I feel so dumb... I got flustered - about a patient in respiratory distress - page 7

by LalaJJB 16,118 Views | 64 Comments

I can't believe I'm posting about this considering I've been an ER nurse for 4 months now... but i got really scared last week and I need advice. Last week I was coming on shift and getting report about a patient who has a... Read More


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    There is definitely no need to panic, remember when your patients see you acting anxious, or nervous it makes the situation worst for them. If a patient's sats is dropping below normal levels, breathing pattern is irregular, poor cap refill, irritable, skin color changing and barely relieved with O2 2L get the MD or anyone who can provide further help. In the emergency room is where you try to save a life, point is what could be more important than a patient who's stats are declinig so if the situation arises again do your part as the nurse then get help immediately.



    We learn everyday so find something positive out of the situation and dont feel bad!
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    Quote from princessCRN
    There is definitely no need to panic, remember when your patients see you acting anxious, or nervous it makes the situation worst for them. If a patient's sats is dropping below normal levels, breathing pattern is irregular, poor cap refill, irritable, skin color changing and barely relieved with O2 2L get the MD or anyone who can provide further help. In the emergency room is where you try to save a life, point is what could be more important than a patient who's stats are declinig so if the situation arises again do your part as the nurse then get help immediately.We learn everyday so find something positive out of the situation and dont feel bad!
    Absolutely. This is why you must present your assessment data to the doc, np,pa... If you go to them w/ one or a few pieces of information, it doesn't mean as much as when you cluster data and present the picture w/ the relevant information.


    Just look at all the nurses that have responded to your post. If we all see the picture as you presented it, and we all mostly feel like this pt needs an abg, etc, what makes you think the doc, np, or pa won't as well?

    Nursing is about knowing your stuff and advocating for pts and families. You can do it. Go get em!
    tewdles and Altra like this.
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    In this situation my first call would have been to RT and second call to my charge while I stayed with my patient. I am a huge fan of utilizing our ancillary staff and it took me a while but I became a big fan of utilizing the charge. In fact, I would have had my rear end handed to me in this same situation had I not called the charge. I walked into a patients room once and she started tanking right in front of me. I started doing what I could, (she was septic and was going hypotensive) I got her trendelburg and was hanging fluids while calling my charge and right away they were in there (it was shift change so she was giving report to the new charge) and we grabbed a tech and they got the doc and we got another line in there and more fluids and I had the help and support to make me feel like I was not alone. Afterwards the Doc came to me and gave me a hug and thanked me for being on top of the patient and saving her life by realizing what was going on and being on top of it, especially during a busy shift change. Since then I have never hesitated to ask for help if I felt out of my league.
    DC Collins and LalaJJB like this.
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    Quote from brainkandy87
    You page the MD and get your co-workers to help you. I don't care what they are doing. If someone is circling the drain, you go grab someone. If they feel inconvenienced, too bad.

    -----

    In your situation, I would've called RT to assess (and draw an ABG if not already done) and worked on getting a large bore IV in her while you had another nurse find the MD to come assess.
    Communication is key! Tell your charge nurse if your coworkers aren't available. The CN can eval the situation and make that pt a priority so that another nurse can come help you. Plus most ED CNs are experienced enough to 1) Know what to do, and, 2) Not freak out.

    But I wholeheartedly agree. Get RT in there right away. If the pt really is circling the drain, if you can't reach anyone, another RN, CN, RT, doctor, push 'the button', whatever you have for an emergency notification. That will not be ignored. Better to have to explain why later than to have the pt go south.

    MOST important: Relax. Over time such things will be like a day at the fair for you. Give it about a year in the ED. That's what I was told by coworkers when I started, and darn if they weren't right.

    DC :-)
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    Additional thought inspired by what someone wrote above. Yes, nursing is about knowing your stuff. That comes with time. But IMHO even more important about nursing is knowing what you *don't* know. Then call for help. MAKE someone help. Doing so takes guts, so work on that aspect of your working day.

    DC :-)


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