My patients have an awful lot to say about me, I guess because I don't say much of anything so the silence has to be filled somehow, right? Nearly every single shift and sometimes a few times a shift, I get compliments on my hair. All the old people think it's natural and I can't lie so I have to confess it's bottled. But they love it anyway. All the little old ladies think I am so beautiful and I smile sweetly and say "Thank you, now don't move while I put this IV in!".
Last week I took care of an 82 year-old man who introduced me to his wife like this: "This is RaDonna my nurse, she takes really good care of me and she also has a really nice butt!". I was mortified! My face turned a brighter shade than my hair and I ran out there as fast as I could! The funny thing is I got a text the next day from a paramedic friend of mine saying that he was transferring my little old man to the next hospital over and he wouldn't stop going on about my nice butt. So now my derrière is apparently the talk of the county!
My favorite thing that my patients say about me isn't my hair or my tush, but that I have a very gentle touch. It made me so happy when I finished putting in an IV today, and my patient says "Thank you for being so gentle with me." So many times I see nurses or aids roughly turning patients or grabbing their arms to put the blood pressure cuff on them and it makes me so sad. One of the ICU nurses I followed around the last month of nursing school told me that patients can tell you care by the way you touch them. That has stuck with me throughout my year-long nursing career and I hope I never forget it.
I tell you what though, I didn't feel very gentle last Tuesday when I was holding a tiny little 7 week-old baby for a lumbar puncture. Poor little baby had a fever that wouldn't break so we had to give him the full workup: labs, IV fluids, cath urine, lumbar puncture, and antibiotics. I was terrified taking care of such a tiny baby and the worst thing was he never stopped crying the entire 6 hours I took care of him. Every time I walked into the room I brought some other method of torture with me. I looked for a vein on him but had to bring reinforcements because he had nothing that I could see. I catheterized him for the urine sample and that was hard because I had never cath'ed anyone under thirty before! When it was time for the lumbar puncture, we laid him on his side at the edge of the bed and bent him into a fetal position and held on as tight as we could without hurting him. He wailed the entire time but Dr. C was good and nailed it.
We ended up transferring that poor little boy to a hospital with a PICU to rule out sepsis. One thing I hate about emergency nursing is that I rarely get to find out the end result of my patients, and the few times I do find out, I usually don't like what I hear. The little old man who like my butt was transferred because he had a massive aortic aneurysm and he only had a 50% chance of surviving the surgery to repair it. A sweet man I took care of last week for gallstones ended up coding the following day. This morning I cared for a man with a 106.9 F rectal temp and after I finally got him cooled down enough that he wasn't delirious from the fever, all he wanted to do was hold my hand because it was warm.
I don't know if any of these patients lived or died but they touched my heart, each in their own way. I am so glad I can make a difference to them by the gentleness of my touch and hopefully bring God's comfort through my hands.
I found the following blessing for nurse's hands on the internet and I wanted to share it with you.
Blessed be these hands that have touched life.
Blessed be these hands that have felt pain.
Blessed be these hands that have embraced with compassion.
Blessed be these hands that have been clinched with anger or withdrawn in fear.
Blessed be these hands that have drawn blood and administered medicine.
Blessed be these hands that have cleaned beds and disposed of wastes.
Blessed be these hands that have anointed the sick and offered blessings.
Blessed be these hands that grow stiff with age.
Blessed be these hands that have comforted the dying and held the dead.
Blessed be these hands, we hold the future in these hands.
Blessed be our hands for they are the work of Your hands, O Holy One
Showing posts with label ED. Show all posts
Showing posts with label ED. Show all posts
Saturday, July 10, 2010
Saturday, May 8, 2010
For Randi and Rachel
Happy Nurses Week to all my fellow nurses out there!
This was my first time celebrating it as an actual RN and I was blessed to be nominated as the "Rookie Nurse of the Year" at my hospital and I won! The ceremony was beautiful and I had no idea I had won til I got there. My boss called my parents and they were able to come and share this special moment with me. I actually got 4 free tickets to Disney world too!
I had a very boring three day weekend at work last week. Nothing happened and I was hounding the doctors for stuff to do and annoying my fellow nurses with constantly asking them if they needed help. So yesterday I had to pay for all my boredness. I had a 44 year old woman come in as a diabetic unresponsiveness but that was actually the least of her problems. She had liver cancer and her prognosis was very poor, her oncologist had told her already that there was nothing that could be done for her. She was a train wreck, all her systems were already shutting down. Her lungs were filling up with fluid, her abdomen was distended with what the ED doctor thought was blood because her hemoglobin was half that of a healthy person. She wouldn't keep her blood pressure up, her kidneys weren't working and although she was conscious, she was confused and unresponsive to everything going on around her. Her core temperature was only 91 degrees.
She was going to die. I knew it, the other nurses knew it, and the doctors knew it but her sisters wouldn't accept it.
Liver Cancer runs in their family, one of the sisters had already had a liver transplant. I don't know if they thought this one sister could survive the cancer because the other sister already had or what. Either they didn't understand how grave my patients situation was or they just didn't want to accept it but they told us that they wanted everything done for this poor woman.
EVERYTHING.
I let the two sisters stay in the room because I knew they didn't have much more time together. I had to work to keep my mind busy on all the interventions I was doing like foley catheter, NG tube, and managing all 5 of the IV pumps, because every time I let myself focus on the three woman in the room with me, I would tear up because they reminded me of myself and my beautiful sisters. The nurse in me was incredulous that these women would allow my poor patient to suffer like she was but at the same time, the sister in me could understand because I am sure I wouldn't want to let go of one of my sisters at such a young age.
I stabilized her as much as I possibly could and had my charge nurse help me transport her to the ICU. We were a very grave procession going down the hall followed by the chaplain, the sisters, and the rest of the family. They coded her 3 times in the ICU, the second time was right at shift change and since I didn't have any patients, I went up with the ED doctor to work it. I found out from the ICU nurses that the patient hadn't wanted all of this...she didn't want the tube down her throat or her heart being shocked back into rhythm. But family members can overrule the patient's wishes. Finally, after she coded for the fourth time, her family signed the DNR and let her go.
When I got home last night, I just wanted to hug my sisters. Being the young age that I am, I still have that immortal mentality that hard things will never happen to me. Days like this show me that I don't know what the future will hold for me and my family. I hope that if I ever find myself in a similar situation I will make the right choice. But I won't know what the right choice will be until I get there. So for now, I won't yell at Randi Jean when she steals my perfume or say no to Rachel when she asks me to ride bikes with her. God truly blessed me when he linked me for life with these two women(oh my word, I'm crying right now!). I pray that I will always cherish them for as long as I am privileged to have them.
2004
2009
She is your mirror, shining back at you with a world of possibilities. She is your witness, who sees you at your worst and best, and loves you anyway. She is your partner in crime, your midnight companion, someone who knows when you are smiling, even in the dark. She is your teacher, your defense attorney, your personal press agent, even your shrink. Some days, she's the reason you wish you were an only child.
~Barbara Alpert
This was my first time celebrating it as an actual RN and I was blessed to be nominated as the "Rookie Nurse of the Year" at my hospital and I won! The ceremony was beautiful and I had no idea I had won til I got there. My boss called my parents and they were able to come and share this special moment with me. I actually got 4 free tickets to Disney world too!
I had a very boring three day weekend at work last week. Nothing happened and I was hounding the doctors for stuff to do and annoying my fellow nurses with constantly asking them if they needed help. So yesterday I had to pay for all my boredness. I had a 44 year old woman come in as a diabetic unresponsiveness but that was actually the least of her problems. She had liver cancer and her prognosis was very poor, her oncologist had told her already that there was nothing that could be done for her. She was a train wreck, all her systems were already shutting down. Her lungs were filling up with fluid, her abdomen was distended with what the ED doctor thought was blood because her hemoglobin was half that of a healthy person. She wouldn't keep her blood pressure up, her kidneys weren't working and although she was conscious, she was confused and unresponsive to everything going on around her. Her core temperature was only 91 degrees.
