In a hospital, patients are classified as medical or surgical. Each discipline has it’s ups and down regarding nursing care but the general rule is this: with a surgical patient many little things often go wrong. With medical patients, things rarely go wrong but when they do, my God they really, really do.

Today I spent my day keeping track of 37 medical patients, of course with my team. The day started out smoothly. Until 10am. That’s when it all came crashing down.

10.05am: doctor finds one of my patients in fast AF. Now when that happens, you have got to act FAST because the patient can arrest and you end up with a CPR. My back ground is mainly surgical, this rarely to never happens so at first my mind drew a blank. But then it’s funny how your nursing school days flash before your eyes and you all of a sudden remember: hey, I actually do have clinical knowledge, I’m not just a glorified pooper-scooper. With aggressive and immediate treatment the situation was soon resolved and the patient regained sinus rhythm. Cue tremendous sigh of relief: ahhhhhhhhhhhhhhhhh.

10.30am: the lab phones because a patient was found with a very high potassium level in his blood. Doctors need to be notified because this could mean renal failure and a cardiac arrest and treatment needs to start IMMEDIATELY.

10.45am: a patient who was somewhat lucid all day long had a psychotic break. She started running all over the ward screaming and calling all the nurses crazy. Anyone who tried to get near her was getting whacked in the face with her cane. I was terrified she would harm herself and others. Somehow, I managed to calm her down by bringing a chair near the nursing station and telling her that we were going to have a little tea party and a chat. It seemed to do the trick, because she sat there quietly, sipping tea under my watchful eye. None of her sedatives seemed to be working, or else they were taking very long to kick in. Calming her down took about 2 hours.

12.45pm: some nurse drama- a nurse and a carer were having a shouting match. Thank god it wasn’t visiting time. I had to separate the two and listen to them individually. Turns out, they both had a point and with some cajoling they both patched things up. This is to be expected. The average ward has 25 patients. We had 37. It’s a high stress situation. And none of them were easy patients, they were all highly acute cases. Getting angry and irritated with the slightest error comes with the package. You start to see everyone as a waste of space. Well, this isn’t carebear land, it’s a hospital, a different world entirely. A dystopia if you wish. I have become an expert at conflict resolution. My main motto is, you do not have to be best buds, but you do have to work together. As peacefully as possible. Please.

14.00: this telephone conversation:
Patient (who was discharged a week ago): nurse, I received an appointment card saying my appointment is next week.
Me: yes, very good…
Patient: but I already had an appointment for next month.
Me: if it’s with the same doctor, then they decided they needed you to come in sooner. You can ask if you will still need the other appointment when you come face to face with the doctor.
Patient: no way! I am keeping both.
Me: but you may not need both….
Patient: hospital is paid by my taxes, and if I am entitled to two appointments, I will take them!
*hangs up angrily*

Okey dokey……

15.45: visiting hour. Every relative under the sun wants an explanation about something or other. No problem. What really gets me seething is when I catch relatives asking different nurses the same question to see if they will get a more desirable answer. Since most relatives understand jack shit about medicine, they then come to me to complain that different nurses told them different things and that we are ‘not even capable of agreeing amongst ourselves on patient care.’ (the rude fucks). So I call both nurses involved and realise that they both basically said the same thing but in different terms. Cue exasperated sigh: fffffffffffffffffffffuuuuuuuuffffffffffff

16.30: a colleague runs frantically towards my person.
Always a bad sign.

‘CPR! CPR!’
Oh shit oh shit oh shit oh shit.
I am fully up to date with my CPR training. But CPR on a mannequin and CPR on a frail old person are rather different, while doctors are yelling out orders and the general noise and commotion. Monitors bleeping, pagers going off, phones ringing. And all during visiting hours. People were EVERYWHERE. Doctors, nurses, ECG technician, CPR team, anaesthetists, the priest, carers. And of course, relatives, because it was visiting time. And then security personnel to get rid of the relatives.
Through some miracle of God, after about 10 compressions the guy got a pulse. Sweet Jesus. As I was getting the emergency drugs drawn up, I smell something weird….

16.40: …..something in the pantry caught fire. Yes, seriously. Because when it rains, it pours. Even more noise ensued due to fire alarms and more personnel to deal with it.

17.15: since we got a pulse and the patient was not in the best state, he needed to be transferred to a more intensive care ward. Because everyone was terrified that it would happen again, this patient was escorted by me, another nurse, a doctor and a carer. Which meant personnel absent from my ward. But no worries, this was more important. During transportation, the patient all of a sudden went quiet and I panicked and shouted ‘hello! HELLO!’ and the poor dear muttered ‘don’t shout, I’m just tired…for God’s sake, I almost died!’

While walking back to my ward, pushing the empty stretcher that my aged friend had previously occupied, I suddenly felt exhausted. The grave realisation washed over me. We stopped someone from dying. Which although is pretty damn amazing, it’s also pretty damn terrifying.

18.30: finally my shift is over.

When I see my day tabulated here, I can not help but think: it is all a little too much. But then I also think, I did it. Correction, WE did it, because I am nothing without my team. And when push comes to shove, no matter the drama, anger and exhaustion, we all come together when it counts.

Was it a day from hell? Well, yes. But my goodness, I never could believe I could learn so much in one 12hr shift. Fast AF, hyperkalaemia, cardio-pulmonary resuscitation, conflict resolution, human nature…
Oh. And fire fighting.
It’s a full life.
And an incredibly special one.

And here is a picture of an incredibly full and special salad which I then made for dinner. Each and every bite tastes different, due to the different ingredients and flavour combinations.
Kind of like each 12hr shift.

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Until next time, everybody.

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