I did it again today, saved another life. Walked in on my patient and knew immediately they were in trouble. I heard the patient panting. Resps were at 48. Immediately did a full resp and cardio assesment to rule out CHF. Lungs clear, called RT to be on the safeside to cover all of the bases. Grabbed a sat of 85 on the pt, and then called non-teaching.
I was in the room close to 4 hours. Pushed verset and then had to figure out the code status. When I came in, DNR, then it went to full code with the family wanting to do everything. Then back to DNR with pressors and intubation.
We intubated and the pt got worse. Extubated pt got better, (sats went from 80 to 70 back to 80.) Intubated again sats down to 63, extubated and bagged, back up to 75. Intubated, and got confirmation that we were in the lungs. Dropped sats down to 65, did a pulmonary toilet, and got mucus plug gallor and sats went up to 100%!!
Got them down to the unit and afterwards the RN as well as RT's who knew I was still learning and new gave me a pat on the back and told me that I handled it like a seasoned professional. Turns out, down in the unit, they had to do a chest tube on the pt.
Wednesday's shift was the shift from you know where. One of my pts displayed the signs of CHF and caught it. I am suddenly picking up on the little things left and right. Now I feel 100% comfortable and handle just about anything that is thrown at me.
Wednesday's shift I delt with everything. From the pt who was demanding and condisending. To having to take on 8 patients, four discharges. My CHF patient. No lunch 30 minutes, one half my lunch (someone went to the coffee shop to get me a chicken wrap because I just did not have the time.)was eaten while talking with a doctor to plan the care for our patient who drove 120 miles confused into our state when their MD told them to goto the hospital 5 minutes away. Long Story. Got the adminsion assesment done at 1830, my pt came at 0715. The last time I had a shift like this, I left me in tears. This time, it left me with a smile on my face, and the best sleep in the world.
Friday's shift, probably the easiest shift I had. Nursing students from my nursing school had four of my six patients. I found out from my former instructor that her students have been requesting to pair them up with me. I not sure how to respond to that. The fact that I am tough on them (I will ask them why I am doing something the way I am, and if their instructor asks me to help them admin meds, I will ask them why it is being given. And I do get on top of them to make sure the meds are given.) doesn't seem to phase them. And if they do make a mistake, I will explain to them, away from the patient in private, their error and how to avoid it in the future. But I will not make them feel bad. Because I tell them I even make errors.
God I love my job. Can't wait for tomorrow's shift. (Let's see if I can confuse the patient who saw me in my whites yesterday, navy blue today, with my ceil blues tomorrow. She thought I was two different people. And thought that I must be a good nurse because she always saw me walking quickly.)
Are you saying this patient was intubated 3 times in a 4 hour span??
While I was in the room for four hours, and running back and forth getting things, it was the last 30 minutes before we sent them to the unit that we intubated them three times. We weren't sure if we were in the lungs or not. Because each time we intubated, the sats would drop.
HappyNurse2005, RN
1,640 Posts
Are you saying this patient was intubated 3 times in a 4 hour span??