She was going to die. I knew it, the other nurses knew it, and the doctors knew it but her sisters wouldn't accept it.
Liver Cancer runs in their family, one of the sisters had already had a liver transplant. I don't know if they thought this one sister could survive the cancer because the other sister already had or what. Either they didn't understand how grave my patients situation was or they just didn't want to accept it but they told us that they wanted everything done for this poor woman.
EVERYTHING.
I let the two sisters stay in the room because I knew they didn't have much more time together. I had to work to keep my mind busy on all the interventions I was doing like foley catheter, NG tube, and managing all 5 of the IV pumps, because every time I let myself focus on the three woman in the room with me, I would tear up because they reminded me of myself and my beautiful sisters. The nurse in me was incredulous that these women would allow my poor patient to suffer like she was but at the same time, the sister in me could understand because I am sure I wouldn't want to let go of one of my sisters at such a young age.
I stabilized her as much as I possibly could and had my charge nurse help me transport her to the ICU. We were a very grave procession going down the hall followed by the chaplain, the sisters, and the rest of the family. They coded her 3 times in the ICU, the second time was right at shift change and since I didn't have any patients, I went up with the ED doctor to work it. I found out from the ICU nurses that the patient hadn't wanted all of this...she didn't want the tube down her throat or her heart being shocked back into rhythm. But family members can overrule the patient's wishes. Finally, after she coded for the fourth time, her family signed the DNR and let her go.
When I got home last night, I just wanted to hug my sisters. Being the young age that I am, I still have that immortal mentality that hard things will never happen to me. Days like this show me that I don't know what the future will hold for me and my family. I hope that if I ever find myself in a similar situation I will make the right choice. But I won't know what the right choice will be until I get there. So for now, I won't yell at Randi Jean when she steals my perfume or say no to Rachel when she asks me to ride bikes with her. God truly blessed me when he linked me for life with these two women(oh my word, I'm crying right now!). I pray that I will always cherish them for as long as I am privileged to have them.
2004
2009
She is your mirror, shining back at you with a world of possibilities. She is your witness, who sees you at your worst and best, and loves you anyway. She is your partner in crime, your midnight companion, someone who knows when you are smiling, even in the dark. She is your teacher, your defense attorney, your personal press agent, even your shrink. Some days, she's the reason you wish you were an only child.
~Barbara Alpert
Friday, April 23, 2010
Florida: Heaven's Waiting Room
The last few weeks I have been struggling through dealing with death. Particularly elderly patients being brought to my room in full cardiac arrest and me and my co-workers do everything we can and despite all efforts, it's not enough and my patients die. In 3 weeks I have had four patients just like that and it's rough. For two of the patients, I had to go with the physician and tell their spouses that we couldn't save their beloved family member. It caused me nightmares and it put many questions in my mind about how I am supposed to react to this situation because I know I am going to have to deal with this my entire nursing career.
I received very wise counsel from several nurses that I work with and also Nurse Corrie, and my hero daddy who is also a nurse (not sure if I have mentioned this fact before). Life and death are not in my hands nor in the hands of my co-workers or the physician's. It is solely in the Master's hands. My responsibility is to use the gifts and skills that He gave me to carry out His plan.
Even though I understand this, it's still hard to prepare a body for the morgue. This is something I don't think I will ever get used to doing and I don't like it one bit. I've done it twice and I can't even express how hard it is for me. But, it's part of my job.
Last night I had a different sort of patient. He came to us as a possible overdose and he was only in his 30's. EMS brought him to us and he was barely breathing but they hadn't intubated him. He was completely unresponsive and Narcan did nothing to bring him around. The doctor prepared to intubate him and since he was my patient, I had to grab the drugs. I was nervous and my hands were shaking because the physician working the patient has a reputation for being harsh during code situations which this wasn't but it ended up turning that direction.
Almost everything went wrong with this guy, he was tough to intubate and even after the doc and respiratory got it he still wasn't ventilating well. It turns out that the cuff on the intubation tube that keeps it in place was blown so they had to switch the tube out. After he was intubated his blood pressure dropped to almost nothing and nothing we did could get it up. Bag after bag of fluids were hung, two types of pressors were started and still his pressure was only like 70/50. I felt such despair and hopelessness because I felt like all my efforts were for naught and he wasn't going to make it.
I juggled with the pressure issue for like 45 mins and finally got it stabilized but then it was another issue and then another. This young man was sick and I was virtually taking care of him by myself because five patients from a car accident were brought in who required the attention of the doc and the rest of the nurses.
I really can't even properly express how tough this patient was to care for and how badly I wanted him to pull through and how defeated I felt. He ended up being in rhabdomyolysis and metobolic acidosis, secondary to whatever he overdosed on. He never woke up despite not being on any type of depressive medicine to keep him asleep while intubated. I never did get him stabilized enough to take him to get his head scanned in CT. Night shift came and even though I would have liked to have gotten the patient up to the ICU, they weren't ready for him yet so I had to pass report to night shift. Luckily the night nurse is a man whom I respect very much and he has taught me a lot through this first year of me being a nurse and he didn't criticize what had or hadn't done and he didn't complain about getting dumped this drain-circling patient.
I didn't leave work til 8pm which NEVER happens because I had to catch up on charting for the past 4 hours. I was mentally and physically exhausted when I got home. I called my dad to talk about everything and see if I did right by this patient. I work again Sunday so it will be interesting to see if I can figure out what happened to this patient after I left and how he's doing now. I am pretty sure I did the best I could and I hope it was enough. I learned a whole lot through all of this and I hope it makes me a better nurse.
A nurse once quoted M*A*S*H to me, actually the very same nurse who took over for me last night. He said, "The first rule of medicine is people die. The second rule is doctors (and nurses) can't change the first rule."
I must press on and keep doing my best and leave the outcome in God's hands. So much easier said than done.
I received very wise counsel from several nurses that I work with and also Nurse Corrie, and my hero daddy who is also a nurse (not sure if I have mentioned this fact before). Life and death are not in my hands nor in the hands of my co-workers or the physician's. It is solely in the Master's hands. My responsibility is to use the gifts and skills that He gave me to carry out His plan.
Even though I understand this, it's still hard to prepare a body for the morgue. This is something I don't think I will ever get used to doing and I don't like it one bit. I've done it twice and I can't even express how hard it is for me. But, it's part of my job.
Last night I had a different sort of patient. He came to us as a possible overdose and he was only in his 30's. EMS brought him to us and he was barely breathing but they hadn't intubated him. He was completely unresponsive and Narcan did nothing to bring him around. The doctor prepared to intubate him and since he was my patient, I had to grab the drugs. I was nervous and my hands were shaking because the physician working the patient has a reputation for being harsh during code situations which this wasn't but it ended up turning that direction.
Almost everything went wrong with this guy, he was tough to intubate and even after the doc and respiratory got it he still wasn't ventilating well. It turns out that the cuff on the intubation tube that keeps it in place was blown so they had to switch the tube out. After he was intubated his blood pressure dropped to almost nothing and nothing we did could get it up. Bag after bag of fluids were hung, two types of pressors were started and still his pressure was only like 70/50. I felt such despair and hopelessness because I felt like all my efforts were for naught and he wasn't going to make it.
I juggled with the pressure issue for like 45 mins and finally got it stabilized but then it was another issue and then another. This young man was sick and I was virtually taking care of him by myself because five patients from a car accident were brought in who required the attention of the doc and the rest of the nurses.
