I am not sure if the chart would prove that when it was all said it did because I did not have the time to chart things as they were done.
5 more minutes till I leave for work. Its raining outside. I work with a wonderful ground of very supportive women who I know are there for me and are always very helpful, as were helpful last night as well. Tonight will be a better night. My patients will be better. My charting will be better. My day will be shorter.
It has to be!
I know just what you mean…sorta. I am an EMT. Although we get into this type of profession in order to help people, we spend more of our time and energy on paperwork and worrying about the idea that "if it isn't in writing, we didn't do it." What makes it more difficult is when we have on call right after another…after another…and we are trying to do a report from 6 hours ago. I am sure you did fine and even though we always have to cover our asses, it is good that YOUR patients weren't neglected just so you could get your paperwork done. Too many people put paperwork before patients' needs! Hang in there! Hope today is better for you!!
WOW!!! I just hope that if I ever need it there will be a blessed soul like yours to be there for me!! I hope you have a much calmer night and just remember “You do what you can and it is alot!! ” I thank you on behalf of everyone!!!!!