Asking for Help

23 Mar

Who you work with on any given shift sometimes can make your day better or crack your twelve hours to pieces when you when you find your assignment in crisis.

I walked in on day one to crisis #1 in respiratory distress admitted to the floor by night shift RN who got ABGs and the patient on bipap but um….5 hours later I walk into this (the bipap is not helping) and the patient is getting tired with a breaths per minute greater than 40 who needs immediate intubation.  And I am stressed out but somehow managed to be calm and I even surprised myself with how clearly I “knew” how to do what I needed to do, restraints, suction, versed….very different scenario 2 years ago when I could barely find my voice in a crisis and just wished I could blend into the wall and let someone else figure it out and speak for me. I have to add that I had the awesome st respiratory therapist by my side, the calmest critical care nurse across from me, the loves to teach physician  keeping it all in perspective, as well as all the other helpful staff.

I walked into day #2 with a blood pressure in the 60s Systolic, clearly septic, on no antibiotics, and platelets count of 19 also struggling to breath and I knew and I felt sad. Blood was everywhere.

I walked into day #3 with a  patient made npo in the night, diabetic on insulin and pills with a blood sugar of 30 and no IV access due to infiltration and no palpable vein in site or touch. I learned that the glucagonIM works in about twenty minutes.  

The insanity is that I felt the adrenaline and I kind of liked it although of course it is a paradox as I would never wish that to be the norm. I think I am gearing myself towards emergency nursing or maybe intensive care at some point, sooner or later.

So the fake seizure in room #2 was annoying, but I regress.

Picture this: I am in the nurses station, the ICU RN has taken care of my intubated patient on day 1 while waiting for a bed to be available on the unit. I am officially relieved of my major responsibility for the patient and nurse A says to me all super loud, “You always get the worst group with sickest patients!” I am still trying to piece together what just happened so fast and my 4 other patients have not seen me except for my quick morning assessments and not one patient has been medicated.  Nurse B gangs in and starts chiming the same tune and I am thinking what fresh hell is this? Nurse C starts ringing in with her sympathy for me and I lose my temper! They sounded like a bunch of cackling hens pecking at me…their morning bird food. So I flipped out and demanded the cacklers get out on the floor and start medicating my stable patients so I can catch up.

It worked! They scurried out and passed all my morning medications. I was able to assess my patients and spend ions charting in detail the crisis and all the interventions provided.

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