LalaJJB 3,431 Views
Joined Feb 7, '09.
Posts: 95 (26% Liked)
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 hx of pneumonia x2 weeks ago. She came to the ED that day with difficulty breathing. Her room air sats were at like 88%, she was put on 2L via NC and her sats went to 92%. If she did any sort of activity her sats would go to like 82-85%. She was then put on 4L NC. Her sats rose to 94-95% if she was still and the head of the bed was at like 90 degrees.
Anyway, her chest xray showed a mild pneumonia developing in her left lung, her hemoglobin and hematocrit were in the toilet and she needed blood and in a bad way. SHe had an IV, but it was a 22g in her AC and it wouldn't draw worth dirt. We needed to type and cross her, but she was a tough stick and the previous nurse couldn't even to a blood draw. She had 2 doses of abx and 2 neb treatments at this time but her breathing sucked. Finally I got type/cross and blood was ordered.
The reason I am writing this is to figure out what I could do for her breathing. I know that giving her blood would help her tremendously, but in the mean time, what do I do. She was getting all worked up and anxious because she couldn't catch her breath and I was silently freaking out! I'm sure she was getting septic because she met at least 2 of the SIRS criteria. I was getting SO scared that she was going to quit breathing and then I would panic and forget everything I've ever learned about nursing.
My question is: If a patient is in respiratory distress, what do I do especially if the MD is nowhere to be found and my RN co-workers are busy with their patients? I'm new and I don't want people to die on my watch.
Thankfully for this patient, she got an ICU room before her breathing got too bad. She was also perfusing fine and her O2 sats were reasonable if she wasn't doing anything. I'm just scared for when I get a patient who is in respiratory failure and I have nobody to turn to. PLEASE HELP ME!!
adrenaline junkie doesn't = good ER nurse. Being confident and smart..AND knowing when to ask for help makes a good ER nurse...especially as a new grad. Also, know how to effectively accept criticism regardless if it's deserved or not will make you a good ER nurse. There's nothing more annoying than a new grad who gets offended when an experienced nurse gives them advice or provides criticism. As long as you go into your career with knowledge, a take-charge attitude, willingness to learn anything and aren't arrogant, you will succeed.
I had a patient just the other night bring a welcome mat and put it at the entrance of the room. Not even kidding.
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