Published Jul 2
Dondon
2 Posts
I am an ICU nurse with 1.5yrs experience. 2yrs prior med/ surge. During my regularly scheduled yearly-evaluation I was told I could work on my time management and confidence. I was not disciplined but I was told that I should wait a while before being trained on XT/CRRT, and that we'd check in a couple weeks to see how things were going, and see about CRRT next quarter.
A month later I saw the clinical coordinator and asked if we should do a check in, since they never followed up with me. That same day an RT complained to her because I had set a non-rebreather to 8L, which was only partially true. I had turned a non-rebreather down from 15, to 12, to 8... then removed it a moment later because the pt had recovered. (They had HHFNC on under the mask). I wasn't thinking and I should have stopped at 12L. The pt was unaffected, but a NRB should never be set below 12L, even for a moment that's true.
It just seemed like there was no follow up from management, and the one day I needed teaching was the only time a clinical coordinator happened to talk to me. Then...
2 months later I took my pt on BiPap off of BiPap for PO meds and some water. He actually tolerated RA for about 5min, but I put him back on the BiPap as I was taught to do by RT. RT's get upset if you call them just for that.
But after a deep breath the BiPap didn't re-initiate as it has for the last year of me using this method / equipment. So I looked around and saw the RT in the hall unoccupied. I walked over and brought her in the room. I believed the or could breath RA. These masks have a 2-way valve for this very reason. The pt's SPO2 dipped from 90 to as I brought the RT into the room. Which as within 30sec. She started the BiPap and emailed the manager.
I am frustrated because I have observed and corrected equally serious mistakes with more impact on pts. It's not unreasonable in this last instance to get an email from a clinical coordinator. But I am afraid I'll be fired. The talk after setting the non-rebreather to 8 was pretty casual, IDK if it was officially recorded. But this is more legitimate. I've been asked to meet her in a week, after my 3 upcoming shifts. Would they let me continue working for a week if they were going to fire me?
"The SpO2 dipped suddenly from 90 to 78, then returned to 90 over about 30sec.”