Saturday, November 27, 2010

A few minutes in the life of a nurse.

I can't believe how many things my brain has to deal with at work. For instance, in my way to work I walked past my own patient being emergently transported with the paramedics from an outside hospital - not that I knew it was my patient yet. They were arriving at the change of shift, so within five minutes I was getting report from the day nurse while simultaneously helping the paramedics slide the patient into bed, assessing the patient (are they breathing right? vitals stable? pupils working? talking? oriented? following commands? moving all extremities equally?) and holding a pan and towels while they vomited all over the place. Meanwhile I'm trying to make a list of things in my head that I needed immediately: oxygen, blood draws, drugs, do I have IV access?, doctors to be paged, etc. I trusted, by faith alone, that the neurosurgeon had already seen the scan by computer and that the intensivist had got some kind of report from the other hospital. But I was the only one (besides the day nurse, who was trying to go home) who was actually seeing the patient. Getting the patient semi-settled for two seconds, the day nurse and I go to the desk to give a decent report, but in the middle of that the doc calls, so I have to grab the phone while I can and get all the orders I'll need (otherwise I'll have to page in the middle of the night) - IV fluids, labs, electrolyte replacement, insulin, DVT prophylaxis, pain meds, antinausea meds, are we doing another CT scan?, consults, and by the way we're not going to surgery emergently, right?, give a quick run-down of my assessment in twenty words or less, try to rifle through the paperwork from the outside hospital to see if this patient had gotten fresh frozen plasma to reverse their bleeding (they hadn't, so that meant I had to stat draw a type and crossmatch and send for the blood products ASAP), all while the day nurse still talking in my other ear with suggestions for what else I might need from the doctor (which I actually appreciated a lot). Getting off the phone, I had to still get a report on my other patient, including a rundown of the issues I'd have to take care of related to them being an agitated, neurologically compromised patient on a ventilator and titrating cardiac drips.

This was the first five minutes of my shift. The day nurse said "Wow, you're a good multitasker." I'm, not really. This is just me panicking.

But I felt kinda good about myself and my pace....until the family came in while I was trying to figure out my next step, and asked what the plan is, and my brain froze for several milliseconds while I tried to formulate and distill everything that was currently happening and would happen in the next several hours - without using medical jargon. NOT EASY.


  1. Bravo, bravo! I was just talking to a few ladies at work today about maybe working in the ER when I'm done with nursing school, but after reading your post it kinda scared me. I realize that things like this happen all the time, but man you make it seem crazy and fun all at the same time. How do you do it?

  2. Excellent post...I'm a nursing student and can't wait that I become proficient enough that I'll be able to handle similar situations in the way that you were able to. I've developed an even greater appreciation for all the balls that nurses have to juggle in a 12 hour shift...society totally underestimates the value that nurses play in patient care.

  3. Wow, I was starting to freak out just from reading it :) much respect for being able to handle that!