As I related in a previous post (here), room #66 and I have a storied history. Some of it good, some of it bad. I finally figured out the mojo that was haunting me: it was the particular charge nurse. Each and every time I have had an issue in room 66 it was one particular charge nurse. Didn’t have a problem with that room when other charge nurses were on. It was her. Not that she is a bad person, or even a bad charge nurse, there is just some weird mojo about it. Superstitious? You better believe it. And I’m not the only one. Nurse Sean has shared his superstitions. Do I have some? Yes. But that’s not the point.
How did I figure all of this out? Stick around, you’ll see.
A couple of months ago, my assignment included room 66. Housed there was one of our frequent flyers. Atypical chest pain, responded only to morphine. Chronic shortness of breath. On top of all of that he was a smoker. Loved to leave the floor to smoke. For two nights I had him with another charge nurse. Yeah, there were a couple of hairy moments. But nothing a little morphine and a neb treatment couldn’t fix. But then the charge nurse rotation happened and you know who was in charge.
At first, the night went like normal. Nightly nursing things done. Meds were passed. Mr. Chest Pain was doing just fine. He had even gone down to smoke twice and never had a problem. I had everyone except him tucked in. I had even charted my first set of nightly charting before midnight – which never happens. The call light rings for room 66. The aide comes up to me and says, “He can’t breathe and is complaining of chest pain.” Down the hall I go. I peek in. He’s tachypneic, distressed but not too bad. I head down to the med room, call RT on the way and grab a touch of morphine to both calm him down and help him breathe until the neb got there.
By the time I got back to to the room however, things had changed. He was bolt upright in bed, using every muscle in his torso to breathe. I swear he was rocking his hips to help him breathe. For a second I sat there, transfixed by what was happening before my eyes. Then I grabbed the phone, “Rapid response to room 66, rapid response to room 66!”
I began hooking him up, grabbing a set of vitals when help began streaming into the room. The doc took charge as I gave him a run down of the situation. Shot a CXR, took a 12 lead, and he got a double strength neb. After a bit of time, he began breathing better, calming down a bit. Of course first thing out of the RT’s mouth was, “When was the last time he went to smoke?” Lucky for me he hadn’t been down since 8pm (and it was 2am). Soon he was breathing better. No longer straining, no longer using every muscle to breathe.
As the crew left, we sat and talked. He had a bit of a wide-eyed look to him. As we talked re told me how scared he had been, especially when all the people began flooding into the room. Of course I couldn’t share how scared I had been. He told me the thought in his mind was, “Please don’t tube me!” He told me he had been tubed before and it had been the worst experience of his life. Then he said, “I think I may go for a smoke…” To which I said, “Y’know, I really don’t think that’s a good idea right now, do you?” Grudgingly he agreed, then settled in and went to bed.
When I walked out my charge nurse met me in the hallway. She said, “They never said which room, but I knew. I knew it had to be 66.” “Yep, ” I replied “it’s my room, but I really think it’s you. Things seem to go well when you’re not charge and I have it, but when you’re charge…”
Since then she’s tried not to give me 66 when she’s charge. At least I learned a lot since then though. I looked back at the situation and know what I should have done differently and if presented with a similar situation, would probably do better and probably wouldn’t have called an RRT. Oh yeah, and Mr. Chest Pain? Yeah, he went down to smoke no less than 3 hours after the commotion. I guess some people never seem to get the point.