Whew! I just arrived home after surpassing another milestone in my budding nursing career in the UAE – my first night shift (7pm to 7am). This was after a year of having my nights spent on sleeping, and the days on working. I knew I had to make adjustments in my body clock.

 

My preceptor and I had 7 patients last night. The cases and activities were as follows:

 

1. A patient with cancer of the larynx who had tracheostomy and PEG insertion. Because he can’t talk, I had difficulty trying to understand him. I had to clean the Swedish nose attached to the trache twice because there’s no stock of that at the moment so we could not throw that one away. His IV line got infiltrated so a new line was inserted. He had very difficult veins, and after several tries, one of my co-nurses managed to put one. He’s a sharpshooter! He needed that for his IV antibiotics.
2. A patient with cancer of the pancreas, who had a whipple’s procedure two weeks back. He passed BM twice and everytime he did, I had to change his bed linens because he messes everything up. I also did his abdominal dressing which was very mucky, because aside from the oozing wound, it was stained by his stool. I got a low blood sugar from him in the morning, so I encouraged him to eat something. I rechecked his blood sugar after an hour, and it picked up to within normal limits. His IV line got infiltrated as well but reinsertion was unsuccessful because his veins were all so bad.
3. A patient with Osteomyelitis on the right femur who previously had an Incision and Drainage surgery inThailand. His wound looks infected. He’s in the hospital for pain management.  
4. A patient post road-traffic accident with compound fracture of tibia/fibula. He recently had removal of the external fixator, with intermedullary nailing. This guy is already mobilizing full weight bearing, and is for possible discharge today.
5. A patient who was admitted for hematuria. He was on a foley catheter draining reddish urine. He called twice just to get his urine bag emptied when it was only half full.
6. A diabetic patient who had amputation of the 2^nd, 3^rd, and 4^th digits of the right toes two weeks back. He was scheduled for Angiography today, so I inserted an IV line on him last midnight and started him on IV fluids. I did not have any difficulty inserting a cannula for him because he had very visible veins. His blood sugar shoot up in the middle of the night so I had to give him some regular insulin. It went down to within normal limits in the morning. His groin was shaved in the morning in preparation for the angiography.
7. A patient who had renal stones, and had undergone urethroscopy to remove ureteric stones. He complained of flank pain around  1030 in the evening, so I gave him a tramadol injection in the right gluts. He complained again at 2am and said that the injection I gave did not work much. I then gave him a more stronger analgesia – Pethidine injection on the left gluts. That knocked him down, sleeping till the morning. I feel he needs to be reviewed again this morning because of these pain episodes even if he is for possible discharge. He did not have an IV line but he had orders for IV antibiotics this morning so a line was inserted using a butterfly, and I removed it after the medication was consumed.

 

And that goes my first night shift. I survived. Glad to be still alive. And yup, I have another night tonight.