July 25
Stupid tape
Removing an IV is a simple and basic skill that I learned early on in nursing school. You remove the tape holding the IV in place, place a cotton ball over the site where the IV is, and then pull the catheter out and apply pressure with the cotton. The hospital I am working at uses something I have never worked with before called a Statlock.
The Statlock is the blue clamp in the picture. It firmly holds the IV in place better than tape alone. To remove the Statlock, you have to rub the white tape holding in on with alcohol, and then pull it off. We put the Statlock on and then put a lot of clear tape over it to ensure that nothing moves that IV out of place.
Yesterday while starting an IV on a patient, I noticed that he went out of his way to avoid seeing what I was doing. Most patients don't look when I first poke them, but do look over while I am drawing their blood just to see what is going on. This man kept his head turned away and his eyes closed during the whole process. He was not a fan of seeing blood, which I can understand. A few hours later I went back in to remove his IV. I had my cotton ball ready, and I started removing the tape above the Statlock. All of the sudden, the IV tubing fell apart, leaving just the IV in his arm (the green part in the picture below).
Yesterday while starting an IV on a patient, I noticed that he went out of his way to avoid seeing what I was doing. Most patients don't look when I first poke them, but do look over while I am drawing their blood just to see what is going on. This man kept his head turned away and his eyes closed during the whole process. He was not a fan of seeing blood, which I can understand. A few hours later I went back in to remove his IV. I had my cotton ball ready, and I started removing the tape above the Statlock. All of the sudden, the IV tubing fell apart, leaving just the IV in his arm (the green part in the picture below).
Blood started spilling out of the now open IV, so I quickly put pressure on his vein to stop the bleeding. This slowed it down, but did not stop it. I would have taken the IV out right away, which would have solved the problem, but that stupid Statlock thing was still on, and I couldn't get it off. Noticing that his blood was now dripping onto the floor, the man closed his eyes and looked away. Great, my two hundred pound patient is going to faint on me! Thankfully, closing his eyes was enough, and he didn't lose consciousness. One crisis avoided, but I still had blood pooling on the floor. Had I just calmed down and thought clearly, I would have focused more on just putting pressure on the vein to stop the bleeding, but at the moment, I was just focused on getting that IV out. I tried ripping the Statlock thing off without the alcohol, but he yelped in pain (stupid hand hair), so I quit. By the time I got the IV out, it looked like a small animal had been killed next to his bed.
Lesson of the day: Bring your brain and common sense along, even for the "simple" tasks.
Lesson of the day: Bring your brain and common sense along, even for the "simple" tasks.
July 23
Anger management
Back when I was in high school, I remember going out to restaurants with groups of friends and getting frustrated at the waitresses. Why did they always take so long to bring us our food? The worst part was when we would see them standing around talking instead of waiting on us. We're hungry!! Once I started waiting tables in college though, I quickly realized that the waitress has no control over what goes on in the kitchen. If you have a slow cook, your tables are going to have to wait. Why didn't I think of that before? And why didn't any of my customers seem to realize that simple fact either?
I see this same situation occur in the ER all the time. Patients have to wait several hours to be seen, and they take this out on the nurses. We can't move any faster than the doctors! And you shouldn't get upset at the doctors for taking their time with each patient, because you expect them to spend the necessary time with you too...
I think that we all need to step back when we are getting upset about something and question what we are really mad at. Don't take your anger out on the wrong person, especially if she is about to poke you with a needle. ;)
Things have been great in the ER. I have become a pro at IV's, and haven't missed one since Vicki showed me the proper way to start them. I have seen more things in these last few days than in all of my clinicals combined. The best part was that I got to be there while Vicki helped another nurse save a patient's life. I pretty much just stayed out of the way and handed the nurses what they needed, but just being there was enough of a rush for me!
I see this same situation occur in the ER all the time. Patients have to wait several hours to be seen, and they take this out on the nurses. We can't move any faster than the doctors! And you shouldn't get upset at the doctors for taking their time with each patient, because you expect them to spend the necessary time with you too...
I think that we all need to step back when we are getting upset about something and question what we are really mad at. Don't take your anger out on the wrong person, especially if she is about to poke you with a needle. ;)
Things have been great in the ER. I have become a pro at IV's, and haven't missed one since Vicki showed me the proper way to start them. I have seen more things in these last few days than in all of my clinicals combined. The best part was that I got to be there while Vicki helped another nurse save a patient's life. I pretty much just stayed out of the way and handed the nurses what they needed, but just being there was enough of a rush for me!
July 18
Lessons
One of the perks of being an ER nurse is that you get to hear a lot of interesting stories from people who have somehow or another hurt themselves. From these stories, I have learned what not to do:
~ Sit outside drinking nothing but beer all day in 99 degree weather
~ Slide tackle somebody in a parking lot full of broken glass
~ Stick your finger into a pipe to measure its diameter
~ Jump out of a moving car
~ Close the car door with your hand still in it
~ Anything your friend tells you if it starts with the words, "I dare you..."
~ Whatever it is you are currently doing if your friend says, "I need to watch you so I know what to tell the paramedics."
~ Sit outside drinking nothing but beer all day in 99 degree weather
~ Slide tackle somebody in a parking lot full of broken glass
~ Stick your finger into a pipe to measure its diameter
~ Jump out of a moving car
~ Close the car door with your hand still in it
~ Anything your friend tells you if it starts with the words, "I dare you..."
~ Whatever it is you are currently doing if your friend says, "I need to watch you so I know what to tell the paramedics."