I really can't even properly express how tough this patient was to care for and how badly I wanted him to pull through and how defeated I felt. He ended up being in rhabdomyolysis and metobolic acidosis, secondary to whatever he overdosed on. He never woke up despite not being on any type of depressive medicine to keep him asleep while intubated. I never did get him stabilized enough to take him to get his head scanned in CT. Night shift came and even though I would have liked to have gotten the patient up to the ICU, they weren't ready for him yet so I had to pass report to night shift. Luckily the night nurse is a man whom I respect very much and he has taught me a lot through this first year of me being a nurse and he didn't criticize what had or hadn't done and he didn't complain about getting dumped this drain-circling patient.
I didn't leave work til 8pm which NEVER happens because I had to catch up on charting for the past 4 hours. I was mentally and physically exhausted when I got home. I called my dad to talk about everything and see if I did right by this patient. I work again Sunday so it will be interesting to see if I can figure out what happened to this patient after I left and how he's doing now. I am pretty sure I did the best I could and I hope it was enough. I learned a whole lot through all of this and I hope it makes me a better nurse.
A nurse once quoted M*A*S*H to me, actually the very same nurse who took over for me last night. He said, "The first rule of medicine is people die. The second rule is doctors (and nurses) can't change the first rule."
I must press on and keep doing my best and leave the outcome in God's hands. So much easier said than done.
Saturday, March 20, 2010
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!
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!
Friday, February 5, 2010
Bus Ride
I'm not sure if I have mentioned this to ya'll before but I come from a family who is waist deep in Emergency Medicine. My dad helped found the rescue squad in his hometown and he has been an EMT, ED RN, Flight Nurse, and ED Director, among others. My older sister has been an EMT for 5 years and is currently a Paramedic. I always enjoy hearing my dad and sister talk about life on the street and the excitement of being in an ambulance and secretly I have always been a little jealous. Well, Monday I got to ride in a ambulance during an emergency transport of my patient to the closest hospital with a neurosurgeon!
It started with a call from an ambulance crew stating they were brining in a patient with a severe headache and left sided weakness that had started 30 minutes ago. The patient was a gentleman in his 60s who was visiting from up north with no prior health problems except an enlarged prostate. After he arrived we started to work him up and we saw that he was experiencing decerebrate posturing only on his left side, meaning his left arm and leg were involuntarily spasming and rigid. His pupils were unequal and sluggish and he was lethargic but oriented.
We scurried around to initiate the Brain Attack protocol and soon enough I was accompanying him over to ct scan. I am no ct tech but even I could see the bleed in his brain as the images from the scan scrolled across the screen. After I rolled him back to the resus room, I had to start him on a drip to keep his blood pressure below 120 mmHg systolic. The secretary quickly made arrangements and the patient soon had an accepting physician at the nearest hospital with a neurosurgeon. The ambulance crew soon rolled in and as I gave the lead medic report he stopped me and said that he would need a nurse rider because the blood pressure drip the patient was on wasn't in their protocols so he wasn't allowed to titrate it.
I was excited because I've been looking forward to my first ride-along and this was the perfect patient because he was relatively stable, I just needed to keep an eye on his pressure and adjust the drip as necessary to keep it down. Plus I knew the ambulance crew better than most so I was comfortable with them.
They loaded the patient up and I hopped in. We drove all the way to the hospital lights and sirens and I was surprised how bumpy it was in the back of the ambulance. I don't know what I was expecting but definitely not such a fast and crazy ride. The patient remained stable for the duration of the transfer and I only had to adjust his meds a few times. The ride over went super quick and we arrived before I knew it. I gave report to the nurse, transferred the patient over and headed home.
I felt like a grown up nurse, doing my first transfer. I cannot wait until I get to do another because then I won't be as nervous and I'll know what to expect the second time around. It gave me taste of life on the streets and I got to see why the unpredictability and excitement of bus life is so enticing. Someday, I think I would like to be a flight nurse. I haven't made it a definite goal for my future but I am keeping it on the back burner. We shall see...
It started with a call from an ambulance crew stating they were brining in a patient with a severe headache and left sided weakness that had started 30 minutes ago. The patient was a gentleman in his 60s who was visiting from up north with no prior health problems except an enlarged prostate. After he arrived we started to work him up and we saw that he was experiencing decerebrate posturing only on his left side, meaning his left arm and leg were involuntarily spasming and rigid. His pupils were unequal and sluggish and he was lethargic but oriented.
We scurried around to initiate the Brain Attack protocol and soon enough I was accompanying him over to ct scan. I am no ct tech but even I could see the bleed in his brain as the images from the scan scrolled across the screen. After I rolled him back to the resus room, I had to start him on a drip to keep his blood pressure below 120 mmHg systolic. The secretary quickly made arrangements and the patient soon had an accepting physician at the nearest hospital with a neurosurgeon. The ambulance crew soon rolled in and as I gave the lead medic report he stopped me and said that he would need a nurse rider because the blood pressure drip the patient was on wasn't in their protocols so he wasn't allowed to titrate it.
I was excited because I've been looking forward to my first ride-along and this was the perfect patient because he was relatively stable, I just needed to keep an eye on his pressure and adjust the drip as necessary to keep it down. Plus I knew the ambulance crew better than most so I was comfortable with them.
They loaded the patient up and I hopped in. We drove all the way to the hospital lights and sirens and I was surprised how bumpy it was in the back of the ambulance. I don't know what I was expecting but definitely not such a fast and crazy ride. The patient remained stable for the duration of the transfer and I only had to adjust his meds a few times. The ride over went super quick and we arrived before I knew it. I gave report to the nurse, transferred the patient over and headed home.
I felt like a grown up nurse, doing my first transfer. I cannot wait until I get to do another because then I won't be as nervous and I'll know what to expect the second time around. It gave me taste of life on the streets and I got to see why the unpredictability and excitement of bus life is so enticing. Someday, I think I would like to be a flight nurse. I haven't made it a definite goal for my future but I am keeping it on the back burner. We shall see...
Saturday, January 23, 2010
Welcome to Six Flags
January has definitely been a ride so far and if it's any indication for the rest of the year, I'm gonna need some Dramamine.
The highlight of the month so far was the five day cruise I went on with my family. We all had such a blast and we picked literally the coldest week in Florida to go visit the Caribbean so it worked out beautifully.
I am finally to the point where I can walk into an exam room with confidence and assist my fellow ED nurses, knowing that I am actually going to do more good than harm. I can finally start thinking about the reason my patient is ill instead of just focusing on each task as the Doctor orders them.
I have by no means "arrived" but the destination is getting closer each and every day.
The low point this month would have to be the mid-twenties young woman who rolled into our ED dead on arrival because she had taken 90 days worth of her anti-depressants at once. Her mom and dad weeped in each other's arms and her finance's anguished cries echoed throughout the department and I was stunned. I wondered what happened to this poor girl to cause her to think that death was the only alternative. I tried to picture what it would be like to discover that someone in my family or one of my friends had taken their own life and I was instantly choked up. I got home that night and hugged my mom and sat on my baby sister's bed as we chatted about her day.
I love my job but I didn't that day. I adore being Super Nurse and victoriously snatching people from the fangs of death. I hated the thought that this beautiful woman who had so much to live for could only see the pain and tears and chose to end her own life prematurely.
I hope that God never lets me grow callous towards the plights of my patients.
So there you have it. 2010 starts off with bang.
In my personal opinion, roller coasters are the best part of theme parks even though some times you drop so low you don't feel like you can take it anymore and you want off so bad but you know there is now way out unless you hang on for the ride. Why should I spend my journey scared and miserable, clinging to the handrail in terror? The best way to ride a coaster is with both arms high in the air, screaming with laughter.
I'm going to enjoy the ride.
Sunday, January 3, 2010
out with the old, in with the new
2009 has been a much harder year than I thought it would be. I endured the toughest semester of nursing school, started out my nursing career in the emergency department, survived the flu and shingles in one week, went right back to school and proceeded to fail College Chemistry, and had my heart ripped out my chest and was left to bleed. Wow...it sounds awful when I put it that way. I had such high expectations last New Year. "I'm going to be a nurse and all my problems will be solved".
