I knew it was going to be a hysterical shift when I arrived to find the supervisor at the desk, frantically phoning for a replacement day nurse. Within minutes, the phone--which never seemed to stop--rang again. I was asked to take an ER report on an incoming patient. "I haven't even clocked in!" I protested mildly. Then the call lights started in again, and they never quit, all night long.
I caught the squeal on the new patient. Thanks be to God, ER had done the H&P, the off-going nurse stayed long enough to get the admitting assessment, and the patient was alert.
The rest of the night was a blur of blood vitals and on-the-fly computer charting. At 0600 I realized we had not had a single Code Brown. In fact, I had found three (THREE!) patients wearing clean undies. The one patient who did move the bowels made it to the appropriate porcelain receptacle without incident. For our unit, this was truly astonishing.
Three of them actually slept through much of the night, but wouldn't you know the other two made up for it in spades. IV Lasix at 2300 is not a thing designed to produce a good night's rest.
The other problem with alert patients is they are difficult to distract when you have to do something unpleasant. This morning's patient hates injections, which are ordered q12H, but she has that all worked out. When the needle begins to pinch, she sings "Mairzy Doats"...out loud! She was delighted when I sang along; my Grandmother was quite a fan of Mairzy Doats. I know all the words. End of Nasty Injection Time.
Don't you think we ought to adopt Mairzy Doats as the unit theme song?