Friday, January 29, 2010

all in a day's work!

Wow, I don't know how or why, but I suddenly have an influx of new readers! Totally cool. Hi, everyone!

Yesterday was absolutely insane at work. And even though I barely had time to drink (I'm definitely still dehydrated this morning) and I pretty much had to force myself to go eat, on my way home from work, I really thought, "wow, my job is so cool."

To any experienced ICU nurse, yesterday was just a normal day. But since I'm still new in the unit and on days now, I haven't experienced a lot of scenarios on my own.

When I think about tasks, they all sound so insignificant, as if they go in any sort of sequence when they don't. Everything is happening together, all at the same time. It's insane:
-2 patients
-Both with "lung issues."
-Patient #1: s/p extubation, stable at her baseline dementia. no issues, except for some new CDIFF. Luckily, the RN on night shift placed a dignacare over night, so I had nothing to worry about...

-Patient #2: ICU day 4, procalcitonin (PCT) had double over night. Intensivist was not happy about this. He was on antibiotics, so what the heck? We switched some things around during 'rounds. This patient was the best. She/He was getting out of bed to use the toilet (with my insistance that she/he call me first) and doing ok, but his/jer respiratory status? Not so much. The patient was on 15 liters high flo and when the intensivist decided he/she needed a line and saw how out of breathe he/she was getting back in bed, he/she said he/she wanted to intubate her/him before it got too bad.

I felt sooo bad for this patient because all morning he was telling me that he couldn't believe this was happening. And he even said, "I hope I don't die here." I was like whaaaat?!! stop saying crap like that (on my shift....kidding). He had a great sense of humor, too.

And then suddenly I was running around getting versed, propofol, succinylcholine, intubation kit, suction, calling RT, central line kit, etc etc. All through this, too, she/he/it has blood hanging because the patient's H/H dropped from 9.9 to 7.4.


By the time everything finished: intubation, central line wih CVP, vigeleo

Arterial line, bronchoscopy, foley, small bowel feeding tube, portable chest xray, KUB for SBFT placement...I had about 4 pages of orders and an extremely messy room!

But I did it!! The whole time I just kept telling myself, "you rock, you can do this." I had help from the other nurses for sure, but I did it.

And I know if an experienced ICU nurse was reading this, they would think..."ok, that is normal, all in a day's work." And it totally was, and I loved it, but I am just proud and happy that the mayhem finally occurred because in order for me to learn something, I need to DO IT! I did it, and I even got out of work on time, if not earlier.

I am definitely a DO-ER! I'm a Kinesthetic learner.
How 'bout everyone else? Do you learn best by doing (Kinesthetic), seeing, or hearing?
I think we're all a mix of one or two, but have dominant ones. Especially when it comes to my career as a nurse, I've found that if one shows me to do something 34545 times, I will not get it until I physically do it myself. I also learn better and remember once I write it.

Mirza and Max last night:


Niki said...

Yep, definitely a day in the ICU! Sometimes I miss the chaos, sometimes not!! I am definitely a do-er! That;s what helped me decide between CRNA and NP. I want to be "doing", not just rounding, writing orders, etc. Definitely comes from my type A personality but also my time as an ICU nurse!!

Eco Yogini said...

yep i am a kinesthetic AND auditory AND visual learner. LOL, i need all of it!

I was just talking to my SLP friend who's working in 'Head and Neck Cancer' unit.... and has been dealing with patients dying this week (full moon? not sure). She hopes to never become jaded as she sees some of the experienced nurses on the floor have become. Although, I have no idea how anyone could keep that balance....

Yay for you! getting it done!!! :)

Susan said...

Did you learn about all this stuff during your internship? I floated to the unit and felt kind of lost...I think I forgot everything I learned in nursing school and I LOVED the science-y "why is this happening and what do i do about it" stuff.

parlez-vous-kiwi said...

Hi Im one of your new reades too :) Im starting nursing school next year and love your blog. Thanks!