Hot Mess City, population: YOU?

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Ever have One of Those Days? Sure you have. There’s nothing like a previously stable patient suddenly seizing, getting a huge mucus plug or taching up to the 130s to make you wish you could be in three places at once.

What turns a busy day into a bad day, though? I asked around at work and got plenty of answers. Here are some of the best:

“When a patient comes back from a day surgery intubated and with eight drips.”

“When anesthesia pulls its anesthesia-thing and leaves all your lines in knots, your patient too cold and the wrong pressor hanging. And then doesn’t give you report.”

“Dementia plus diarrhea plus anxious family members.”

“A fresh post-op hitting the floor when all the bedrails are up.”

All of these scenarios have one thing in common: a total lack of control over the situation. Nurses are control freaks; “go with the flow” is not a phrase we recognize. When control goes out the window, a manageable-but-nuts day turns into The Worst Day Ever.

After 10 years, I’ve learned a few things. One of them is how to keep from completely losing it when a day turns Officially Bad. This one thing has three parts.

First, you have to ask for help. No matter how bad-ass your reputation is, it’s not worth preserving at the expense of safety or sanity. Delegate, scream for help, beg, whatever it takes. People will generally help if you ask them, and it’s worth the hit to your pride.

Second, double-check everything. There’s nothing worse than discovering you charted that code on the wrong patient. (Yes, I’ve done that.) Have somebody else check your drips, your insulin, your meds, your vitals. Get another set of eyes on everything. Two heads really are better than one during a crazy shift.

Finally, decide what you have to do to get out of the building at a reasonable time. Mostly this involves catching up on charting. In that case, don’t allow yourself to be distracted by cleaning up wreckage after your official shift ends. Do what you can do, then go home. This is a 24-hour job and we all have bad days. The coworker who helps you out today will need help next week, so it’ll all even out

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