[brutusmylab1]

Hi Bethem! Don't feel like a patient extubating themselves was your fault. I have been on the unit as a RN for a year and worked previously an extern for 2 years during school. Some patients are like Hoodini's --they can tongue their tubes out, chew on them and find ALL kinds of ways to get it out. Why someone on here would ask you why a pt was restrained is beyond me. It is releveant why they are used. Don't worry about it and we are only human as well. Being an ICU RN is challenging but rewarding. Hang in there!

[tutu123]

I have been a MICU nurse for 4years and I can tell you that your pt will extubate themselves even if they have restraints on. Dont be hard on yourself. You have only been a nurse for 2 years, it is a learning curve everyday. Many pts can bite the tube, tounge it out or my favorite is to slump down in bed an mange to pull it out. And dont forget that sometimes it is not secured very well. I have worked in both teaching and non teaching hospitals. Drs make mistakes, nurses make mistakes, respitory make mistakes. The point is you are human, remember to relax, take one order at time. And if you are in code do not panic, the pt is already dead, so anything that you do will not make them more dead. The point is just remember to treat the pt not the monitior and one order at time. And you will be just fine. Hang in there it does get better.

[bethem]

Thanks, everyone.

I feel a lot better lately. Today the nurse next to me had 2 patients (we have a 6 bed ICU, and we didn't have ONE intubated patient all day yesterday and today!), while I only had 1, so I was keeping an eye on one of her patients as well.

The patient was having multiple seizures which required IV midazolam to abort. I have never seen a seizure and didn't really know what I was supposed to do when she started to seize. Obviously something kicked in, though, cause I ran to the pt before I even realised and turned her into the recovery position, calmly calling for the doc at the same time, then grabbed the midaz without being prompted while the doc guarded her airway. By the end of the shift, the poor pt had had seven seizures, so I could recognise the early warning signs and get midaz into her before she got too into the seizure. I know this is a little thing, but it makes me feel better! I guess I am learning something/have some critical thinking skills (or, you know, common sense) without realising it.

I think I might just be able to do this, as long as there are always lovely people around to help and mop up my tears!

Thanks again.

[rndick01]

Bless your heart! It's perfectly normal! Don't beat yourself up! For the first few years in ICU after school I just knew I was going to kill somebody because I felt I had no clue what I was doing but 13 years later I'm still there! Feeling better about my knowledge but never knowing everything! Comfort will come with time. Give yourself at least 2 years! It's a lot to learn in a very stressful area and ICU nurses can be harsh! Take a deep breath and keep on going! You'll be fine!

[sicushells]

If she flew everytime, why did she need to be tubed 5 times? Just curious...