Sandy Klever, RN, currently works in hospice care in Des Moines, Iowa. At the time of the events described here, she was working on a medical/surgical floor at a Veterans Administration hospital.

julie kertesz/ via flickr creative common

“Can you work tomorrow evening?” sweet-talks my nurse manager. Even though I will miss handing out treats on Halloween, I say yes. “But what about all my candy?” I ask. “Just bring it with you!”

Halloween night should be an easy shift. Do not say the ‘Q’ word, I tell myself. As I’m drinking coffee in the staff room, I’m assigned to four familiar patients, one of whom is a discharge.

Then the door opens and a colleague hands me a notecard about a direct admit coming from the ER, tells me that he’s having a COPD exacerbation and is homeless.

Well, I can manage a COPDer. At least he’s not a challenging laryngectomy patient transferring from the ICU.

“Oh, and by the way,” my colleague adds, “he’s confused and bipolar.”

Off to the floor! Because his room is still being cleaned, I have plenty of time. Within minutes, I have performed a complete assessment on my first patient. Moving on to my second patient, I see a commotion in the hallway and realize my new admit is coming on a cart already. As we maneuver the […]