July 15
First impressions
Vicki, my preceptor, is an angel. At the beginning of our shift yesterday, she gathered together IV supplies, sat down at a table in the break room, and told me to start an IV on her so she could teach me how to do it. I started the IV perfectly!! And twelve hours later, Vicki didn't even have a bruise where I put the IV in. This gave me the confidence that I have been lacking over the last year, so I am extremely grateful to her.
My friend John has had an interesting Capstone so far:
On my first day I was talking to my preceptor, Nancy. The charge nurse came over and asked Nancy to verify a death with her (it takes two licensed RN's to verify that a patient has died). We walked into the patient's room and saw an obviously very dead elderly woman. The charge nurse stood there as Nancy felt for a carotid pulse. Suddenly Nancy said, "I know this is weird, but I think I feel a faint pulse." The charge nurse replied, "It can't be, but we had better make sure. I'll put a heart monitor on her and you put a Doppler on the artery." Nancy started with the Doppler and found absolutely nothing, as the woman really was dead. The charge nurse put the monitor leads on the body, then turned her back to us to see the reading. She was getting a flat line (of course). I said to Nancy, "Show me what it would sound like if there were a pulse," and I held out my neck. She stuck the Doppler on me and suddenly the room was filled with the sound of, "whoosh, whoosh." Well, the charge nurse still had her back turned to us and had no idea what was going on, but heard the sound of a wonderful pulse. She turned around and all but threw herself on the poor woman thinking that she was still alive. She grabbed her shoulders and started shaking her. Nancy and I were just stunned. After about two seconds the charge nurse looked over and saw Nancy holding the Doppler on me and said, "What in the %@#% are you doing?! You just gave me a friggin heart attack!" Thankfully, after she calmed down she thought it was funny. She spent the rest of the afternoon telling everyone about it. I certainly made a first impression on that one!
Attack on your eyes?
Today was an interesting day. Vicki told me to go pick the next patient up from the waiting room, take him or her back to their ER room, and begin their assessment. To complete the assessment, the nurse must document what is going on with the patient so that the doctor can look at the chart and know the majority of the important background information before even entering the room. Most patients in our ER are there for non-emergencies that are simple to describe. "Headache for two days." "Vomited this morning." I confidently picked up my first patient's chart, called her name, and looked down at her reason for visiting. "My navel had a fever last week, and I have an attack on my eyes." Oh great! My first patient is a psych patient. How do I handle this? I don't want to embarrass myself by documenting something like this! While walking the woman towards her room (and looking for a place to hide), I was picturing the doctor gathering all of the ER staff together to laugh at my paperwork after I was done- "Navel fever?!" Crazy nursing student! Then I started thinking that this was some sort of practical joke- they had a nurse from the next shift pretend to be a patient just to see how I'd handle their crazy symptoms. Thankfully, this was not the case. Once I had the patient in her room, I was able to figure everything out- she had a hernia and has auras with her migraines. She just had a creative way of explaining everything!
A few hours later, I got to start my first IV! It didn't exactly go as planned, but it didn't go as bad as I feared either. The patient was a teenager who was extremely dehydrated, and I needed to draw blood and start an IV. I was able to get a vial of blood, but then the vein blew, so Vicki had to poke her again. I felt bad, but she was understanding. Maybe next time?
A few hours later, I got to start my first IV! It didn't exactly go as planned, but it didn't go as bad as I feared either. The patient was a teenager who was extremely dehydrated, and I needed to draw blood and start an IV. I was able to get a vial of blood, but then the vein blew, so Vicki had to poke her again. I felt bad, but she was understanding. Maybe next time?
July 11
Mary, RN
My little sister just passed the NCLEX (licensing exam for nurses)!!! I am so proud of you Mary!!
Amazing!
I had an incredible time at my clinical today! It was a long day- I was at school or in the hospital from 9am-11pm, but it was worth it. I loved almost everything about it. My preceptor Vicki (the nurse I work with) is amazing- she is patient, knows her stuff, and is a wonderful teacher. The chemistry among the staff, including the ER doctors, is fun to be around, and for the first time at any clinical I felt like one of the nurses instead of some idiot hanging around waiting to ask a stupid question. My feet hurt and my back aches, but I am still smiling! It was embarrassing to tell Vicki that I have never started an IV or a catheter on a patient before, and although she was stunned by the news, she said that she could teach me how. Other than that, the only time I really embarrassed myself was when I accidentally walked into a glass window (there was a screen covering it and I thought there was a door there).
Wednesday is the big day- I will actually be starting all the IV's! Keep your fingers crossed for me (and your veins hidden). ;)
Wednesday is the big day- I will actually be starting all the IV's! Keep your fingers crossed for me (and your veins hidden). ;)
July 09
Finally!
The big day is finally here- I start my Capstone in the ER tomorrow!! I will be working with one ER nurse, Vicki, for the next five weeks. I will work all of her 12-hour shifts with her, and hopefully learn a lot. Because I will be dealing with patients again, I'm sure I'll have plenty of experiences to write about. I hope that each entry begins with, "Today was amazing..." but as you all know, "Today was so embarrassing..." is much more common on my site. ;)
July 05
Time warp
I just got back home from Dallas. There was some confusion at the airport, and I can safely say I will never fly with American Airlines again. Here is an example of just how off things were today- this is an email update from Orbitz:
American Airlines flight 2046 is delayed. Departure from Dallas/Fort
Worth International (DFW) is now estimated at 10:45PM Gate A20.
Estimated arrival at Kansas City International (MCI) is now 10:40PM
Gate 76.
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