A bitch before sleeping

I'm tired and cranky, so please excuse me while I rant a little before going to bed.

Last night I had a patient who went bad. I called our rapid response team, which is basically just one step away from calling a full on code. The patient was diaphoretic, heart racing, can't get a blood pressure...bad stuff. The team comes in and checks her out. They run a battery of tests. They're yelling out labs to be drawn, EKG, chest x-ray. I'm running trying to get them all ordered and to call the appropriate people to get the job done. Ultimately they decide to transfer her to one of our critical care units. I hate transferring patients to critical care. Not only is it bad news for them, but it means I usually have to deal with some bitchy critical care nurse.

Don't get me wrong; I love most of our ICU nurses. They're a great group of nurses who work really hard and know their shit. They can run codes in their sleep. I just always seem to have to report off to that nurse who feels the need to quiz me on the patient's entire medical history and hospital stay. It just bugs me. I'm giving you a patient who has just had a major cardiac event, so why are you so concerned about the type of fucking tube feeding she's getting? It's not important right now and you can get the information from the chart just as easily as I can.

I also feel like a lot of the critical care nurses look down on us "lowly floor nurses". Granted, I can't read the 12-leads, I don't draw my own blood gases, and frankly I probably wouldn't know what the hell to do with most central lines, but that doesn't make me an idiot. I work my ass off every night I go to work and I'm a fucking good nurse.

A nurse manager once told me that the easiest way to make an ICU nurse cry was to have her work the floor and take six patients. Most of them wouldn't be able to do it since they're so used to only having to deal with one or two patients at a time. I like to think about that every time I encounter some witch of a nurse. I imagine them desperately trying to pass meds on six patients while answering call lights, toileting, bathing, completing assessment and charting it all before the end of shift. I think about that and just smile.