So my patients blood pressure is 70/40 and she's screaming in pain. Welcome to work. I pop a second IV in her get ready to start her blood. We need some volume resuscitation people. She lost a lot of blood in OR and the recovery room thought she'd be a good candidate to put back on the floor with us unintelligent "floor nurses." I'll show them.
I get the blood going. Pushing in fluids wide open in my other IV. Oh guess what? Her body decides to react to the blood. Stop the blood. Push more fluids. Call doc. Verbal throwing up into the phone with doc, telling of all things gone wrong, but with class, I might add. We order labs, more fluids, and no more pain meds for screaming in pain patient. Oh this will be fun.
Take a deep breath. Drink a little water myself, before someone has to pick my crumpled body off the floor. Take another blood pressure. No change. Take a deep breath. This patient is handling her low blood pressure quite well, amidst the cries of pain. This IV benedryl will help. She'll just go to sleep. It's for the blood reaction, I'm not just pushing it to make her go to sleep, that is just an added benefit. :)
Three hours later, doc okays me to restart blood based on patients lab levels. Great. I have an hour to push as much blood into her as I can. Blood is only good for 4 hrs before it goes bad per policy. I get about 100cc in trying to be safe with previous reaction. Patient does fine.
Start a second unit. Blood pressure is improving, but not enough for her to get any pain meds. 80's/40's isn't that good. The pain meds have a tendency to drop blood pressure, thought you might want to know that. Finish 2nd unit of blood, patient seems to be perking up. Chat a little with sweet little patient. Apologize for not letting her get any sleep tonight. Oh and now we're going to take your drains out and cause you more unrelenting pain. Pretty sure I'm satan. Sweet patient probably thought she was in hell. Cause sweet patient so much pain her blood pressure actually comes up enough to give pain meds. yes!
Pain meds given. Patient resting better. More stable. Check in on other four patients. Make sure my student met their needs and prep a couple of patients for surgery. Pass some meds to other patients. Oh guess what, it's time to report off to next shift. Must be morning.
Did I eat lunch?