Silly Girl.
I think back to who I was a mere 365 days ago and I honestly barely even recognize that girl. I'm thinking that's a good thing. I was living stagnantly for the past 3 years. Same boyfriend, same school, same secretary's desk--every day was exactly the same. I was was living in a tiny box and I was very comfortable there. Thankfully circumstances both of my own doing and some out of my control, have destroyed my cozy little box and forced me out into an open space that I have no idea where it ends.
So what have I learned?
1) My family rocks. I have the two most beautiful, smart, funny, and amazing sisters that roam God's green earth. Yes, we still fight and I still want to inflict bodily harm on them occasionally but I love these two girls. They truly are my best friends and I wouldn't trade them for anyone! My parents are so supportive and thoughtful and just overall awesome. My dad has been my biggest cheer leader listening to me talk about my patients and encouraging me when I want to throw in the towel. My mom has put up with my valley's and rejoiced with me on my mountaintops. Always there for me and really good at keeping my feet on the ground. Yes...I love them all so.
2) Don't give up and never let them see you cry. I just realized today that I have been an ED nurse for 6 months. 6 MONTHS! I feel that this is a major accomplishment. I have never once cried at work since I became a nurse and this is also a major accomplishment for me! I may have cried after I got home but that's ok. There has been about 3-5 days at work that I have wanted to give up and say "screw it, I don't need this career" and I seriously was considering walking away. But that's not an option for me and I am glad I have stuck with it. I am learning so much in my ED and lately I have been getting assigned one of the resuscitation room which is scary but a great way for me to learn.
3) Life goes on. Be grateful for the good times and forget about the bad.
As Good Charlotte says...
"We break up
It's something that we do now
Everyone has got to do it sometime
It's okay, let it go
Get out there and find someone
It's too late to be trippin' on the phone here
Get off the wire
You know everything is good here
Stop what you're doin'
You don't wanna ruin
The chance that you got to
find a new one"
And that's all I'm going to say about that.
4)God doesn't give us more than we can handle. Sure I had a rough year and few times I didn't think I was going to make it or quite frankly, I didn't want to make it, but here I am. I'm alive, I have my health and my family and my awesome friends who keep me sane. God has a plan and purpose for me and these rough patches are shaping me to fulfill my destiny.
So welcome 2010, I'm glad you are here. Let's have a good time, eh? :)
P.S. Corrie, you rock. Thanks for always being there. 2010 will be great! Enjoy the journey my friend!
Silly Girl.
I think back to who I was a mere 365 days ago and I honestly barely even recognize that girl. I'm thinking that's a good thing. I was living stagnantly for the past 3 years. Same boyfriend, same school, same secretary's desk--every day was exactly the same. I was was living in a tiny box and I was very comfortable there. Thankfully circumstances both of my own doing and some out of my control, have destroyed my cozy little box and forced me out into an open space that I have no idea where it ends.
So what have I learned?
1) My family rocks. I have the two most beautiful, smart, funny, and amazing sisters that roam God's green earth. Yes, we still fight and I still want to inflict bodily harm on them occasionally but I love these two girls. They truly are my best friends and I wouldn't trade them for anyone! My parents are so supportive and thoughtful and just overall awesome. My dad has been my biggest cheer leader listening to me talk about my patients and encouraging me when I want to throw in the towel. My mom has put up with my valley's and rejoiced with me on my mountaintops. Always there for me and really good at keeping my feet on the ground. Yes...I love them all so.
2) Don't give up and never let them see you cry. I just realized today that I have been an ED nurse for 6 months. 6 MONTHS! I feel that this is a major accomplishment. I have never once cried at work since I became a nurse and this is also a major accomplishment for me! I may have cried after I got home but that's ok. There has been about 3-5 days at work that I have wanted to give up and say "screw it, I don't need this career" and I seriously was considering walking away. But that's not an option for me and I am glad I have stuck with it. I am learning so much in my ED and lately I have been getting assigned one of the resuscitation room which is scary but a great way for me to learn.
3) Life goes on. Be grateful for the good times and forget about the bad.
As Good Charlotte says...
"We break up
It's something that we do now
Everyone has got to do it sometime
It's okay, let it go
Get out there and find someone
It's too late to be trippin' on the phone here
Get off the wire
You know everything is good here
Stop what you're doin'
You don't wanna ruin
The chance that you got to
find a new one"
And that's all I'm going to say about that.
4)God doesn't give us more than we can handle. Sure I had a rough year and few times I didn't think I was going to make it or quite frankly, I didn't want to make it, but here I am. I'm alive, I have my health and my family and my awesome friends who keep me sane. God has a plan and purpose for me and these rough patches are shaping me to fulfill my destiny.
So welcome 2010, I'm glad you are here. Let's have a good time, eh? :)
P.S. Corrie, you rock. Thanks for always being there. 2010 will be great! Enjoy the journey my friend!
Monday, November 2, 2009
3 crazy days
I worked this past weekend and Friday as well, and boy did I have a crazy three shifts! It started with a pretty busy morning, my favorite part was helping the vascular surgeon put in a chest tube! It was awesome!!! It was the first I had assisted as the primary nurse! The patient did it on 0.5 mg Dilaudid and local anesthetic which probably explains why he jumped 6 inches off the stretcher! The surgeon was mad!! He was like "I said don't move!!!" I felt sorry for the guy, it was a spontaneous pneumothorax and he was only 26, he nearly cried.
After that, I got my first review as an RN and I got high marks! I was pleased to discover that my coworkers enjoy working with me and my boss thinks I am doing a good job!
Saturday was a strange day, we saw barely any patients all day long until 1500 when we got a call from EMS saying they were bringing in a 25 year old unrestrained driver involved in an accident on 95, she had been ejected 40 feet from her vehicle. Originally they were brining her to us to be pronounced because no one ever dies in an ambulance but halfway to our hospital she got pulses back so we were gonna have to stabilize her then fly her to Halifax. Right after that trauma call came over the radio we got another saying that a 7 year old in respiratory arrest was coming in. 7! I was ready to freak out because I had the pediatric trauma room so that patient would automatically go to me!
I raced around my room, hooking up the small blood pressure cuff and whipping out the Broslow tape, all the while terrified because I knew half the help would be with the trauma and not in there helping me with the child! Thankfully, we got a correction on the age and it was a 75 year old not 7. I was relieved but still nervous. My respiratory arrest arrived first, intubated, and as they rolled her into the room, they handed me the DNR. I was very confused as to why they had a patient with a valid DNR intubated but we rolled with it. She was in PEA which means the electrical circuit in her heart was still running but her heart wasn't actually beating. As soon as the doctor came in he pronounced her and we ceased all life saving measures. Dr T asked me to go with him to tell the family and after informing them that their mother didn't make it, the son asked what do we do now? Dr T says "RaDonna will tell you" and he walked out of the room.
Keep in mind that this is my fist expired patient and I have never had to deal with grieving family members before so I did my best and was as kind and compassionate as I could be and I called a priest for them and after removing all the tubes and cleaning her face, I let them come be with their mother. It was scary dealing with this new experience and also with preparing the body but you just have to take the hand you are dealt and learn to adapt.
My charge nurse was also very nice and helpful and he showed me how to fill out all the paperwork and told me everything I had to do. The rest of the day went pretty uneventful but we were all a little somber, especially when we found out that the trauma victim didn't make it.
