something exquisite

not my night last night

so it began bad with five patients already at the start of shift and progressively got worse as i had:

• a hepatic encephalopathy pt who kept trying to get out of bed and was also a diabetic whose blood sugars stayed in the 400s all night even after multiple doses of insulin 
• my first rapid response because my other pt desaturated to 77% on 4 liters oxygen and only went up to 84% on 15 liters non-rebreather. the pt was fluid overloaded and even after two doses of lasix, lungs were still fluid filled. the pt ended up needing BiPAP and transfer to the step down ICU (in retrospect, the restlessness and anxiety had to do with the hypoxemia and not just the pt’s psych history). (and note to self, a rapid response/code blue is not the time to get emotional)
• an admission right after my transfer
• three lost kardexs 10 minutes before shift change which i had to redo as i was giving report

my co-worker asked me yesterday to switch and work her wednesday while she worked tonight for me and i am so glad it got approved because i did not want to be back at that place tonight. 

i’m going to have a nice quiet night in watching tv and eating junk food and try to forget this is what i do for a living.