Dehydrated: 12 hours of Hell

Had a lovely shift recently.

25 patients to one Nurse.  That Nurse was me.  My only help was an agency carer with no experience who could not do any lifting due to a back problem. Yeah. WTF.  I complained to the supervisor of the hospital.  When he informed me of the even worse staffing situation on other wards (worse!) I realised I was in for a long shift.  This was the staffing for 12 hours. For the last hour I was alone. And compared to other wards I was damn lucky I only had 25 beds and less overall acuity.

Two cardiac arrests.  Mostly down to failure to rescue.   I caught the first one as he was deteriorating just by luck I had a gut feeling to check in on him again. Now he wasn't talking.  I fast paged the senior medics.  I didn't think he would arrest quite yet but I like to prepare for the worst.   I was alone with an agency carer with no experience.  When I realised we might have an arrest I told the carer that we might and asked him a few questions to prepare.

Me:  Do you know how to put the arrest call out?

Carer:  No.  What is that?

Me: "Do you know how to do CPR" ( I could run to the phone and put the arrest call out if he could start the cpr)

Carer: "No"

Me: "If I yell the word CRASH you run your ass to the phone and dial xxx. Then you say "Doe Ward".  You have 5 seconds to do it, don't fuck up.

Thank goodness the registrar was up there 30 seconds later, and then  the patient really really deteriorated.  I am so lucky I caught onto it when I did rather than just finding a corpse in that bed.  I only got a chance to check back in on him by abandoning the turns, toileting round, and leaving people covered in shit.  I just got a feeling in my gut and heard a little voice telling me to watch him. By the way,why does the 85 plus crowd play in poo and facepaint with it?  I guess if I ever see 85 I will find out.  It's not always the confused and dementia patients who do this either. 

Two people fell out of bed whilst I was dealing with the crash.   They were , of course, left on the floor. Thankfully they didn't get hurt.And another one arrested.  That one was an expected death but a DNAR was never signed so we needed to attempt resus.  It failed.  But the first guy ended up in ITU.

People were extremely dehydrated.  I didn't get a drink or a scrap of food for 12 hours either so I was empathetic.  But even so, I still couldn't get around to them all and do anything about it.  God help them, the oncoming shift staffing was terrible as well.  At least I can get home at the end of the day and have a coffee.

So many people do not get the drugs they need and are prescribed.  This was even the case on the shift preceding mine.  Either the drugs are not there or the patient has some kind of problem that we cannot work around in the way that we need to in order to give the drug.  It's not as if we say "oh yeah, I am just not going to bother with that".

 Rang switchboard after I handed over and demanded that the chief executive get called (at home if necessary) and ring me back immediately.  I was half out of my mind at this point.


 Do you think he called me?

Yeah right.

Day off today.  Mr. Militant Medical Nurse is doing the cooking and the cleaning and nursing the nurse.