Sunday was a crazy day. I think it was actually a full moon. I had this one nice lady who was only a couple weeks older than my mom who came in for new onset seizures. She was very scared and worried that maybe it was a side effect from the flu medicine she recently started. Unfortunately, after a CT scan, the ED Dr. diagnosed her with a frontal lobe tumor. She had never had cancer of any sort and this came as a complete shock to both her and her husband. The week before they had buried a family member who had died as a result from cancer. I felt completely incapable of caring for this woman emotionally which is part of my job as a nurse. My heart ached for this woman who after sobbing in her husbands arms for more than half an hour, just sat on her bed, staring at the sheet. There was absolutely nothing I could do for her. All I could do was work on transferring her to nearby Hospital for neurosurgical care.
Meanwhile, in room 9, I was given a 15 year old boy who snapped his femur falling off a motor cross bike. He is crying in pain and if that isn't enough to make me feel bad for him, I have to deal with his father in my face at the nurses station asking me why his son hasn't been medicated for pain. I calmly explained the nicest I could that I am realize that his son is in pain and a doctor would see him asap, but until then, aside from an ice pack, there was nothing I could do for him.
(I have had a broken ankle and that hurt like heck so I can't imagine the pain that he was in but seriously, there isn't anything I could do without a doctors order aside from having it x-rayed. Just wanted to make sure ya'll don't think I am heartless shrew. Besides, both docs were busy with a lady who had O2 sats in the 70s and a STEMI)
The father didn't believe me that there was nothing I could do and kept demanding that I do something. Unortunately, my forked tongue betrayed me and I said in not the nicest of tones: "Sir, I do not have a medical license, therefore, I cannot give your son anything for pain! You are going to have to wait until the doctor sees him!" I felt bad afterwards because I can't imagine how hard it is to see your son suffer but he wasn't listening to me! Plus, I was stressed to the max because I had my poor tumor lady in 10, and a SOB guy in 8, AND a pneumonia lady in the hall. I never have four patients and needless to say I was a bit frazzled.
After the doctor finally saw him and I gave him some happy juice, the dad apologized and in my sweetest nurse voice I told him there was no need, because I understood he was stressed.
Everything ended up quieting down and I didn't receive any phone calls today from the Florida Board of Nursing informing me that they would be revoking my license for shoddy patient care so I guess I'm good. I learned so much and had some great experiences this weekend. I wish I could hear how my tumor lady ends up. I don't think the prognosis will be good though because she has developed some abnormality to the roof of her mouth and the CT report said it required further testing. Please keep her in your prayers.
One of the nurses I worked with on Saturday said that one day it will hit me and I will say to myself "I'm an ED nurse". I'm not there yet but I'm getting closer everyday.
After that, I got my first review as an RN and I got high marks! I was pleased to discover that my coworkers enjoy working with me and my boss thinks I am doing a good job!
Saturday was a strange day, we saw barely any patients all day long until 1500 when we got a call from EMS saying they were bringing in a 25 year old unrestrained driver involved in an accident on 95, she had been ejected 40 feet from her vehicle. Originally they were brining her to us to be pronounced because no one ever dies in an ambulance but halfway to our hospital she got pulses back so we were gonna have to stabilize her then fly her to Halifax. Right after that trauma call came over the radio we got another saying that a 7 year old in respiratory arrest was coming in. 7! I was ready to freak out because I had the pediatric trauma room so that patient would automatically go to me!
I raced around my room, hooking up the small blood pressure cuff and whipping out the Broslow tape, all the while terrified because I knew half the help would be with the trauma and not in there helping me with the child! Thankfully, we got a correction on the age and it was a 75 year old not 7. I was relieved but still nervous. My respiratory arrest arrived first, intubated, and as they rolled her into the room, they handed me the DNR. I was very confused as to why they had a patient with a valid DNR intubated but we rolled with it. She was in PEA which means the electrical circuit in her heart was still running but her heart wasn't actually beating. As soon as the doctor came in he pronounced her and we ceased all life saving measures. Dr T asked me to go with him to tell the family and after informing them that their mother didn't make it, the son asked what do we do now? Dr T says "RaDonna will tell you" and he walked out of the room.
Keep in mind that this is my fist expired patient and I have never had to deal with grieving family members before so I did my best and was as kind and compassionate as I could be and I called a priest for them and after removing all the tubes and cleaning her face, I let them come be with their mother. It was scary dealing with this new experience and also with preparing the body but you just have to take the hand you are dealt and learn to adapt.
My charge nurse was also very nice and helpful and he showed me how to fill out all the paperwork and told me everything I had to do. The rest of the day went pretty uneventful but we were all a little somber, especially when we found out that the trauma victim didn't make it.
Sunday was a crazy day. I think it was actually a full moon. I had this one nice lady who was only a couple weeks older than my mom who came in for new onset seizures. She was very scared and worried that maybe it was a side effect from the flu medicine she recently started. Unfortunately, after a CT scan, the ED Dr. diagnosed her with a frontal lobe tumor. She had never had cancer of any sort and this came as a complete shock to both her and her husband. The week before they had buried a family member who had died as a result from cancer. I felt completely incapable of caring for this woman emotionally which is part of my job as a nurse. My heart ached for this woman who after sobbing in her husbands arms for more than half an hour, just sat on her bed, staring at the sheet. There was absolutely nothing I could do for her. All I could do was work on transferring her to nearby Hospital for neurosurgical care.
Meanwhile, in room 9, I was given a 15 year old boy who snapped his femur falling off a motor cross bike. He is crying in pain and if that isn't enough to make me feel bad for him, I have to deal with his father in my face at the nurses station asking me why his son hasn't been medicated for pain. I calmly explained the nicest I could that I am realize that his son is in pain and a doctor would see him asap, but until then, aside from an ice pack, there was nothing I could do for him.
(I have had a broken ankle and that hurt like heck so I can't imagine the pain that he was in but seriously, there isn't anything I could do without a doctors order aside from having it x-rayed. Just wanted to make sure ya'll don't think I am heartless shrew. Besides, both docs were busy with a lady who had O2 sats in the 70s and a STEMI)
The father didn't believe me that there was nothing I could do and kept demanding that I do something. Unortunately, my forked tongue betrayed me and I said in not the nicest of tones: "Sir, I do not have a medical license, therefore, I cannot give your son anything for pain! You are going to have to wait until the doctor sees him!" I felt bad afterwards because I can't imagine how hard it is to see your son suffer but he wasn't listening to me! Plus, I was stressed to the max because I had my poor tumor lady in 10, and a SOB guy in 8, AND a pneumonia lady in the hall. I never have four patients and needless to say I was a bit frazzled.
After the doctor finally saw him and I gave him some happy juice, the dad apologized and in my sweetest nurse voice I told him there was no need, because I understood he was stressed.
Everything ended up quieting down and I didn't receive any phone calls today from the Florida Board of Nursing informing me that they would be revoking my license for shoddy patient care so I guess I'm good. I learned so much and had some great experiences this weekend. I wish I could hear how my tumor lady ends up. I don't think the prognosis will be good though because she has developed some abnormality to the roof of her mouth and the CT report said it required further testing. Please keep her in your prayers.
One of the nurses I worked with on Saturday said that one day it will hit me and I will say to myself "I'm an ED nurse". I'm not there yet but I'm getting closer everyday.
Sunday, October 25, 2009
Monday Blues
I have to go back to work tomorrow and I really, truly don't want to go. I am terrified. I used to feel pretty good about my job and my abilities to function as a nurse but lately I seem to have misplaced my confidence and instead there is nasty dread and fear. I think it has something to do with our census creeping up and the fact that all of the patients have been sicker. I also think I should not be getting the trauma room assignments. I am but a baby nurse and 3 very critical patients is a bit much for me. I still need to perfect my time management skills,something that is difficult to do when I have to give one-to-one care to three patients.
I thought that once I graduated, all my problems would dissipate and I would be a kick butt nurse. But instead, I have a whole new set of problems like being scared of losing my license and causing permanent damage or death to my patients. Another new problem is the loneliness, when I had a "boyfriend" I was never, ever lonely. Now I am lonely all the friggin' time. I also thought that school would no longer be an issue but I am struggling so very hard to keep my head above water in my chemistry class/lab.
