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.

Carpet.

If there is one thing that should not be in hospitals, at least in the parts that have patients, is carpet. YUCK. Do you know what I get on my shoes on a daily bases? MRSA, CDiff. Blood. Patients leak on the floor on the way to the bathroom. They drop things. Their bandages fall off. NASTINESS gets on floors in hospitals. Up until last year when I first started working, we had carpet in patient rooms,which was gross. Then they got smart and my boss had it all replaced with linoleum. Ugly, but when a patient has a fem pop blow and looses have of her blood in two minutes flat until I can start holding pressure and yelling for help all I have to do is get house-keeping to come mop it up. When the patient starting chasing us in the hallway with a full urinal trying to splash us and then tripped and fell backwards and slammed his head into the floor and started bleeding out of his ear, that blood was still there nine months later thanks to the carpet. There is a limit to now much you can get out of carpet. Especially when it is ten years old and already full of nasty junk.

Nine months being the key word to when the carpet was replaced last week. We were all excited about the new floors, until we figured out that they were putting down more carpet. Yup. My hospital which is perpetually broke spent money to place more carpet down, not something solid that we can mop. want to see what it looks like?
(okay, so apparently I fail at paint and this pic is kind of small but if you click on it it gets bigger)

nice, huh? We are somewhat flabbergasted. The carpet is actually somewhat nice looking. At least it was, until like the second day after it was laid when one of B's patients managed to break his IV tubing, leaving the port open and blood pouring out of his arm. He walked out of his nice, linoleumated floor and onto our brand new carpet to get help. There is now blood all over that section of floor.

Blood that will probably be there for the next 10 years until they get around to replacing it again.

That, my friends, is why I will never like carpet. And why I will never wear work shoes anywhere but work.

(in other news, my dad had an article published in the Wichita Eagle about health care reform. He used some of the info I sent him... exciting. Click here to read it)