Work has been crazy lately, Very busy, lots of patients. The administration has combined the Units so we have Rehab patients, Suicidal patients and the elderly all on one unit! I will work that unit as well as the psychotic unit. I have been running back and forth taking care of both units at the same time. Our administration is also trying to cut down on staff so there will only be 4 of us for 20 patients until 10:30pm and then they are sending somebody home every night, so it leaves us to 3 staff for the rest of the night. I think most people think of a night shift as sitting around doing nothing bored all night, but it is actually the opposite. I don’t sit down for hours, I am literally running around doing multiple tasks at once, until about 4:00am. Last night went as such, I got everyone in bed except for 1 patient, turned down the hallway lights, and then had a patient in the hallway who is extremely confused. She was sitting in the middle of the hallway in a chair with papers that she was “reading” but they were all crumbled and ripped up. My co-worker and I had to drag her in the chair to her room because she refused to get up and walk. Once we got her in her room it was another 20 minutes until we got her to change her diaper, mostly because everytime we tried to help her she would hit us. All the while I had to go do my rounds every minutes, attend to any patients who would come out asking a question, ” Can I have something to help me sleep?” Is the most common question, even though it is only 11:00pm and they haven’t even tried to go to sleep. Once we got the ” hitter” to bed now it is time to get the Round sheets ready for after midnight, file a pile of paperwork, log the vitals into the charts, do chart audits, do about 6-10 loads of laundry, stock the cabinets, take out the garbage, redo the white board, make the paperwork for the next day, empty the linen bags, log the fridge temps, set out the lab work for the morning clean the day room…. These are all of the nightly duties that will have to be done no matter what. I am doing all of these things after the patients are in bed and the first 4 hours of chaos are over and this does not include the patients that could potentially be awake during the next 8 hours becoming agitated, yelling, being psychotic or just asking for meds because they are in pain or cant sleep. Multi-tasking in this job is extremely vital as you can see. You are always doing at least three things at once. I am always answering a question, giving advice, giving patient care, answering a phone, calming someone down and doing paperwork all at once.
Aside from all of this, the next thing that adds to all of this is getting admissions. We can get 0 admits in a night, or we could get 8 in a night. We just never know. An average night would be about 3. An admit basically just puts us back in all of our duties and adds more stress. Once the admit gets to us two of us take the patient to the exam room, we ask them to take off all of their clothes, we give them a gown to put on and we look at all of their body to document anything on them, scars, bruises, cuts ext. We then give them back only what they can take onto the unit. They cannot have a lot of things. Once they get back to the unit we take them to their room ( which we had to make right before) and then give them their hygiene bucket. Once they are given some meds and are asleep we have to put together their chart ( everything is paper, nothing is computerized) which adds a lot of time, energy and work to our jobs. While someone is putting together the chart someone else has to go through all of the patients belongings and document every single item. If they have anything of value, phone, money, wallet ext.. we put in the safe and then everything else goes to our storage unit.
The stressful part of all of this is not knowing and not being able to control how the patient will be when they get there. We get a basic breakdown from the ER or Police before they come in, Ex: ” They were found wandering around on the highway confused.” or “They became aggressive at home threatening to kill their mom.” But this doesn’t always mean they will be aggressive or psychotic once they get to us. Sometimes they come in completely calm and cooperative and others time they come in yelling, confused, psychotic and uncooperative. We just never know. Some admits can take 20 minutes, others can take 2 hours. This is what makes our job so unpredictable. We never know what kind of night we are going to have which makes it interesting for sure. And somehow no matter how easy or how stressful and busy it is we always manage to get all of our work done. It just shows how adaptable humans are, we can adapt to anything if we have to. And something I have learned and become good at is not taking my stress or irritation or anxiety out on the other patients. Even if it is crazy and someone is going off on me I can walk away and tend to another patients needs as if the craziness behind is not even going on. It really has been such a great growing experience and I am so grateful for it. It really does bring excitement to my life and at the same time I get to fulfill my love for taking care of others.