Saturday, February 5, 2011

Sleep Assessment

The past couple of shifts have been INSANE! Multiple codes every day, transfers to other facilities every other hour, police crawling all over the department all the time and everyone wearing the look of incomprehensible exhaustion. My ER saw a record number of patients this week. To say that it was absolute chaos and insanity would be the understatement of the year. When I finally got home after my last scheduled shift, I could barely walk in a straight line let alone speak coherently. I don’t know how I managed to change out of my clothes and wash up before heading to bed but it happened (I had witnesses).

Just as I settled into a really deep sleep, my sister woke me up in a panic and said that she just got a very sharp and sudden pain in her stomach and she feels like throwing up. Sister hasn’t been sick, hasn’t had any changes in her diet and wasn’t injured. She also never ever EVER gets abdominal pains, nor does she take any meds. I asked her some detailed questions and of course asked about her last normal doody (yes even family members aren’t safe from doody questions if they bring up abdo issues) and if she had any urinary symptoms. She said no to everything. Since I was too lazy to get out of bed, I asked her to gently palpate around her abdomen and tell me if any part hurts or is relieved by palpating. She told me that everything was normal. Not being able to think of anything else, I told her to take a gravol, go back to bed and if the pain worsens, wake me up. Naturally, she fell asleep.

The next morning, she told me that her stomach was still hurting and asked if she should go to our family doctor. I was at a complete loss. “When has your stomach been hurting since?”

“Since last night loser!”

Baffled by her annoyance, I shot back, “Well how the eff was I supposed to know that?”

“Dude wtf is wrong with you? We had this conversation at 3 this morning. You told me that if my stomach was still hurting, I should go to the doctor”.

At this point, I was completely baffled. “Alright imma hold you up a minute. What exactly did we talk about and what did I say?”

Now it was sister’s turn to be lost. “You don’t remember?” She then repeated everything I had told her up to and including the part about me telling her that if I didn’t sleep at that moment, my eyes would bleed out of my head.

I honestly don’t remember a single word of that conversation. In fact, the only thing I remember is getting into bed at around 0130 and waking up refreshed at 1230. As far as I’m concerned, I slept for eleven straight hours. This is troubling because up until now, I have never had a conversation that I haven’t remembered. My sleep assessment is the first incidence of amnesia I’ve experienced (or at least, the first incidence that I've been made aware of). However, once I managed to snap out of the ‘holy exhaustion related memory loss batman’ frame of mind, I was quite impressed that even while I was half asleep, I was able to go through an abdominal assessment. Maybe I should sleep through assessments more often at work (kidding – sort of).

Btw, the sister is not 100% fine but we did have a yummy lunch together. She is no acute distress at present :)


Grumpy, M.D. said...

You're a damn good nurse. You can do this job in your sleep. Take it as a good sign.

RehabNurse said...

So glad you got to sleep. It is truly the miracle drug.

And I second Grumpy. You also proved you could do the abd assessment with a hand tied behind your back. ;->

Just another thing I detest about rotating shifts...exhaustion!

Old MD Girl said...

Those are some damn fine assessment skills you have that you can do them in your sleep.

shrtstormtrooper said...

I'm pretty sure I sleep through like 30% of important activities in my life, yet still manage to look present. Kudos to you for a killer sleep assessment.

prada nurse said...

"She also never ever EVER gets abdominal pains" - I often wonder about the logic of this...just because one has never been sick/had a fever/had abdominal pain - they think it should/could never happen?

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