The past two nights at work were pretty intense. Saturday night started off rough due to the fact that I’d been awake since 4am already, but we all had a feeling it was going to be a brutal one. Our EPIC system (which is what we do our charting on) was scheduled to be down from 1am until 5am. Anytime, and I seriously mean anytime, EPIC is down, something goes wrong.
A girl I work with was recently in a motorcycle accident with her boyfriend. They were doing a drive to raise money for Breast Cancer and when her boyfriend hit the front breaks, he did it too hard. My friend got away with three fractured bones on the side of her face, some pretty bad scrapes and bruises, and a concussion. Her boyfriend, on the other hand, ended up in critical condition and placed on a medical coma. He died Saturday night around 8:30pm.
At 1am, we were informed that one of my patients needed to be transferred to another unit so they could keep a closer eye on him. His INR was high, which means his blood was too thin. While the charge nurse and I were waiting to get back on the elevator after bringing him to special care at two, we received a phone call that there was a rapid response called on a patient on our unit.
We rushed back to the unit and ran to the room as soon as we got off the elevator. Nothing could prepare me for the scene I’d walked in on. She’d been found spitting up blood – no one knows where from – and it was inhibiting her breathing. If you’ve ever seen The Walking Dead, you can imagine what we walked in on.
At 530am we had to call the help desk because EPIC still hadn’t come back up yet. There had been some issues with the updates and by the time we left at 730, the system still wasn’t up. I definitely can say I do not like paper charting.
At change of shift last night, we had a behavioral disturbance and had to get security to the unit to deal with the patient who had gotten increasingly agitated. He was redirected and was fine the rest of the night.
Around one, the charge nurse told me “I’m not holding my breath about tonight just yet. This is around the time shit hit the fan last night.” She was right.
At three this morning, one of the other CNAs came into the charting room where I was sitting. He asked me if a patient was mine and when I told him he was, he informed me a rapid response had been called on him. I ran to the room. This particular patient was in respiratory failure and I could hear him gasping for air, saying he couldn’t breathe, and he was clearly in a lot of pain.
At seven, which is change of shift, I was informed I needed an updated weight on a patient because of a certain mediation she would be getting. I wasn’t too pleased, as she’s bedridden and it would take at least half an hour to convince her, get all 15+ pillows off her bed, put a pad under her, lift her with a machine to get her weight, place her back in bed and get her comfortable again. Not to mention I’d just re-positioned her half an hour earlier and her pain level was maxed out.
Nonetheless, at 730 (when it was time for the night shift to leave) I went with one of the day shift CNAs to get the weight done. After we’d gotten her back in bed, the CNA went to put the weight into the computer while I replaced pillows and noticed there was a 20kg (48 pound) weight gain in a week. There was no way that was possible, and even though the bed hadn’t been zero’d we decided to check there. Since it came up as exactly the same weight, we knew it wasn’t accurate. Because of the meds she’d be getting, having an inaccurate weight would be dangerous.
I spoke with my boss, (it was now 750, 20 minutes past the time I was supposed to have gone home) and came up with a plan: we’d get her back up using the ceiling lift, zero her bed and reweigh her. After reassuring my boss that I didn’t mind staying late to take care of it because the day CNAs had enough to do already, I did this with the nurse who’d be administering the medication and the result was 20 pounds less than the other weight we’d gotten. It still equaled to a 28 pound weight gain, but it was more accurate and I felt better about it.
I finally left work at 815 and got home about 845 (the latest I’ve ever gotten home from work when I don’t have a meeting). Being a CNA is a tough job, but I love it. As scary as it is, I want to be a trauma nurse someday. Participating in these code situations has definitely helped me prepare.