Today was the BEST day in clinical in, well, ever I think? Since it’s the second half of our last semester which is SUPPOSEDLY all about “critical care” we’re supposed to have the opportunity to rotate through the ICU and ER. I drove the whole way to clinical BEGGING the air “pleeeease let me be off the floor tonight, PLEASE”… I showed up and me and one other student got my wish and we spent tonight and tomorrow night in the ER. Sweet!
I dread clinical, I hate clinical. Clinical makes me feel like I’m totally incompetent to graduate and start taking care of my own patients in a few months. Why? Because we’re not allowed to do ANYTHING without our instructor standing over our shoulder. That’s at least part of the reason why I’m glad I started working in the ER as a tech, because I was able to finally see that there was more opportunity than just med-surg “floor nursing” BLAH. When people would tell me that you need to spend at least a year working med-surg before you do anything I totally wanted to drop out of school. So tonight we went down to the ER and got assigned 1:1 with a nurse and the nursing director pulled us aside with the nurses and said “the rules down here are you can do absolutely anything you want to take part in as long as the nurse is there with you, if there’s a code and you want to try defibrillating someone, just ask to step in, meds, IVs, anything as long as the nurse is with you.” SWEET!
I started my first IV! Yayyyy, on my first try! I was so excited, I was just waiting and watching for the opportunity all night! I was a little trigger shy on the first few patients because I felt no veins… so the nurse started those, but then I found one! And I got it in! I totally expected her to at LEAST talk me through it, but she didn’t. In fact right when I was feeling around for a vein the nurse said “Oh I’ve got to run and get ___” I nearly said “but but wait” but then I didn’t want to freak the patient out and let on it was my first shot so I just did it! I made a huge mess, lol. From talking to people and asking questions I already knew the basics, so I just kept in mind I should start a little lower on the vein than I would for drawing blood and go in at a more shallow angle. My mom also gave me the advice that she frequently sees people mess up and she thinks it’s because they’re used to just sticking the bevel in far enough to draw blood but that to start the IV you need to got just a shade farther till the catheter is in the vein too… so that’s what I did, I started low to give myself room, went in shallow, and then went just a smidge deeper than usual and I got blood return right away. Then blood return all over the lady’s arm. lol.
I said to the patient “Sorry, I made a big mess on your arm… but I got it in on the first try and that’s what matters right?” She agreed. 🙂
totally disgusting way cool thing I saw that I’d previously only read about is an old man with a bowel obstruction bad enough that he was puking poop. Of course we didn’t know why he was puking all over the place till AFTER the Xray. After the Xray I got to watch them sink the N-G tub to suck it all out… my god… by the time he was admitted to the floor the nurse had emptied his suction canister for nearly 4L of diarrhea/liquid. And that’s not even counting everything he threw up. (because even with the suctioning, he didn’t stop vomiting)
So the other student came over to me at one point through the night and said “so um, I think you need to go take a look in room 15…” I said “why?” she said “I think it’s just one of those things you need to check out”…. so I did, but wasn’t shocked because I did that patient’s admission vitals… he was there for a nose bleed and had no real face. I don’t know why, whether he was born that way or something else happened… anyway. I got her back later and said “Hey, I think you need to go take a peek in 2″… she said “Why?” I said “I just think it’s one of those things you need to check out while we’re here” she said “Does this have something to do with the awful smell in the hallway?” I said “Oh big time” she said “what it is, just so I can be prepared” I said “Bowel obstruction, bad enough he’s puking poop” she said “REALLY?” I said “well you know, I’m not a doctor so I don’t want to be handing out any diagnoses but, dark brown rank liquid, coming out the mouth with chunks…. I’m just sayin’ ” 😉
Anyway… I had a good time tonight, I’m glad I get another day there tomorrow, and the other student is now also totally in love with the ER… 🙂 she’s wishing she hadn’t already accepted a position as a floor nurse 😉