I guess problems will never go and they will always come. We just have different problems and we have to conquer each one as it comes along. I would like to think I will be happier next spring but that is too much to hope. Something else will come along and I will have to struggle through it. The point must be that it depends on my reaction to the problems. Do I come home from a hard days work and snap peoples heads off, cry and curl up in a fetal position or do I come home, shake it off and pull out my text book so I can handle the situation better in the future and thank God for the experience?
Yes...that must be it...I must react better so that I can learn this lesson and move on to the next lesson. I must be happy with and in myself. Co-dependency is very unattractive and something I shall never be again. I guess I need to give myself some credit too. I cannot rely on everyone else to stroke my ego and say "RaDonna, you are a good nurse." I need to believe it and do my best. The rest will fall into place eventually if I live and learn.
I wish I could have a pre-name and post name for this blog. My pre-name is "Monday Blues", the post name should be "Live and Learn".
P.S. Sorry for the particularly rambling state of this blog. I can't seem to dust the cobwebs off my mind today.
I thought that once I graduated, all my problems would dissipate and I would be a kick butt nurse. But instead, I have a whole new set of problems like being scared of losing my license and causing permanent damage or death to my patients. Another new problem is the loneliness, when I had a "boyfriend" I was never, ever lonely. Now I am lonely all the friggin' time. I also thought that school would no longer be an issue but I am struggling so very hard to keep my head above water in my chemistry class/lab.
I guess problems will never go and they will always come. We just have different problems and we have to conquer each one as it comes along. I would like to think I will be happier next spring but that is too much to hope. Something else will come along and I will have to struggle through it. The point must be that it depends on my reaction to the problems. Do I come home from a hard days work and snap peoples heads off, cry and curl up in a fetal position or do I come home, shake it off and pull out my text book so I can handle the situation better in the future and thank God for the experience?
Yes...that must be it...I must react better so that I can learn this lesson and move on to the next lesson. I must be happy with and in myself. Co-dependency is very unattractive and something I shall never be again. I guess I need to give myself some credit too. I cannot rely on everyone else to stroke my ego and say "RaDonna, you are a good nurse." I need to believe it and do my best. The rest will fall into place eventually if I live and learn.
I wish I could have a pre-name and post name for this blog. My pre-name is "Monday Blues", the post name should be "Live and Learn".
P.S. Sorry for the particularly rambling state of this blog. I can't seem to dust the cobwebs off my mind today.
Sunday, October 11, 2009
Growing Pains
The beginning of the latest schedule at work marked the beginning of my life as an Independent ED RN. I was now officially off orientation and ready to take my very own assignment! My first shift went great and nothing unusual happened and all my patients survived!
The next day was Monday and I got my first Code STEMI all on my own and did pretty well, even had a cardiologist breathing down my neck and still got the heparin hung and the second IV started and the patient shipped out in excellent time! And then I asked the Physicians Assistant to look at the suspicious rash that had been developing on my neck and shoulder and she diagnosed me with shingles! Normally I would have just let it go it's own course and get better over time but there are three prego nurses at work and I would never have been able to forgive myself if my shingles caused harm to their babies. So I told my boss and was promptly sent home from work for a week! I was disappointed because I really wanted to keep up my momentum and get into my own pattern and ways of doing things. But I used the time to relax and tried to find ways of cutting the stress out of my life because that is why I got the shingles at such a young age!
Then I got the flu on Sunday, the day before I was supposed to go back to work, so I had to call out again! I had never been so sick in my life and what's more my mom was out of town so I had to nurse myself back to health! ( I am a very whinny sick girl!) But I finally got better and went back to work. I was behind in school though and my teacher was giving me grief about a doctors note and yadda yadda and through all of this I was doing an excellent job at feeling sorry for myself!
I finally got things back on track and felt like life was going good again until that Sunday I helped work my first pediatric code. It is impossible to describe how it feels to see a 6 year olds' body mangled and broken on the stretcher and seeing all the nurses and doctor working as hard as they can to save him while wiping tears from their eyes. He didn't make it and we didn't have time to grieve for him before two more pediatric patients from the same accident came rolling through the ambulance bay doors. Those were three of the hardest hours I've had so far as a nurse and I'm sure I will have many harder ones to come.
I had been doing pretty well working on my own, all was well and the biggest personal triumph I've had is that I've only needed help twice starting an IV and even was able to get a successful IV start on a 6 year old dehydrated boy on the first shot! That made me happy! For some reason I am fixated on IVs. :)
Like I said, everything was going fine until last Wednesday. I had a 67 year old male patient complaining of blood in his stool. He said he’d been eating raspberries the night before and now his stool looked as pink as my scrub pants. His vital signs looked great, in fact his blood pressure was actually elevated at 152/90. His skin was warm and dry and his color was great: nice and tan. I hooked him up to the monitor and started a line on him and went ahead and ordered some labs tests on him and sent the blood down to the lab since I knew that Doctor wasn’t going to be able to see him anytime soon.
15 minutest later, I walk past the room to find blood all over the floor, the stretcher, my patient, and even the wall. It looked like someone had slaughtered a pig in my patient’s room. He had lost what looked like .25 to .50 of a liter of blood from his GI tract. He was pale, drenched in sweat and complaining of weakness and horrible cramping. I called for help from a tech and another nurse and I started running fluids on him immediately. By this time his blood pressure is now 100/55 and I am downright terrified. The doctor came in, examined him and ordered 2 units of blood stat for him. Meanwhile, a code was coming in so I lost the help of the other nurse and the tech. I got him all cleaned up, the best I could, and after about thirty minutes got him stable enough that I wasn’t certain he was going to keel over any second. About an hour and a half later, I shipped him up the ICU to get his blood transfusion.
I feel like I failed him. I wish I had been able to recognize sooner that he was so sick and was going to go downhill so quickly. I should have gotten a doctor in there sooner to see him or at least observed his stool so I could determine that yeah, this man was having an active GI bleed and not just overreacting about some raspberries. The rest of this shift and day, I felt like a horrible nurse. On Friday, I was grateful I got to work in fast track which meant I had a 99.99% certainty that I wouldn’t kill anyone because all the patient’s were just complaining of minor issues like colds and lacerations.
So now I am terrified of going to work tomorrow. It’s Monday and I know it’s going to be crazy busy and I will be running my butt off and will probably get some very sick patients. I just pray to God that He will be merciful to me and my patients and use my hands and my mind to bring healing and not harm to each and every one of my patients.
I bought some new scrub tops and a nifty new stethoscope hip holder so I am going to walk in to work tomorrow dressed to impress, with apprehension in my stomach and this prayer on my lips: Please God, please don’t let me kill anyone today.
Amen.
Wednesday, August 19, 2009
Long Overdue
Today I went to the movies and watched Julie & Julia and was inspired to once again do my part and contribute to A tale of Two Nurses.
Hi--Longtime no see :D
I feel like a different person since the last time we have spoken. I have been through the ringer so to speak and emerged a little damaged and a lot changed. For the better I hope. Oh where to begin...the last time I blogged I was trying to keep from freaking out over a dirty needle stick.
Clinically I am still a spastic nurse...I recently attempted to bleed a patient out one of her anticubital veins because I started her IV without properly preparing my supplies and when I scored a superb vein, I was unable to staunch the flow and had to call in reinforcements to help me unwrap my supplies and cap the the IV catheter. The patients daughter was on the verge of freaking out. I was mortified. And about a week ago I forgot to take the tourniquet off my patient's arm after drawing blood. The tourniquet was found by the paramedic who wrote on it "No circulation is a great thing!!! RaDonna!! Ha ha ha!!!" I was humiliated!!! But I learned 2 valuable lessons that I won't soon forget.
