Wednesday, November 29, 2006

It's 5, all hell must be breaking loose.

I will probably never know why, but at 5 o' clock all hell breaks loose. Suddenly patients IV's all infiltrate, and when asked if it has been bothering them, look down at their stay-puft marshmallow arm dumbly, and say, "yeah, it has been hurting for a while." Which of course infuriates every nurse, or at least me, because they have been keeping their arm under the blanket the whole day because it is cold in the room and refuse to let the nurse, or anyone else for that matter, turn up the heat in their room.
Suddenly at 5 o'clock any NG tube will miraculously disolve any tape adhesives and slip directly out of their respective nose and land on the floor, still sucking away. Of course, this patient will not let the nurse know because they are reveling in the fact that they don't have a tube hanging out of their nose.
If anyone had even an inkling of coding, their breathing will most definately become suddenly very labored, and will quit, or somehow their heart will decide to try out a new rhythm right at the stroke of 5. Maybe V-fib would be more exciting! Everyone loves a 5 o' clock code!
Anyone who has not told anyone they are nauseated will vomit at 5, and it will, of course be all over the bed, which will require ALL the linens to be changed. Then they will say they feel fine, and no they don't want to take anything for the nausea, because the nausea is gone now. Once the linens are changed, and we have all sat down to give report, they will promptly vomit again, missing the basin, again.
At 5 o' clock, people who have not had a fever all day, will suddenly spike a fever, requiring blood cultures to be drawn from every central line lumen, as well as requiring a peripheral "stick," which whoever tries will be completely unsuccessful, regardless of skill. Or we will be out of blood culture tubes. Or the line will rebelliously decide not to give any blood this time.
If there is an admit who you expected to arrive at 9:00 a.m. or so, he or she will be sure to not show up until 5, right after you had breathed your sigh of relief for not having to get that admit. And the doctor will be sure to write a ton of STAT orders, but not until slightly after 6.
Today is one of those rare days that I can sit and write, and all my patients are actually quite wonderful. I jump up to switch one bag of FFP (fresh frozen plasma) to another, and sit down again after I have washed my hands for the thousandth time today. My patients are nicely grouped in rooms along the wall I face: 357, 359, 360. Nice. It is a great day. Of course, at 6, my admit has not shown up, and I've got my fingers crossed that he or she won't. One hour to go. Then comes report....

(P.S. Mom- I tried the spell check. I think I spelled everything right, or else it is not working. ;-) )