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This is a discussion on First day, first code in First Year After Nursing Licensure, part of Nursing Career Advice ... So yesterday was my first day of orientation at a TCU. I am still in school finishing my...by NJForte Dec 10, '12So yesterday was my first day of orientation at a TCU. I am still in school finishing my associate's degree and I just got my LPN license so I am a brand new nurse, as fresh as it gets.
Anyways, yesterday one of the other nurses found her patient in her bed unresponsive but breathing with a protruding tongue. The patient is a diabetic so the nurse had me check her BG and it was in the low 50s, we gave her glucagon but it didn't seem to help, she began to desat into the low 90's so we put her on 2L of 02. We took her BG again and she was up to 80 and but still no change in LOC so the nurse gave her another shot of glucagon. After trying to rouse her for several minutes she began to desat again and we began chest compressions. I think her sats bottomed out at 66%. By the time the paramedics got there she had decerebrate posturing.
This situation was really upsetting for a first day in training. I keep wondering if we did everything that we could. I am also thinking that it is possible that she just had a stroke and blood sugar wasn't really the main problem.
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- Dec 10, '12 by Lev, BS, RNIsn't checking for a pulse the first thing to do even before checking the blood glucose. If you saw she was pulseless, compressions should have been started right away. The blood glucose could have been checked later. Also, a blood glucose in the 50s is not terribly low.
- Dec 10, '12 by littlepeopleRNICUI'm a little confused about the order of things too, and why compressions were started if her blood sugar and sats were the only things checked, but I'm sorry you experienced that on your first day either way! Patients do decline. Sometimes very fast, no matter what we do for them :/ It's not unusual to feel like you did something wrong or missed something, but many times, it isn't anything the nurse did/didn't do!
- Dec 11, '12 by NJForteI was a little confused , too. After reflecting on it I feel that the situation was handled very poorly on many levels. I'm really bummed about this because as a new nurse I am looking to other nurses for guidance and I'm not sure I'm going to get it at this facililty. Even worse I feel that the guidance I do recieve is going to be misleading. I guess I am going to do my best there this winter and then try to find a new gig when I pass the RN boards in May.
- Dec 12, '12 by Lev, BS, RNI personally think you should try to find another job ASAP. This is no place to learn!
- Dec 12, '12 by RN2012NewbieLike what was said in the previous replies, im confused with the order of interventions. After finding them unresponsive but breathing, a pulse should have been taken... With compressions following right away if no pulse was felt. What was the outcome of the patient? Was it an actual arrest? I'd be surprised if a BS in the 50s caused all of that. Hopefully your unit manager reviewed this incident and made plans for staff education to learn from it! Sorry that you had to experience that. Keep pushing along, more experience to come!
- Dec 14, '12 by NJForteThanks for your interest and for replying to my post. I didn't want to post any more of this on the board so I sent you all private messages.
RN2012Newbie - I couldn't send one to you on account of your message receiving preferences but if you want to know more send me a message.