Encountering the “crazies” while at work

One of the things that I love most about my job as a nurse is the unpredictability factor. Unlike an office job that holds a routine from 8am-5pm, each day that I come to work I know that I will be experiencing different patients, different families, and sometimes even different doctors. Even if I treat multiple patients with the same diagnosis, no two patient is ever the same. People cope with the stress of hospitalization differently, some patients can take a turn for the worse within minutes, and each family has their own belief system that can sometimes impact the nature of our care. My days can range from quiet and even slow with stable patients, to madness and chaos for an entire shift (we like to refer to the madness as organized chaos). One good thing about crazy days at the hospital? The shift flies by and before you have a chance to take a deep breath, it’s 7pm.
I’ve taken care of my fair share of “crazies”, as I’m sure we all have. Here are just a few of my more out of the ordinary days at work, the ones that keep you on your toes…

One day I was sitting out at the nurse’s station when a morbidly obese patient with Prader-Willi syndrome came barreling out of his room towards me. Thankfully there is a desk that acted as a barrier as he was leaning over and aggressively grabbing for stuff. He was not my patient that day so I was unaware that I had settled myself down to chart in a hot seat- right next to his breakfast tray that is delivered to the nurse’s station so they can check his blood sugars prior to meals. As the nurse was getting the Accucheck machine, the patient was anxiously waiting at the door of his room searching for his tray. When his grandmother scolded him for standing in the doorway, he lost his cool and his temper sent him into a rage. Before security arrived to the floor, he had successfully toppled over five desk computers and pulled three phones from their jacks. It took four strong security personnel to control the flailing, spitting, usually-gentle but easily-tipped-off giant and he was unfortunately given haldol and put in restraints until he settled down. None of the computers were badly damaged, and my nerves were easily reparable.

Another day as an innocent bystander walking down the hall of the unit, I heard yelling coming out of our corner room in the form of a man and woman’s voice. I entered the room to make sure everything was fine to see the mother standing in the doorway of the bathroom completely stark naked and her boyfriend yelling at her from across the room about some money that she owed him. I quickly grabbed a towel and tossed it to mom, demanding that she cover herself up and asked that they lower their voices. The worst part about the situation was the although the eight month old patient in the crib was oblivious to the argument, the two-year old daughter was hiding behind her mother in the bathroom, scared silly. After the yelling persisted and curse words were heard all the way down the hall, I realized that there was no sense in trying to convince them logically to pipe down. I coaxed the little girl out of the bathroom and distracted her in the hallway while I called security. Mom then emerged from the bathroom, naked again and nearly made it to the room door before she was stopped. I’m not quite sure where she thought she was going but my guess is that she wasn’t to make it far in the nude.

We had an admission arrive one day from home with reports of a broken pacemaker. He was an adorable pre-teenage boy that entered the floor with all smiles and a warm affect. As we were chit chatting about what grade he is in at school and medical history with mom, I noticed the alarms behind me for telemetry were going haywire since I had just hooked him up. I glanced back briefly as we kept chatting only to see his heart rate at 29. Yes, 29 beats per minute. I think he saw the panicked look on my face because he asked if everything was okay as he was just sitting there still smiling. I immediately checked for pulses, checked the telemetry leads again, and called for the cardiologist. He ended up going for a pacemaker revision early that next morning but could be seen walking about the unit with adequate perfusion and a pulse in the high 20s. I had to keep reciting, “look at the patient, look at the patient” to keep me from jumping him in the hall and starting CPR.

Although those stories are merely just skimming the surface of what I encounter on work on a somewhat regular basis, I am thankful for stories like these because like I said previously, it keeps me on my toes. Every new, out of the ordinary experience is an opportunity to learn, so the next time something goes haywire on the unit, I can be more and more prepared. Do you have your share of encountering the “crazies” while at work?