I’m slowly bouncing back from H1N1 and trying to get into some kind of a groove. That flu just kicked my ass. I was actively sick for about 3 weeks and am now still kind of weak. Still, I was able to return for three hard nights in a row and keep my energy up (it was only after that that I slept like a stone). I’m trying to be an unusual nurse and, you know, take care of myself.
My orientation obviously was disrupted by my not going to work for weeks, so I still have another three shifts’ worth. At this point my preceptor is trying with various degrees of success to sit on her hands and let me fly solo. I was alone for 4 hours on Friday, and it was incredibly busy. I forgot some stuff (thank god for unit secretaries, who bring stuff back to me so I can fix it before my errors are engraved forever) and would like to have been speedier, as, I’m sure, the docs would’ve liked me to have been, but all told I kept my head above water and felt pretty good about it. My preceptor called me the next morning especially to tell me I was doing a good job, and that phone call meant the world to me. I don’t care what anyone says: even adults do need external validation from time to time.
The ER is a huge change from everything I learned in the CCU. Most of my patients are on one of two ends of a spectrum: they have a hangnail or they’re dead (we do raise the dead in the ER). I’m used to patients who are pretty sick, but not actually dead, when I assume their care. Conversely, I’m definitely not used to “I’m here because I have a stomach ache/fever/sore throat/runny nose.” What? Don’t people ever just go to bed and rest anymore when they’re sick?
Mostly, in the CCU I was used to getting patients who’d already been stabilized (largely by the ER), so I already knew their history and presumptive diagnosis OR they’d already had an intervention or surgery. Now I’m on the other end, trying to figure out what the heck is wrong and helping to stabilize them. You start from scratch in the ER…big difference from being handed a nice H&P and given report. (And then there’s the matter of learning all the little widgets and gizmos that are needed for splints, stitches, and foreign-body extractions; no, it’s not a myth.)
The cool part about the ER is that I see some truly cool stuff. I saw a stroke patient who came in shrieking with nonverbal confusion and terror, unable to move her extremities at all at one side, and who left for the ICU sitting up on her cart, talking and thanking us for caring for her. This was the miracle of t-PA, which I’d never seen in action before. I’ve seen some dramatic stuff with cardiac drugs, but the t-PA was just almost unbelievable. I think I stood there gaping at the patient, so dramatic was the recovery. The ER docs, the patient’s primary nurse, the charge nurse, and the unit secretary were like stroke ninjas the second they spotted this patient (we don’t keep a CT team in house overnight, so the secretary has to call in necessary personnel), and then everyone else pitched in, and it was impressive. Lurrrrrrrve it.
(Plus, it’s fun to work at a job where staff regularly threaten to kick each other in the junk, but maybe that’s just me.)
It’s because of numbers like this, the Centers of Disease Control (
