Monday, May 26
So because I had already gone through orientation and been working at the hospital some, I had the pleasure of working this past week instead of sitting in classes.
Monday and Tuesday were quite eventful, Wednesday not so much.
For those who don't know, I'm in the ED (formally called the ER) in a community hospital. We get it raw basically. Monday I was with an awesome nurse who started me out first thing in the morning doing anything and everything she could find for me to do. I attempted all the IVs on her patients, except the first one and maybe one other one. I wasn't successful on any of them, although she was able to use the one I blew through. =\ She let me give almost all the meds to the patients including subcutaneous and intramuscular injections. So exciting!! =)
I felt somewhat bad putting unsuccessful IVs in people, but I know it's happened to every nurse at some point in time. The best way to learn is through experience and practice makes perfect. I got better. She didn't give up on me and kept showing me techniques. I felt more confident each time I attempted.
Giving injections was a big thrill for me. I feel very confident about those. I even remembered to pull back for IMs!!!! I was really glad I didn't make anyone scream. =)
One of our patients was a respiratory patient with pneumonia. His oxygen blood saturation levels were dropping the whole time he was in there so we had to intubate him. They let me push the meds for it. It was exciting and scary at the same time to know that I was paralyzing someone. Everyone was wonderful though explaining what was going on during the procedure.
We also had a falls patient that turned out to be a cardiac patient. She had fallen the night before and came in short of breath, pain on deep inspiration, and slight retractions when laying down. It wasn't until she had been in there for a WHILE and her cardiac blood work came back and one of her cardiac enzymes was EXTREMELY elevated indicating and MI (heart attack) or equivocal cardiac event. They got started with meds on her really quick.
I found it interesting how those in the medical field get so set on the "common" presenting signs and symptoms for a certain condition that they miss little things or not so common. Kind of like not giving credit to the few small trees that are starting to sprout because there isn't a big forest around them. They don't see the forest those trees will eventually turn in to. I'm not in any way saying that I would have considered an MI or any cardiac event. I'm just saying that I think it's interesting how much faith some people place in doctors to know an excessive amount of information and be able to determine within a few minutes or hours what's wrong with them and how to fix it.
Tuesday, May 27
I worked with a different nurse mainly in the OB/GYN rooms. We had lots of women with pelvic/abdominal pain and cramping. I attempted a few IVs. I was successful with one, but it slid out on me - stupid catheter. I saw a few pelvic exams and we administered a lot of morphine. One patient was in the ED from 0700 to 1500 or 1600. Long time. Finally found out she had gallstones, but she didn't want surgery - just pain meds and to go home.
I'm beginning to think it interesting how many people will come spend half a day in an ER just to get some pain meds that they can't refill and have to come back later. Instead they could go to a doctor who can monitor them and all their conditions, instead of just their current condition. A regular doctor can also give them refillable pain medication. I just don't understand what kind of logic some of these people are operating with.
The main excitement of my day came as I was rounding the corner to leave for lunch. My nurse directed me into one of the cardiac/trauma rooms where a CODE was in progress. Unfortunate for the patient, but loads of excitement for me. I walked in about halfway through, but they were still shocking, pushing meds, and trying to pace the patient's heart. I put in my first catheter during that event and it was successful on the first attempt! =) Unfortunately after a good 15-25 minutes, the time was called and me and a nurse cleaned up the room and made the patient as presentable as possible.
As I reflected on the situation later, I wondered why it wasn't difficult for me to watch a patient die in that manner, but it was in the situation of cancer or other progressive disease. The only answer I came up with was it was easier to watch someone just die without them really knowing it or at least appear to know than it was to watch someone suffer day after day and then just give up. I can't stand to watch other people suffer. I suppose that's why I like an ER. We take care of the people for the moment - other people with more patience endure the suffering. I don't mean it to sound harsh, I just don't like watching the suffering.
I'm beginning to think it interesting how many people will come spend half a day in an ER just to get some pain meds that they can't refill and have to come back later. Instead they could go to a doctor who can monitor them and all their conditions, instead of just their current condition. A regular doctor can also give them refillable pain medication. I just don't understand what kind of logic some of these people are operating with.
The main excitement of my day came as I was rounding the corner to leave for lunch. My nurse directed me into one of the cardiac/trauma rooms where a CODE was in progress. Unfortunate for the patient, but loads of excitement for me. I walked in about halfway through, but they were still shocking, pushing meds, and trying to pace the patient's heart. I put in my first catheter during that event and it was successful on the first attempt! =) Unfortunately after a good 15-25 minutes, the time was called and me and a nurse cleaned up the room and made the patient as presentable as possible.
As I reflected on the situation later, I wondered why it wasn't difficult for me to watch a patient die in that manner, but it was in the situation of cancer or other progressive disease. The only answer I came up with was it was easier to watch someone just die without them really knowing it or at least appear to know than it was to watch someone suffer day after day and then just give up. I can't stand to watch other people suffer. I suppose that's why I like an ER. We take care of the people for the moment - other people with more patience endure the suffering. I don't mean it to sound harsh, I just don't like watching the suffering.
Wednesday, May 28
I was with another nurse today. We received report about 0715 or so. By 0730, I had put in my first successful IV. I had a major boost of confidence and my day was made. The day was fairly uneventful. I administered some pain meds to that same patient. We had a respiratory patient come in. I started another successful catheter.
to be continued....
I was with another nurse today. We received report about 0715 or so. By 0730, I had put in my first successful IV. I had a major boost of confidence and my day was made. The day was fairly uneventful. I administered some pain meds to that same patient. We had a respiratory patient come in. I started another successful catheter.
to be continued....
