Friday, February 17, 2012

i laughed, i cried....

I've been having some great shifts! I feel more and more confident everyday and am proud of the work i'm doing. I'm actually taking on some extra shifts to get more practice and make a lil extra money :)

Some interesting scenarios:

#1 I walked into a another nurse's room to grab some gauze and happened to look up at the patients monitor. I noticed the heart rhythm was very fast (supraventricular tachycardia) so I glanced down at the patient. His eyes started twitching, rolling around in his head and then it began...the seizure of all seizures. He was having a tonic clonic seizure:
Tonic–clonic seizures (formerly known as grand mal seizures or gran mal seizures) are a type of generalized seizure that affects the entire brain. Tonic–clonic seizures are the seizure type most commonly associated with epilepsy and seizures in general, though it is a misconception that they are the only type.

I called for assistance as he was flailing and banging his head and neck repeatedly on the bars of the bed. He was biting down really hard on his tongue and blood was spraying all over the floor. We managed to protect his head but the seizure kept coming and coming. Ativan (seizure medication) was given and slowly he relaxed into a calm state. His vitals were all over the place and he was admitted to the floor immediately. The doc and nurse were thankful i 'happened' to be in the room at the time. You just never know......

#2 50 yr old male, addicted to cocaine with a family who loved him very much. A regular guy who couldn't kick the habit. He must of wanted to get more of a high so decided to take morphine with his daily dose of cocaine  and his wife and son found him on the floor. They didn't know how long he was out and by the time he arrived he'd been asystole (no heartbeat) for 20 minutes. Epinephrine, bi carb and the defibrillator could not save this man. He died. His wife and family were screaming for what seemed like an eternity. Moral of the story; say no to drugs.



#3 Disclaimer:not for the faint of heart
30 year old woman, 4 months pregnant..She was having clear fluid leaking and was concerned. We did an ultrasound and the baby still had a heartbeat. She was informed to go home and see her OBGYN the next day because in the ER if the baby has a heartbeat we can't perform a D&C ( also known as dilation and curettage, is a surgical procedure often performed after a first trimester miscarriage. Dilation means to open up the cervix; curettage means to remove the contents of the uterus. Curettage may be performed by scraping the uterine wall with a curette instrument or by a suction curettage (also called vacuum aspiration), using a vacuum-type instrument). I cleaned her up, gave her all her information and discharged her. 5 Minutes later a paramedic tells me someone is calling for me from the bathroom near the exit of the ER. I run over and it was my patient, she was sitting on the toilet crying and screaming. I close the door to help her and ask what happened. She said " my baby is there, my baby is there"! I look into the toilet and the 4 month old baby was hanging from the umbilical cord. His little heart was not beating. There was a lot of blood and to be honest with you, I felt my utterly devastated for this woman. I felt my eyes well up and my heart ached. I called for help from the doc and he advised me to get her back into a room and we would admit her to the OB department. Here's the problem: the baby was still attached. She had not birthed the placenta. I had to scoop the baby into a basin and assist her and the baby to a stretcher. She sat down with the little basin between her legs and I dashed to cover it up so she wouldn't have to see it. I was instructed not to clamp or cut the cord and for me that was the hardest part. How that woman sat there for 30 minutes with the her dead baby between her legs is beyond my wildest comprehension. Woman are so strong when we have to be. We push on and overcome so many horrific things. I don't think I will EVER forget this patient or the moment when I had that little baby in my hand. God bless him.

Being a nurse is a huge mix of highs and lows but at the end of the day, the fact that I can be there for my patients and absorb some of the hurt....makes it all worthwhile.


Wednesday, February 8, 2012

I was so proud of myself! My first shift alone went way better
then expected! I didn't fall too far behind and I had four patients
tell me what a nice nurse I was. That felt amazing :)The doctor I worked
with is known for admitting a lot of patients to the floor which creates A LOT
of work for the nurse but in a way I was grateful my first night was with him.
I felt like, if I can handle him... I can handle anything! Tonight is my second
night on my own... I'm excited and of course a bit weary of what lies ahead....

Side note: winterguard is going amazing! The kids were absolutely remarkable
last weekend at the premier show. I mean....the reaction from the crowd, the staffs,
the judges. I KNOW this year will go down in history. I can feel it.

Friday, February 3, 2012

independance

My orientation is complete. 6 long long weeks of classroom training, hands on robot labs and 6 weeks of actual ER training. I learned the ropes, the ins and outs of an emergency room and the crazy life of an ER nurse. I definately learned a lot and feel that i'm as ready as i'll ever be to be on my own with my 5 patient load.



Random things i've learned:

-Always wash your hands
-Wear a mask....often
-Make friends with the paramedics cause they will be able to get the IV lines when you can't
-Stand up to the doctors and say what you think
-Coffee grounds in a bowl in a stinky person's room, takes away 50% of the stink
-Smiling at people makes a big difference
-Sad things make me cry...i hope i'm always that way
-Dilaudid & Morphine are strong strong medicines that make people projectile vomit...duck
-Wear comfortable shoes
-Bugs do crawl in people's ears
-Always have red bull on hand
-When people feel sick they are sad, be nice to them.
-Smoking does awful things to people.
-People should not be alone in an Emergency Room
-Pregnancy and drugs don't go together
-I wish I could wear those cheesy festive scrubs I used to always make fun of.
-Being a nurse is hard hard work. And I love it.



Sunday is the superbowl and although it is a huge day for those players, its an even bigger day for me...its my first day with a full patient load all by myself with no mentor to guide me. I am ready. I don't feel scared because I know I have tons of people around me to help. I just want to give the patients the best care and don't want them to feel weary in my hands. I hope the patients aren't too critical---when that happens you end up spending all night with that patient and the other 4 don't get enough attention. One thing i've learned though is that the ER is NEVER predictable and i'm sure sunday i'll get 5 ICU patients ;) Bring it on!

Remember...life is a gift. Live it!