By Debbie Moore-Black, RN

My first post-op night after my nephrectomy was a mix of fantastical and almost devastating.

I woke up in the PACU after my surgery, extremely confused and disoriented. I felt like I was trapped inside a video game, desperately trying to escape.

Upon entering my new post-op room on a medical-surgical unit, it had that brand-new, hotel-like decor – shiny and pristine. The nurses, techs, and NPs greeted me with words of encouragement, saying, “Great surgery! Pathology reports will come soon for your nephrectomy due to renal cell carcinoma. You did well.”

I had always avoided working on a medical-surgical unit because, in truth, they are often grossly understaffed. It’s a challenging job.

Throughout the night, I heard an elderly woman repeatedly chanting, “Help me, help me,” and an older man, obviously experiencing DTs, falling out of bed and screaming incoherently. It was indeed a challenging unit.

I was determined to be the ideal patient, exhibiting the best behavior and hoping for no complications.

During the night shift, a seasoned nurse in her 50s arrived to check on me. She informed me that she was a traveler. Nurse-patient ratios on this Med-Surg unit were typically six patients per nurse. She appeared savvy, smart, and practical.

She then shared an interesting and somewhat strange detail – her zodiac sign, Sagittarius. It struck me as an unusual topic of conversation, especially for a nurse.

At 3:00 a.m., I started experiencing intense abdominal pain, reaching at least an eight on the pain scale of 1 to 10. The nurse administered Dilaudid IVP, and for a while, the pain subsided. However, within 30 minutes, I began to have shallow breathing, struggling to force myself to breathe. I became frightened and shifted into ICU nurse mode. I instructed my son (a high school math teacher) on the location of the code blue button and told him to call out “rapid response team stat” if I deteriorated. I also urged him to call my nurse, as something was clearly wrong with me. I was having shallow, rapid breathing, and I feared I might code. Unfortunately, the nurse’s response time was unusually slow.

I pleaded for a stat CBC as my hemoglobin was already below 9, but the nurse refused, insisting that the lab would obtain my hemoglobin levels at 5:00 a.m. I also requested a nebulizer and began giving orders that a typical ICU nurse would issue.

The nurse seemed lethargic and eventually gave me Ativan. Admittedly, I was also experiencing some sort of psychotic reaction to the Dilaudid, but she moved slowly and did not seem to grasp the urgency that I felt. I apologized to her but stressed that I needed help, to which she replied, “I know too much.” Her response baffled me as she claimed to be a Sagittarius.

Fortunately, I made it through that night without becoming a code blue case. When my NP came to make rounds on me, I shared my experience from the previous night. The NP informed me that the only communication she received from this nurse was a request for Tylenol for my headache. Meanwhile, my hemoglobin had dropped to 7.6.

This nurse’s actions certainly left a negative impression on this already hardworking and understaffed Medical-Surgical unit comprised of dedicated nurses and techs.

I’m grateful that my son was with me, as I was able to impart a valuable lesson about what it’s like to be an ICU nurse – the importance of listening to the patient’s symptoms, being readily available, and employing critical thinking skills.

And, last but not least, the importance of never disclosing your horoscope sign to a patient, as it’s entirely inappropriate.

My first post-op night was a combination of a nightmare and incompetence, an experience that warrants reporting.

Debbie Moore-Black is a nurse.