It was that time again, as the day shift filed out of the report room. Offgoing night nurse Linda Licencee groaned as she anxiously scanned the faces to see who would be her relief. Sure enough, it was her, as experienced, middle aged, day shift nurse Angry Amy took a seat beside her, and began rifling through her bag for her pre-printed report sheets. Pushing back her nurses cap, a grunt signaled that Linda could begin her report.
“So, here we have Mr. Tobago, a forty-five year old patient of neurosurgery, admitted here last night with a subdural hematoma he contracted while- “
“WHAT!!!!! THEY KNOW BETTER THAN TO ADMIT ON THIS FLOOR@@!!!!!”, Amy interrupted vociferously, almost spitting the words at her stethoscope on the desk in front of her. “Did you call Dr. Wu and tell him he’s out of his mind trying to admit a case like that??” Amy asked, making eye contact for the first time since entering the unit.
“Well, no, I didn’t actually know that we didn’t accept those patients, and I have been titrating Cardene since the ED- “
“Did you say Cardene!!?? According to the lastest RIM project, we have decided to go to Nipride, titrated using manual BP’s, taken every three minutes, since the hurricane in Puerto Rico cause a nationwide shortage of medication. You should have known that and gotten that ordered,” Amy instructed, extending an index finger while punctuating her point.
“Ok, well, I didn’t, but we were able to get his BP under control, after a couple hours, before intubating my second patient-“
“When was his last BM??” Amy interjected again, pen hovering over the BM box on her pre-printed report sheet.
“I have no idea, but the repeat CT showed…”
Linda paused before delivering the repeat CT results, because she thought she heard Amy muttering something about “new grads and their fads”
“That the bleed is stable, and may have even shrunk a little, from 5.5 to 5.2 cm.”
After a long, pause, Amy asked, “What time did you do his bath?”
After deliberation, Linda decided to take a different tack: “Due to the fact that his nursing diagnosis including risk for hemorrhaging his soul out through the top of his head, as evidenced by a bald spot, in conjunction with his medical diagnosis of SDH, I opted to defer his bath until tomorrow, as per NANDA guidelines.” “That, combined with the fact that he’s forty five, and showered yesterday.”
After delivering the response, Linda held her breath to see if she would be any closer to going home.
After a long pause, a scholarly smile crept over Amys face. “I see you read your care plans, good girl!” She said, before getting up to go make herself a decaf cup of Keurig.
