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by mattcastens

Yeah, it's a slow night ... so sue me!

I was thinking back to nursing school and how it was. I remember when I first gave an IV push med. Because I worked as a nursing assistant in critical care for so long before school, I remember thinking that I knew I would be a "real" nurse when I was allowed to give meds IV push. And then I did. It was a great feeling.

I also remember how it was when I was learning cardiac rhythms. I struggled so hard to follow every step and kept asking questions about interpretation. These days I don't even "see" the interpretation anymore -- it's like being able to read a book it comes so naturally.

I guess I'm saying "hang in there" to all the students. After a few years of nursing you'll look back and smile at how new it all was.

[kids]

I was still in (RN) school...
back in the "old days" here in Washington you used to be able to work as a Student Nurse...NOT to be confused with the Nurse Tech position they now have. Back then a SN could get a paid position in a Nursing Home and signed as a 'SN' you could do ANY task you had passed the theory and skills check off for at school...(my wages were halfway between an aide and an LPN after graduation I signed as a 'GN' and got paid halfway between an LPN and an RN).

Anyway...I had a patient in CHF and I understood in my hear on a cellular level what was going on and what the lasix I was about to give was going to do.

-nancy

[Sleepyeyes]

The first time I felt like a "real" nurse was the time I started an IV with a #20 guage on an elderly GI bleed patient and got no blood return, but
I "knew" it was in there. The site was good for the next 3 days and
3 transfusions.

[Q.]

The first time I felt like a "real" nurse was when I pushed with my patient for 1 1/2 hours while using my finger to push her cervix back behind the fetal head, while at the same time stretching her perinuem to avoid tears and the need for episotomy. The family asked me if I was a midwife, and I replied - "No, simply a Labor and Delivery nurse." Patients really had no idea how much a labor and delivery nurse does until they see it.

The baby crowned, and I calmly called for the MD to come and deliver her. No tears and no epis.

[night owl]

For me, it was the first time I inserted a foley on a male pt and felt good about it! ...because it actually worked!

[Furball]

I was early into orientation at my first job. I called a resident to come check on a pt who was having increased resp difficulty. The resident sharply responded "I just saw this pt 10 minutes ago!" I reiterated my findings firmly (Resp rate up to the 30's, o2 sat dropped 5 points, pt using accessory muscles slightly, ect) and the doc came right back, reaasessed the pt then came out and shook my hand. He admitted being rushed when he was on the floor previously, missed the signs and expressed gratitude for my calling. I suddenly felt like a "real nurse". The pt had a PE.

[Jenny P]

We've been busy this weekend, Matt, consider yourself lucky for having the slow night. I'm glad I'm off tonight!

The first time I knew I was a "real" nurse was when I got the dreaded letter with the state boards results-- I was afraid to open it alone, so went to a friends' house for moral support. He was panelling and painting a bedroom, so when I opened the letter and saw I passed, he gave me a paint brush and I wrote "I'm a REAL NURSE!!" across the wall with dark brown paint, and we covered it with a sheet of panelling. I wonder what the people who took down that panelling ever thought of that....

The first time I felt like a "real nurse" while working was shortly after I got my board results: I was working charge nurse nights newborn nursery and I had a newborn in trouble, no other staff available, maybe 10 other babies that night. Called the doc, got stuff as ready as I could; then when the doc got there he started yelling for stuff-- empty half of the quart (GLASS!) bottle of IV fluids (this was BEFORE there were plastic Iv bags!), half an ampule (a 50cc GLASS ampule-- those things were huge!) of NaHCO3, etc., etc. I managed to slice my thumb open while opening the ampule and was bleeding profusely, grabbed a papertowel, wrapped my thumb with it and just continued on until the baby was stable. It was morning by then, and the head nurse wandered in and then said to the doctor: "Dr. So and So, this is Nurse _____, our new night charge nurse." He looked at me, shook my hand, and said "Nurse_____, someday you will be a good nurse." This was exceptionally high praise in those days and I think I floated the whole walk home that morning!

(I know, it does sound very condescending now, doesn't it?) But that was a different time...

[kids]

Originally posted by Furball
...The pt had a PE.

OMG...

HIGH FIVE Furball!

I had been a Nurse for about 4 years and was working on a sub-acute unit doing rehab (MOSTLY trach and vents)...we got this guy in his mid 70s who had been hit by a Pepsi truck and was beat to hell...fx hip and leg, couple of ribs, arm. Had NO previous medical problems - nada- Was about 3 weeks post injury and still back and blue...Was working with PT, got back to bed and called for pain meds. I took it in and he said something to the effect of "I don't feel so good, PT really took alot out of me today" he was white as a sheet and just didn't look right - pale & clammy,
Grabbed my puls ox and started assessing...sats in low 90s (non-smoker), HR way up (120's) crackling distant lung sounds...my response was "oh ****"and slapped O2 on him at 10lpm with a mask...

Called 911, called the Doc's office and said I was sending him NOW.

EVERYBODY, including the RTs and the NM thought I had massively over reacted...

A couple of hours later the Doc came to the facility to say good call...the guy had the BIGGEST (and silent) PE anyone at the hospital had ever seen.

He lived, came back, finished rehabing and went home independantly...still see him in the grocery store now and then and he looks great (now in his 80s).



and yes, he was on SQ heparin and had good PPTs

[Furball]

kids-r-fun
so awesome!!!

[Chuckie]

The