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."


  1. As a nursing student, I've had a couple clinicals where I felt the same way: unprepared, in over my head, and like I wasn't doing anything. Those were usually the clinicals where my instructor would tell me she was proud of me and I did a good job - a complete shock to me as I felt the exact opposite.
    I love reading all your stories as a new nurse. I'll graduate in December from nursing school & I feel maybe just a little less scared about what to expect out there as a new nurse :)

    1. Thanks Breanna!

      I started this blog in hopes that other new nurses and nurses to be would be able to see that what they are going through is totally normal. It was hard for me because there are no people in my family in healthcare, so I relied heavily on a couple friends from nursing school. We used to call each other all the time and ask "Do you know what I'm talking about?"
      I also think that in the crazy situations people notice not "how well" you handled it, but how you handled it. If you remember to always find humor in everything and keep your cool you will do fine.

  2. Oh man. I'm super nervous about a year from now when I'll be in your position. With clinical experience, I get more comfortable with everything, but once that day comes when I won't have a clinical instructor to look to anymore, i'm sure things will change. So far, my pt load has only been 2 at a time. In the fall, we'll eventually get to 3. THAT even makes me nervous. I do NOT see how these RN's have 7-8 or more patients, and time to hang out at the nurse's station, chatting. I'm running around crazy with only the 2 i get assigned.
    Good job on keeping her alive ;)
    it can be a scary thing knowing YOU are keeping someone alive...

  3. Misty, always remember that in nursing you are never alone. I felt exactly as you do now when i school and I learned very quickly that there is always someone who has your back on the floor.

    As for handling patients, it all comes in time. It's hard for you now because you are still learning skills on top of the theory and trying to "work" while you do. Trust me, it will come to you in time. And then sometimes you just need help, last night I had a second patient as well and I had to ask for help or for someone to check in on him since I could not. You'll do great.


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