Nursing with a Movement Disorder
Beka Serdans | NursingLink
0130 hours – I notice bloody urine coming from Patient #1. Wondering if her liver is failing, I decide to draw her blood and send her lab work off early. She will need more platelets – she is not clotting well.
0140 hours – A patient is dying at the other end of the unit. He’s only 20 years old. The family is living by the bedside. No matter how many times I’ve seen this drama unfold, it never gets any easier.
0210 hours – Now that all the “labs” (as we call them) and diagnostic tests are completed, Patient #2 (the 300-pound woman) raises my blood pressure to a nightly high. Her heart has gone into a lethal arrhythmia. Running into the room, I pound her on the chest, hoping beyond hope to get a normal rhythm to return. My neck is killing me. The precordial thump works. EKG and complete labs are ordered. Uh oh, her oxygen level has dropped again. Does she need even more Lasix?
0240 hours – As I’ve now become to feel quite possessive of Patient #1’s platelet activity, I feel like celebrating as her number goes up from seven to twenty-four! Just for good measure, the ENT guys order more platelets and some liver function tests. Her blood pressure has been stable. I finish my computerized charting entries. However, due to the dystonia, MY arms hurt from hanging bags of platelets on a barely unreachable ceiling pole. What do shorter nurses do?
0300 hours– The few of us on the unit tonight have been running, for what seems like, forever. I do not want to come back as a hamster. Forget ordering take-out dinners, forget about even eating the healthy snacks that some of us have packed. In between ringing bells and critical care nursing, we gulp down chips, soft drinks and the unhealthiest snacks imaginable. What if a dietitian happened to decide to spend the night here? We’d have to find her a bed.
0310 hours – The 20-year old patient dies. I feel sad. His parents were at the bedside. Morgue care is ordered.
0330 hours – “My” platelets are ready. I ask the Unit Clerk to pick them up as well as stop by the pharmacy for some newly ordered antibiotics. This is not a medical mercy mission to a third world country but you’d never know that. The pharmacist, right here in this very large, very busy NYC hospital decides to let us know in no uncertain terms (read: “venting”) that they don’t have the variety that was ordered. Am I in a new “Twilight Zone”? What kind of pharmacy is this?
0400 hours – Meanwhile back on the floor, patient turning is the next activity. What could be worse than trying to perform this task alone? Finding the bed and its surroundings soaked with diarrhea. This is a job for the true angels of nursing: Housekeeping. I clean the patient, giving her a back rub as well as a respiratory treatment. Before leaving the room, I do a platelet check.
0430 hours – Platelets are done. Will this shift ever end? Whatever could go wrong has already happened…I think. My feet hurt. Note to self (and other would-be nurses with dystonia: Clogs might as well be 3" heels …my feet turn inwards, my clogs do not)). A new ER admission arrives on the unit. So much for the lack of staff. The few of us left standing; all help the patient settle in. Do you think that any of us are contemplating “Nurses Week” in early May? No. We just want to sit down and go home.