Saturday, February 25, 2012

After 21 shifts, I am finally updating. (well, when I first started writing this it was 21. Now its been 24)

Its been amazing to see all that I've learned these last 7 weeks. Originally, my orientation was 6 weeks long, but I had asked for an extra week to train just to make sure I was completely ready to be on my own. Ironically, two of those three extra orientation shifts I had to be completely on my own anyway, so I really still only had 6 weeks on orientation.

Tomorrow I begin my 2pm-2:30am shifts officially on my own. I am excited and still scared at the same time. While there's a lot I've learned, there's still so much I don't know. The good thing is, for the most part, a lot of the staff are very helpful. I seem to have a good working relationship with most of the doctors. There's one doctor who works at night that I have not yet worked with, so I don't know how she is. There's one doctor who is a little harder to get along with, but for the most part, she is ok to work with as well. So on that end, all is good.

Here is some of what I've seen so far. WARNING: There may be things listed that are hard to read. Now might be a good time to stop reading.

  • I've seen 1 code so far. I even helped a little, very little. She made it then, however, she ended up coding 2 more times after I left and ended up dying. Most codes do.
  • The other day I had seen the same patient in the ER 3 times. In one day. THREE!! She wasn't my patient, but I had her the week before, and so I noticed her. And then noticed her again. And then I noticed her again. Sheesh.
  • The other night I was with a patient when he died. He was a patient whose wishes were that he not have CPR or breathe with the help of a machine or anything, so we just watched him die. I'm not sure if it was the fact that he was 98, or the fact that he did not want any resuscitative measures, or a combination, but I really didn't feel anything like I thought I would seeing a death. I was fine. Had it been someone younger, or someone who we tried to resuscitate, maybe I wouldn't be. It was kind of strange to see the heart monitor as the heart rate started dropping from the 60s to the 50s, 40s, 30s, 20s, and to see him stop breathing and then the monitor finally go to a flat line. But I was fine, even though I was there when he first came in and was still talking and still had color. It was crazy how much this poor man had changed in mere hours, and I especially remember the color, how it was completely drained from him. I'd never witnessed that myself before. But maybe I was fine because the man didn't have to die alone. No one should. And while he did have family that came to see him and be with him, they had left. I guess it did feel good somehow to be able to be there for someone so that they didn't have to be alone while they died, if that makes any sense at all.
  • One of the patients I had my very first week working was a young woman who had a miscarriage at home. She was around 3 or 4 months pregnant. She wasn't sure what to do with the baby, so she put the baby in a tupperware bowl and brought it with her. I did tear up before I went into see her, but I took a deep breath and held it together when I went in. I must say, the Lord was with me, because the sight of that baby was probably the hardest thing I've seen so far, and for me not to completely lose it, well, that wasn't any strength I had in me. That was a higher power for sure.
  • I had an 8 year old patient who I held his hand, wiped his tears and reassured him while he got a couple of stitches. That made me smile.
  • One of the most disturbing patients that came through the ER, who I partially took care of after the nurse that started her care went home for the night, was a lady who heard voices in her head, specifically the devil, and was told to use scissors to cut out the cancer. I don't know if she actually used them to "cut" but she put them in a place she isn't supposed to. I'll leave it at that.
  • And the grossest thing I've seen, HANDS DOWN, was a guy the other day who was brought in via fire rescue, drunk and found unconscious on the side of the road. He was sobering up, and awake, and I was covering for his nurse while she was on break. He started getting agitated because he wanted a medication that the ER doc was not going to give the patient (it was prescription medication used to treat addiction to opiates) and the ER doctor just stated that the patient would be discharged in time to take his dose, but he needed to sober up before he was discharged. Well as time went on, the patient got more and more agitated, and meanwhile had urinated in these urinal bottles we have for the male patients. So he's holding this bottle, opened, threatening to throw it on someone if he doesn't get his medication. The charge nurse was getting ready to call the police when the guy decides he will just drink it instead, and he gulped down about 32oz of his own urine. Yuck!!
I've seen a few patients more than once in my ER. I've seen some pretty critical patients. I've seen some I wonder why exactly they came to the ER in the first place. I've wondered why some people didn't call 911 to come in while others I've wondered why they felt 911 was the way to go. I actually had a patient who came from a nursing home for a medical clearance to go to our psych unit. The home called 911 to bring the patient over. There are ambulance services in our area who can transport patients from the homes to the hospital and vice versa. This happens everyday at our ER. But this home decided it was ok to call 911 for transporting purposes. This was a non-emergency issue, they just wanted the patient cleared medically before being treated as a psych patient. When the fire rescue guy was telling me this my jaw dropped. He said it wasn't the first time this home has done this to them. Unreal.

One thing I have learned while working in the ER is that nothing ceases to amaze me. There is something new everyday- new patients, new issues, new things to learn. I love working in the ER, but it can be very stressful at times. I'm still trying to find my groove, but for the most part, I have a good team of people to work with. I work the 2pm-2:30am shift, which means I get to work with both the day people and the night people, so I get the best of both worlds, as I like to call it.

So my intent to update more frequently. I will try, that is all I can say.

I am 15% done with my first year as an ER nurse. Yeah, that's kind of a weird way to put it, but thats where I'm at. 24 shifts complete, 132 left and then I will have 1 year of experience as an ER nurse. Strange, but true.

Let's see how those 132 shifts turn out.

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