You want me to do what???

So I stroll into work today and check the assignment sheet and it's blank! The night charge nurse was on the phone and when he got off he said, "The day charge nurse called off, the Manager is talking to the triage nurse, then she wants to talk to you." My heart sunk...I knew what was coming. You see, we can't seem to hold a charge nurse. Nobody wants to do it and so far I have managed to dodge that bullet due to the fact that I am only 9 months out of school. Well, there was no dodging it today. There was only the 3 of us 7a-7p nurses, one was agency so she can't be in charge, and the other has been a nurse a year or so longer than I but she only just transferred to the ED. So I was named Charge by default.

All I had to do was last until noon when some more nurses came in. I was a nervous wreck...a few days ago I had just been telling Nurse Corrie that my biggest fear was having to be charge. Granted, I know the system and flow of the ED as well as most of the nurses including the other charges. But I have such little experience, I am so afraid that I won't be able to recognize a serious problem when I see it or that I won't be able to handle the drips or meds or codes if the situation were to arise.

The first few hours went by very nicely...not busy at all! Then we got 5 ambulances one right after the other...it was ridiculous! Nothing too serious but still, it's rough finding some place to put everyone and not giving too much to a particular nurse. By the time noon came around, we were full and I had 3 patients as well as still being in charge. I decided to stay in charge til three and gave my assignment to one of the noon nurses. Another couple of hours went by and I was relieved to have gotten everyone to lunch and the place wasn't overly packed, we were able to handle it.

The most exciting patient we got was an older woman I had care for before that was in SVT. I love SVT for some reason, I think I love being able to stop a patient's heart with the flush of a syringe! Sadly we didn't need to give her Adenosine, the doc had me start her on Amiodarone instead.

1500 rolls around and the crew talked me into staying in charge because things were going ok. It truly wasn't so bad except I was constantly waiting for the other shoe to drop. There was no relaxing and my stress level was through the roof. But I do a good job staying cool, not letting the situations get to me. Apparently I was hitting the OBS side with too many patients in too quick of succession because one of the nurses came and was basically complaining about the load I had given him, but he didn't even have his facts straight, he just jumped the gun and came and complained about it to me. So I calmly set him straight and he went on his way, I was glad I kept myself in check and stood by my decisions.

An hour before shift change, ICU called a code blue which one ED doc and the ED charge nurse are required to attend. It was a cool code, the patient had just been put in bed after being up in his chair for awhile and he suddenly went unresponsive, apneic, and pulse less. By the time we got up there his pulse was back but it tachy at 150 beats per minute and he still wasn't breathing. He was really tough for Dr. C to intubate and when he finally got it, it appeared that he had aspirated something. I was no longer needed so I moseyed back downstairs...by this time I only had 40 more minutes til shift change!!!

Night charge showed up and I gave him report. I knew the story on every single patient and the place wasn't entirely in shambles so I think I was a success! I am so relieved to have this day behind me. I've always known this day would come so it's nice to have conquered this mountain. The first time is the hardest and now it's behind me. I truly love my job and all the people I work with, and am grateful for the experience I gained today!