dialysis headstands

i feel like i've been working a lot lately. and i think i've mentioned, i've taken on some new responsibilities. being in charge is one of them. i think nurses jobs are underestimated always. tv shows show doctors doing our jobs (seriously, what doctor even knows how to use a blood pressure cuff these days or walks a patient in the hallway). and they show nurses with bedpans. but they don't show us administering 39 different medications in a 12 hour shift. or hanging units of blood, chemotherapy, nutrition, antibiotics, hydration, and morphine all at the same time. even nurses underestimate their jobs sometimes - not realizing how important of a role we play and how much responsibility we have. but who even knows what a charge nurse does? or why s/he is important? let's just say, i didn't understand and i've been a nurse for almost 10 years.

so, this new role. it's hard. in a 12 hour shift, i have NO patients that i am directly responsible for. i don't administer medications or hang blood products. i am indirectly responsible for 21 patients AND my staff of 10 nurses. and i am the liaison for the attending, physicians, physicians assistants, nurse practitioners, nursing assistants, dietitians, pharmacists, the secretary. i sit at the front desk and help field phone calls and family members. i answer questions all day long and get interrupted during every task that i try to complete. when patients decompensate, i am the second set of hands. when new nurses have questions about how to safely care for patients, i have or find the answers. i direct nurses and physicians to our policies and procedures. i call other units to double check protocols. and i attend flow meetings throughout the day to help determine where patients in the hospital land. for instance, which oncology unit does a patient with breast cancer go to? not mine. solid organ cancers go to 7SE. if they're full, then maybe they go to 8SA. when they're full, perhaps they come to my unit. but not if i have a need for transplant patients to come and go. it's a juggling act. and i feel like i have to barter with other charge nurses and the flow supervisor not to give me every patient who is sitting in the ER. a hospital bed is a precious commodity, who knew!

but, one of the most important roles as charge is to assist in emergent situations. to respond to code lights. so when i heard the frantic code bell at shift change on monday night, my heart started racing. i knew the patient was getting dialysis - which means he was hooked up to a machine that filters his blood. two lines connect the patient - one taking all of the "dirty" blood out of his body, and the other returning the cleansed blood back. being disconnected from these lines accidentally is a potentially fatal disaster. and is just one of the risks of needing dialysis. hence, imagine my shock when i found the patient on his head with his feet in the air... almost like a yogi headstand. it will go down as one of the weirdest things i have ever seen. the dialysis nurse was crazed, trying to protect her lines from being disconnected and exsanguinating our patient. and within a minute or two, we had at least 20 people and 40 hands trying to assist us. the patient had felt chest pressure during his dialysis run and as he sat up to cough, he must have passed out and coughed himself onto the floor. somehow, his 6 foot 5 inch body twirled, ever so gracefully i am sure, onto the floor landing on his head with his feet in the air, almost resting on the bed.

thankfully what initially seemed like a disaster turned into just a good story. the patient was fine. his head scans showed no bleeding. he was disconnected from his dialysis machine with ease and without losing any blood. and his nurse survived to tell the tale. but let's just say, being in charge, i had no idea that this is how i might end my shifts - with patients attempting headstands.

namaste!