survival mode

there are nights for "extras" and then there are nights when the goal is pure survival.  you and me.  alive.  until shift change.  tonight was a survival kind of evening.  the kind of night where i gave report and had no idea what was even wrong with my patients.  phrases like "right arm...broke i guess...well at least all wrapped up...whatever" and "rib fractures i think...or maybe not...moving on" came flowing from my mouth.  2100 meds were almost two hours late.  no one got out of bed.  repositioning?  i wish.  I&Os checked?  not.  vitals?  hope they were ok.  pure.  survival.  

i ran all night, literally all night.  up and down the halls, assess one, two, three, four and pass meds.  chart.  then i picked up a fifth.  then i tied down a crazy lady who unscrewed her IV so blood poured out of the tubing.  for a little while, everyone was on the bedpan.  turn on, turn off, wipe, repeat.  i heard calls for help down the front hall, so i went on a mission and discovered a patient with a belly full of drains and a bed full of poop (my favorite...not.).   i answered a desperate call for help and almost got my wrist snapped in half by a trached brain injured patient who was hellbent on face planting on the floor.  after we put him in 4 point restraints, i ran to change the chest tube dressing on an accused child molester who tried to kill himself three different ways and yet is still alive.  i confiscated his metal fork (contraband!) and ran off to finish (read: start) passing night meds.  flush rectal tube...reposition...nighttime insulin...bed change...pain meds, pain meds, more pain meds...boost...linens...crush pills, mix in applesauce, is she aspirating?  my bet is on no...turn, clean, try to scrape old cream off butt...try to figure out which tube of 6 creams at bedside goes back on butt, can't figure it out and give up...gown up for isolation, then run into other isolation room ungowned because patient is halfway out of bed.  run.  run.  run again.  bedside VAC change at 2330, stick finger in patient's belly to see how deep the wound tunneling is and it goes all the way in.  patient across hall is yelling for help again, then the phone is ringing and no one will answer it, so i do.  oh, another admission?  great.  then chart, chart, chart...punch out so overtime will not be used against me at eval time and continue to chart.  drive home, and think about closing eyes in the car.  contemplate being a patient, and force eyes open.  

brain=mush.  patients=alive.  therefore, tonight=success.