0210 hours - Now that all the "labs" (as we call them) and diagnostic tests are completed, Patient #2 (the 300-pound woman) raises my blood pressure to a nightly high. Her heart has gone into a lethal arrhythmia.  Running into the room, I pound her on the chest, hoping beyond hope to get a normal rhythm to return. My neck is killing me. So, is my arm now. The precordial thump works. EKG and complete labs are ordered. Uh oh, her oxygen level has dropped again. Does she need even more Lasix?

0240 hours - As I've now become to feel quite possessive of Patient #1's platelet activity, I feel like celebrating as her number goes up from seven to twenty-four! Just for good measure, the ENT guys order more platelets and some liver function tests. Her blood pressure has been stable. I finish my computerized charting entries. However, due to the dystonia, MY arms hurt from hanging bags of platelets on a barely unreachable ceiling pole.  What do shorter nurses do?
 
0300 hours- The few of us on the unit tonight have been running, for what seems like, forever. I do not want to come back as a hamster.  Forget ordering take-out dinners, forget about even eating the healthy snacks that some of us have packed. In between ringing bells and critical care nursing, we gulp down chips, soft drinks and the unhealthiest snacks imaginable.  What if a dietitian happened to decide to spend the night here? We'd have to find her a bed.

0310 hours - The 20-year old patient dies. I feel sad. His parents were at the bedside. Morgue care is ordered.

0330 hours - "My" platelets are ready. I ask the Unit Clerk to pick them up as well as stop by the pharmacy for some newly ordered antibiotics. This is not a medical mercy mission to a third world country but you'd never know that. The pharmacist, right here in this very large, very busy NYC hospital decides to let us know clearly (read: "venting") that they don't have the variety that was ordered. Am I in a new "Twilight Zone"? What kind of pharmacy is this?

0400 hours - Meanwhile back on the floor, patient turning is the next activity. What could be worse than trying to perform this task alone? Finding the bed and its surroundings soaked with diarrhea. This is a job for the true angels of nursing: Housekeeping. I clean the patient, giving her a back rub as well as a respiratory treatment. Before leaving the room, I do a platelet check.

0430 hours - Platelets are done. Will this shift ever end? Whatever could go wrong has already happened…I think.  My feet hurt. Note to self (and other would-be nurses with dystonia: Clogs might as well be 3" heels …my feet turn inwards, my clogs do not)).My legs hurt. My entire body hurts. A new ER admission arrives on the unit.  So much for the lack of staff. The few of us are left standing; all help the patient settle in. Do you think that any of us were contemplating "Nurses Week" in early May? No. We just want= to sit down and go home. ASAP.

0445 hours - Some of the routine things that nurses do are no longer easy for me to accomplish without help.  Night nurses are responsible for changing IV tubes for new ones.  This used to be a nonevent, but now I can't open the packaging without using scissors or a clamp or a helping hand.  It's frustrating.

0510 hours - A minor miracle: My paperwork is up-to-date and there are only two more hours left to this awful night. More standing left to do.

0522 hours - A colleague is having trouble inserting an IV. I offer to help.  Even though I am unable to turn my head the "right way," anymore, I can do IVs by instinct. With dystonia, you learn to make accommodations and work around the physical limitations. A secret: I usually rearrange the patient's room so that everything is in my line of sight.
 
There's another thing that I have to constantly be aware of since I had DBS; electromagnetic interference. All those security devices may be great but they can cause havoc with my pacemaker (mine goes to my brain rather than to my heart).  This, among other things, is anxiety-producing so my neurosurgeon has me taking a mild dose of Klonopin to reduce spasming PAIN. Did I remember to take it this evening/morning?  No.  I will pay for it on the bumpy bus ride home and those lousy cell phones and nonstop Texters.

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