weekend work race

Today I nearly reached my breaking point. I was mentally prepared for a very intense weekend, but it still took a toll.

Last week one of the pharmacists who has been at St. Joe's over 20 years said he's never seen our IV room as busy as it's been the last while. During the week, a pharmacist and tech are in the clean room making IV's, but on the weekends it's just one tech. Yesterday and today it was my responsibility to make IV's for the entire hospital. The pharmacists helped by sending back drips before they were due so they'd be ready when the nurse requested them. We currently have 7 patients on a ventilator, and as I mentioned before, these patients are on multiple IV's for sedation. Some of them run at high rates so one bag might only last an hour or two. I have no idea how many drips I made over the last two days, but it was enough to give me blisters from manipulating a syringe! By lunchtime today I had almost more than I could take and a few tears were shed, but after a 30 minute break I was ready to tackle the rest of the day! When you're making drips as fast as you can but there's always more to do, it starts feeling like no matter how hard you try, you haven't accomplished anything. The second shift tech came in at 3:30 and helped out, and I stayed over an hour late. Finally I asked a pharmacist to take over so I could leave.

When making IV's, one thing that's very important is that no foreign objects or particles somehow get into the drug. One way this can happen is when you "core" a vial. Sometimes a small piece of the rubber stopper of a vial is sheared off as the needle passes through. These pieces can be very tiny and almost unnoticeable. The pharmacist who checks the final product may not see it. At two different times today I happened to notice a vial had been cored. Once it was after 200 milliliters of propofol had been injected into a bag. The way to fix this problem is to drain the entire contents through a filter needle. A drug flows very slowly through a filter needle and in the time it takes I could've probably made a whole new bag. Very likely I could have let it go and the pharmacist wouldn't have seen it. You simply cannot cut corners when a patient's safety is at risk, though.

Thankfully I'm off tomorrow so the weekend stress can be forgotten by the time I go back to work on Tuesday!