Wednesday, June 20, 2012
Round and Round....
Last night was the last of four in a row for me, I was hoping for a quiet night where everything ran smooth as butter, unfortunately I didn't get my wish. Last night I was assigned a tiny elderly woman who was hypothermic and unable to regulate her temperature. I received my report from the day RN and right after she walked out the door the night took off like a horse at the Kentucky Derby. She was not the "stable vent" that most newbie nurses get, she was a very unstable vent who could not hold a blood pressure without the assistance of pressors, whose blood gases were severely abnormal and making zero urine.
I felt like a gerbil running in a wheel for most of the night, never getting ahead of anything. It was kind of like playing some obscene game of whack-a-mole, just when I thought that I had taken care of one issue another reared it's ugly head prompting yet another call to the Doc and yet another page of orders. At some point that night I began to wonder what the hell I was doing with this patient and that I couldn't possibly handle it another second, but I was in waist deep what was I going to do other than keep going and just try and make it to 0700 with my patient still alive.
Many liters of saline, numerous tests and a number of medications later my salvation arrived. I gave report and finished up what charting I had left and grabbed my bags. My charge nurse had waited to see me out and said to me;
"I feel bad about that assignment, I really thought it was a stable vent and then by the time we figured it out it was too late to change assignments. But you handled that really well, we were all watching you with her and began joking we should give you more of these types of patients so you don't have time to sit around and complain all night." She laughed and gave me a pat.
I was surprised with the comment, I felt so out of control all night, how could she say that I handled anything well? So I told her how helpless and useless I had felt, barely being able to keep up with the orders that flooded in and not really getting anywhere with the patient. She just shook her head at me and told me this.
"Your patient is alive because you did what you did last night, that means you handled everything just fine. Did you think in her condition she was just going to sit up and be better? You can only do what is put in front of you to do, that is your job."
It made me stop and think for a moment and realize that she was right. I did exactly what I had been trained to do, even if it made no visible, immediate difference in my patients condition at that time. In essence, the fact that my patient was still alive, was a victory and a credit to the work I did that night and it did deserve to be recognized. I also realized that I was never once alone that night, she and my co-workers had watched me carefully all night, only stepping in when really needed because I needed to learn for myself what I was able to do. I smiled and thanked her for the compliment, and admitted that in the end I did need the experience to teach me that I could handle the pressure of something more than just a "stable vent" and said;
"Oh and I do not sit and complain all night! I am very careful to keep it to only half the night."