Educationally I am now Trauma Nurse Core Course Certified and Emergency Nurse Pediatric Course Certified which means I will better be able to care for my patients in crisis situations and I will also be more marketable in the likely event I don't stay at my current hospital for the rest of my life. And as of Tuesday I will be a University student! I am going straight back to school for BSN because knowing me if I lose momentum now I won't ever go back. I will also be taking College Chemistry which is the the only class to ever kick my butt so I am going back for more! Wish me luck because it is making me nervous.
Emotionally I am doing pretty horribly. A week ago today I broke up with boyfriend of nearly two years. Irreconcilable differences I suppose would be the technical reason...we just started sucking at being together and decided to call it quits. We are trying the friend route which I really hope works out well because not only was he my boyfriend he was also my best friend and he knows me better than anyone. So we'll see where this goes. I am filling my newly found time with lots of sleeping, lots of Call of Duty 4, some crying and a bit of self-loathing and pity. But I am doing my best to keep my spirits up and look on the bright side...I can now wear high-heels and will be able to focus more on my school this fall. People say that breaking up is hard to do and I think that is a serious understatement. I actually feel like I am walking around with a gaping hole in my chest and nothing that anyone says or does will make it better. But I will be ok, I will emerge a better and more complete person, it will just take time.
That is all for tonight...I am typed out for the present...
Hi--Longtime no see :D
I feel like a different person since the last time we have spoken. I have been through the ringer so to speak and emerged a little damaged and a lot changed. For the better I hope. Oh where to begin...the last time I blogged I was trying to keep from freaking out over a dirty needle stick.
Clinically I am still a spastic nurse...I recently attempted to bleed a patient out one of her anticubital veins because I started her IV without properly preparing my supplies and when I scored a superb vein, I was unable to staunch the flow and had to call in reinforcements to help me unwrap my supplies and cap the the IV catheter. The patients daughter was on the verge of freaking out. I was mortified. And about a week ago I forgot to take the tourniquet off my patient's arm after drawing blood. The tourniquet was found by the paramedic who wrote on it "No circulation is a great thing!!! RaDonna!! Ha ha ha!!!" I was humiliated!!! But I learned 2 valuable lessons that I won't soon forget.
Educationally I am now Trauma Nurse Core Course Certified and Emergency Nurse Pediatric Course Certified which means I will better be able to care for my patients in crisis situations and I will also be more marketable in the likely event I don't stay at my current hospital for the rest of my life. And as of Tuesday I will be a University student! I am going straight back to school for BSN because knowing me if I lose momentum now I won't ever go back. I will also be taking College Chemistry which is the the only class to ever kick my butt so I am going back for more! Wish me luck because it is making me nervous.
Emotionally I am doing pretty horribly. A week ago today I broke up with boyfriend of nearly two years. Irreconcilable differences I suppose would be the technical reason...we just started sucking at being together and decided to call it quits. We are trying the friend route which I really hope works out well because not only was he my boyfriend he was also my best friend and he knows me better than anyone. So we'll see where this goes. I am filling my newly found time with lots of sleeping, lots of Call of Duty 4, some crying and a bit of self-loathing and pity. But I am doing my best to keep my spirits up and look on the bright side...I can now wear high-heels and will be able to focus more on my school this fall. People say that breaking up is hard to do and I think that is a serious understatement. I actually feel like I am walking around with a gaping hole in my chest and nothing that anyone says or does will make it better. But I will be ok, I will emerge a better and more complete person, it will just take time.
That is all for tonight...I am typed out for the present...
Saturday, July 11, 2009
an unfourtunate event
Have you ever had one of those moments where time stands still and in that moment you ask yourself "Did I really just do that?". The room closes in around and you realize in shock that yes, yes you did do that terrible thing you dread. You would rather be swallowed up into the floor than face the consequences of your actions.
Obviously I had one of those moments today.
It occurred at 10:50 am and in 3 seconds I was aware of the fact that I had stuck myself with a dirty needle. I was sick with shame and fear. I calmly threw away the offending sharp and ripped my gloves off. Blood pooled on the tip of my thumb as I walked over to the sink and scrubbed my thumb with soap and hot water. It's amazing how what little they taught me about needle sticks in nursing school, somehow floated to the forefront of my mind. I continued to wash my thumb for several minutes and squeezed blood out of the puncture wound. I slapped a 2x2 on it and sought out my charge nurse.
She calmly heard me out then proceeded to check me into room 17, take my vitals and helped me start the huge file of paperwork. I had a few minutes before the ED doc was going to come in and evaluate me so I went outside to get some air and call my mom. That's when the tears came. I wasn't exactly scared for myself (the patient was very low risk as far as possibly having HIV and Hep B or C), I was mostly furiously angry at myself. I could only imagine what everyone was thinking. "Newbie nurse should have been more careful". I felt so inadequate and stupid. My mom told me it would be ok and it was a good learning experience for me. This is true but I would have rather have learned this lesson some other way.
For the rest of my nursing career, I know I am going to be so cautious with sharps of any sort, especially 23 gauge butterfly straight stick needles. Even now I cringe thinking about what happened! How could I have done this! I know better! ARRRRRRGGGGGHHHHH!
My preceptor found me sniffling in the parking lot and assured me that she had been stuck several times with dirty needs and was even put on the anti-viral medications. So many healthcare workers have stuck themselves but it made them all better at their jobs. She said the risk for getting something was slim to none and to not worry, it would all end up ok. So I pulled myself up by my bootstraps and went back inside and down to the lab to have my baseline labs drawn and to get a urine drug screen (workman's comp you see). The patient consented to having his blood drawn for HIV testing, amoung other tests. The results to the rapid HIV test came back negative much to my relief.
I learned a valuable lesson today, one that I won't soon forget.
Obviously I had one of those moments today.
It occurred at 10:50 am and in 3 seconds I was aware of the fact that I had stuck myself with a dirty needle. I was sick with shame and fear. I calmly threw away the offending sharp and ripped my gloves off. Blood pooled on the tip of my thumb as I walked over to the sink and scrubbed my thumb with soap and hot water. It's amazing how what little they taught me about needle sticks in nursing school, somehow floated to the forefront of my mind. I continued to wash my thumb for several minutes and squeezed blood out of the puncture wound. I slapped a 2x2 on it and sought out my charge nurse.
She calmly heard me out then proceeded to check me into room 17, take my vitals and helped me start the huge file of paperwork. I had a few minutes before the ED doc was going to come in and evaluate me so I went outside to get some air and call my mom. That's when the tears came. I wasn't exactly scared for myself (the patient was very low risk as far as possibly having HIV and Hep B or C), I was mostly furiously angry at myself. I could only imagine what everyone was thinking. "Newbie nurse should have been more careful". I felt so inadequate and stupid. My mom told me it would be ok and it was a good learning experience for me. This is true but I would have rather have learned this lesson some other way.
For the rest of my nursing career, I know I am going to be so cautious with sharps of any sort, especially 23 gauge butterfly straight stick needles. Even now I cringe thinking about what happened! How could I have done this! I know better! ARRRRRRGGGGGHHHHH!
My preceptor found me sniffling in the parking lot and assured me that she had been stuck several times with dirty needs and was even put on the anti-viral medications. So many healthcare workers have stuck themselves but it made them all better at their jobs. She said the risk for getting something was slim to none and to not worry, it would all end up ok. So I pulled myself up by my bootstraps and went back inside and down to the lab to have my baseline labs drawn and to get a urine drug screen (workman's comp you see). The patient consented to having his blood drawn for HIV testing, amoung other tests. The results to the rapid HIV test came back negative much to my relief.
I learned a valuable lesson today, one that I won't soon forget.
