ER life
I am no longer an ER intern. I am now an ER nurse. Saying these words is exciting, yet terrifying at the same time. My first day on my own started off nicely, with most of my patients only having minor problems. I began building up my confidence- I can handle this whole nursing thing! Then a patient with DKA (diabetic ketoacidosis) was brought to my room. I dread DKA patients more than I dread any other type of patient. They require a large amount of work and monitoring from the moment they enter the room until they finally can go up to the floor. I am not sure why the charge nurse gave me this child my first day on my own, but it probably was not the wisest decision. The girl’s blood glucose was above 700 (should be around 100) and her blood pH was 7.14 (her blood was acidic). She was slurring her words, which is never a good sign. DKA puts patients at risk for cerebral edema (brain swelling), which can cause death. I took a deep breath and started working. I had a little cheat sheet I made for myself on how to handle DKA patients- what labs to draw, how to calculate the fluids, etc. I knew I needed two large IV’s, so I overhead paged my tech. No response. I overhead paged any available tech. No one was available. Crap. I tried twice to get an IV on her, but was unsuccessful. Not off to a good start! I finally got a small IV in and was able to get her blood sent to the lab. By the time I got everything organized, it was time to draw more labs. The IV would not draw back blood, a new resident had picked up her chart and was standing there reading through the protocol to see what to do next, and the mother kept demanding that we give her a meal ticket for the cafeteria. Didn't she realize how sick her daughter was? I felt like the room was spinning and that I was going to hyperventilate. I still had two other patients! Right when I was about to lose it, the resident figured out what needed to be done, my tech arrived and was able to start an IV, and the pharmacist helped me hang all the necessary fluids and insulin. Another nurse agreed to check in on my other two patients, and even helped me get that first IV to work again. As I was charting everything going on in the room, it hit me. I am nowhere near being alone! The night nurse arrived and although it took half an hour to give report and try to explain everything that had gone on, I couldn’t help but smile as I walked back to my car. I had made it through my first day “on my own.”
No comments:
Post a Comment