New nurse, proud of myself!

[Dd04321]

Hi everyone,

I am a new nurse, have been on my own for 2 and a half months. I recently had a situation in which a patient with chronic stable Afib stated that they felt themselves go into afib.

I promptly called the doctor and got an order for an EKG and put the patient on telemetry. EKG showed Afib RVR, called back and reported results. I gave a fluid bolus after which did nothing. I called again and reported this and received orders for a Cardizem bolus. I had never given Cardizem before so I got someone to help me do it. Patient had a stable BP and denied chest pain and SOB. They were then moved to a different unit to be put on a drip. Patient is fine.

I guess I am just happy in how I handled the situation being a new nurse and especially one with anxiety.

Have you been in a similar situation?

Would you have handled it differently?

[Orion81RN]

That is awesome! Doesn't it feel great when all the bookwork just clicks in a real life situation....AND you know how to handle it?

My very first night ever working as a nurse, I walked into my patient's room in a ltc facility. The patient was tachypneic, O2 in the 70's, tachycardic, decreased loc....A night I'll never forget as I just knew he had a PE. He was certainly at prime risk for it. Since then Ive seen it 2 other times. It's made me appreciate, and a little OCD about, the measures we put into place to prevent them. And the assessment of presence of DVTs...

I don't put the blame on the nurses or CNAs that he developed a PE, or that a DVT went unnoticed. I do blame the crisis we have in staff to patient ratios. I can mentally think and physically write or type out all the nursing interventions in the world....but if there is no one to implement them, well....patients die. As what ocurred in another facility I worked for. Patient was only in her 30's, staying for some PT. And died. Sigh...so yeah, I'm quite OCD now on PE prevention, detection and implementation.

Well that took a dark turn. Anyway, Go You!!!

[JKL33]

Wonderful!! Great job!

[Crush]

Awesome! You did just fine.

[Dd04321]

If the patient would have been more unstable, would a rapid response have been appropriate? I just want to know if I am ever faced with this situation again

[cleback]

Yay! Great job!

Unstable by low bps, altered mental status? Yes a rapid would be appropriate.

[TruvyNurse]

Way to go!! Sounds like you were cool, calm and collected. That's half the battle right there! You knew what your patient needed and had good communication with the doctor. :)

[ruby_jane, BSN, RN]

Was the patient febrile?

If all vitals WNL then no, not sure I would have called RRT. The answer to that might also have been how many others I had and how stable were they? But yay you! Cherish those moments in the first year when you've put it all together.