Saturday, June 20, 2009
A week of 1sts
I am now a Registered Nurse :)
Thank you to everyone for believing in me and supporting me through this long and hard journey. It isn't cliche' when I say I couldn't have done it without my wonderful family and friends. You truly are amazing and I thank God for you all daily.
I am now settling a little better into my new role at work. It's taking some adjusting not to jump for the phone every time it rings and when the ED doc tells me to call the hospitalist, I politely remind him that I am no longer a secretary. Now I have to retrain my ears to be alert to the sounds of cardiac monitors and call bells, and when the patient in room 12 is calling "Nurse", he means me.
I don't feel stuck in the middle anymore. Going from graduate nurse to rn has made me feel much more purposeful, like I actually belong in ED instead of just looking on from the outside.
All the nurses and doctors and my bosses have been so kind to me at work. They seem almost as excited as I am with my new position. So encouraging and always looking for opportunities to teach me.
I have had many new experiences this week, some good...some bad. I had my first amputation, that was fun! Now I know you wrap the loose appendage (in this case it was a finger tip--painted nail and all!) in moistened gauze then put it on ice. Unfortunately, it didn't look like the orthopedic surgeon was going to be able to save the tip but she would still have most of her finger.
I had a gnarly old man patient that was trying to get me to come home with him and an anxious woman who yelled at me for not being able to read her mind. I am getting better at my IV starts, I can do them on feeling alone now without being able to visualize the vein at all.
There was also a little boy who got hit by a car that was brought into our ED who was in asystole and I was able to watch from a distance as my fellow nurses and the doctors tried their hardest to keep him alive. They brought him back, ct scanned him, and had him packed on a chopper in under an hour. Sadly the 8 year old boy's injuries were too extensive and he died approximately 24 hours later.
Although the outcome was a tradgedy, I was amazed to see how well the nurses and doctors worked together and knew exactly what to do. I can't wait til I am at that skill level and can help save lives.
So I am doing what I can to prepare myself. Under the advice of my daddy, I am taking a Trauma Nurse Core Course next month and tonight, I bought a book called "Emergency Nursing made Incredibly Easy". I don't see how anything in nursing can be termed easy but we will see if it can whip me into shape!
My goal is to be the best possible ED nurse I can and my dear sister Randi Jean says that's the first step in greatness, wanting it to be so and doing everything in my power to achieve it. I'll have to let God do the rest.
Thank you to everyone for believing in me and supporting me through this long and hard journey. It isn't cliche' when I say I couldn't have done it without my wonderful family and friends. You truly are amazing and I thank God for you all daily.
I am now settling a little better into my new role at work. It's taking some adjusting not to jump for the phone every time it rings and when the ED doc tells me to call the hospitalist, I politely remind him that I am no longer a secretary. Now I have to retrain my ears to be alert to the sounds of cardiac monitors and call bells, and when the patient in room 12 is calling "Nurse", he means me.
I don't feel stuck in the middle anymore. Going from graduate nurse to rn has made me feel much more purposeful, like I actually belong in ED instead of just looking on from the outside.
All the nurses and doctors and my bosses have been so kind to me at work. They seem almost as excited as I am with my new position. So encouraging and always looking for opportunities to teach me.
I have had many new experiences this week, some good...some bad. I had my first amputation, that was fun! Now I know you wrap the loose appendage (in this case it was a finger tip--painted nail and all!) in moistened gauze then put it on ice. Unfortunately, it didn't look like the orthopedic surgeon was going to be able to save the tip but she would still have most of her finger.
I had a gnarly old man patient that was trying to get me to come home with him and an anxious woman who yelled at me for not being able to read her mind. I am getting better at my IV starts, I can do them on feeling alone now without being able to visualize the vein at all.
There was also a little boy who got hit by a car that was brought into our ED who was in asystole and I was able to watch from a distance as my fellow nurses and the doctors tried their hardest to keep him alive. They brought him back, ct scanned him, and had him packed on a chopper in under an hour. Sadly the 8 year old boy's injuries were too extensive and he died approximately 24 hours later.
Although the outcome was a tradgedy, I was amazed to see how well the nurses and doctors worked together and knew exactly what to do. I can't wait til I am at that skill level and can help save lives.
So I am doing what I can to prepare myself. Under the advice of my daddy, I am taking a Trauma Nurse Core Course next month and tonight, I bought a book called "Emergency Nursing made Incredibly Easy". I don't see how anything in nursing can be termed easy but we will see if it can whip me into shape!
My goal is to be the best possible ED nurse I can and my dear sister Randi Jean says that's the first step in greatness, wanting it to be so and doing everything in my power to achieve it. I'll have to let God do the rest.
Saturday, June 6, 2009
fake it til you make it
I have completed 4 shifts in the emergency department as a nurse so far and I feel like I have absolutely no idea what I am doing. I make the silliest mistakes like taking a blood pressure in the arm of a man whose finger was so infected and swollen that his skin split. Something is strangely a muck with my IV's--I got them all today but they just didn't seem quite right. I somehow manage to blood-let every one of patients! :)
I feel adrift in the nursing world. Being a graduate nurse is kind of crippling. I am in limbo between Registered Nurse and Secretary and I can't really find my niche. Soon though! 8 days and counting!
I did have my first "trauma" today. An 80 year old man who took a spill on his scooter going thirty miles per hour. Wouldn't have been so bad except he was on a blood thinner so it took a bit of work to get all his bumps and abrasions to quit oozing. He was so nice and sweet but his wife called me Rhianna...haven't heard that one before!
I love being a nurse though. I enjoy being the hands that bring God's healing touch. My people skills are improving so much. Dealing with all kinds of people in all different kinds of situations has a way of launching a crash course in diplomacy and patience. I have been so protected these past 3 years, deep in the nurses station only interacting with the doctors and nurses. Now I am one of them (almost) and I couldn't be happier!
My plan is to take it one day at a time. Do the best I can with each and every patient I see. And continue to fake it til I make it :)
I feel adrift in the nursing world. Being a graduate nurse is kind of crippling. I am in limbo between Registered Nurse and Secretary and I can't really find my niche. Soon though! 8 days and counting!
I did have my first "trauma" today. An 80 year old man who took a spill on his scooter going thirty miles per hour. Wouldn't have been so bad except he was on a blood thinner so it took a bit of work to get all his bumps and abrasions to quit oozing. He was so nice and sweet but his wife called me Rhianna...haven't heard that one before!
I love being a nurse though. I enjoy being the hands that bring God's healing touch. My people skills are improving so much. Dealing with all kinds of people in all different kinds of situations has a way of launching a crash course in diplomacy and patience. I have been so protected these past 3 years, deep in the nurses station only interacting with the doctors and nurses. Now I am one of them (almost) and I couldn't be happier!
My plan is to take it one day at a time. Do the best I can with each and every patient I see. And continue to fake it til I make it :)
Monday, June 1, 2009
GN day 1
I have blood on my right shoe. I survived 3 years of working in the Emergency Department as a tech and 2 years of nursing school and never once did a drop of blood ever come in contact with my scrubs. But my very first day as a Graduate Nurse and I get blood on me.
How awesome is that? :D
I had a very successful first day I think. I missed 66% of my IV starts, charted on the wrong patient only once, and got to perform CPR for the first time. My preceptor called in sick today so I was following around a different nurse than I am used to, who is great but just not what I am used to. It was good to see how other nurses assess their patients and chart and to discover what they have learned over the years and what stuck out the most to them.
I am so very tired though...I think I will write more in the next couple of days because I am just so tired.
How awesome is that? :D
I had a very successful first day I think. I missed 66% of my IV starts, charted on the wrong patient only once, and got to perform CPR for the first time. My preceptor called in sick today so I was following around a different nurse than I am used to, who is great but just not what I am used to. It was good to see how other nurses assess their patients and chart and to discover what they have learned over the years and what stuck out the most to them.
I am so very tired though...I think I will write more in the next couple of days because I am just so tired.
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