Published Dec 8, 2002
New CCU RN
796 Posts
I just got off a P shift (7p-7a) It was awful. Started off slow but I got a "stable GI Bleed". He was in another ICU but came to our CCU b/c of bed issues...whatever.. doesnt matter
My question to you all is do you ever leave a real busy pt and just feel like you wish you could do things faster??? I had him 1:1 but that wasnt even enough. I actually only had him from 3a-7a. Anyway, he got to us, not bleeding.... bp started to drop, started to get real tachy, ab distended..... ng heme pos but not gross at this point... page intern bc bp is 50/30..tells me to bolus him with whatever (dont you love those orders) give him 2L still bp in the toilet page him again..say hey, i think hes going in to shock, bleeding somewhere.... intern wont listen... dont worry just give him more fluuds.............. half hr later pt has blood frank blood emesis... great... now i know im in trouble...ask him if we can intubate....says no not now want to hold off (i am ready to shoot him...bp is still crappy
well to make a long story short he got about 6u prbc, 5u ffp, 3L NS, levo maxed dopa maxed bp still 90 ...tachy to 130. when i left his hemoglobin was 4.8 he did end up getting intubated.... 4inches north of the carina though (intern insisted on intubating rather than anesthesia)
anyway, i just feel luike i wish i could have done more...feel like there was more i should have done...do u ever leave work feeling like a failure, feeling so bad about ur night????
i keep on replaying things in my mind, wishing i could have been faster, should have done this... ahhhh what do u do to get it out of ur mind... !!!!!!!!!!
TEXASWAG, MSN, RN
159 Posts
Yep, I've left work and cried at home, in the car, in the shower, even at work in the restroom, and in the supply room. It's normal for you to cry. But you know what? You did the best job that you could do for that patient. You are just one person. You have to realize that you can't do everything. Once I had a good cry and realized that I could not possibly do everything, I cried less and could leave work and the patients with a clearer mind.
You're new to nursing use others for support like your charge nurse and other experienced nurses. I worked 1 year in a busy CCU and at times felt like I was drowning under so much pressure and stress. If you need help don't be afraid to say so. I also have a mantra "There are 24 hours in a day". For me this is a reminder that what doesn't get done during my shift then the next shift can continue the continuity of care. Like I said I can't do everything.
Don't be so hard on yourself. You're still learning. Learn from that experience. Hope you feel better.
Thanks for such a nice post Texaswag!!! It really did make me feel better about the whole night and about this patient's situation.
I do have to say I have been thinking about it and how much I have learned and grown since I started last June..... a world of difference.... and most of the time I feel pretty comfortable....but most of the time I've had a decent outcome. It just felt like it was all downhill with this guy.
And I just felt like if maybe a different nurse had him maybe things would have been better bc they would have been faster. Everyone I worked with last night told me I did an awesome job..... but I just felt awful about it all bc I know chances are slim that he will make it through this.
I am fortunate to have had an awesome preceptor who is now one of my close friends so I was able to vent to her as well about it and so it has helped me alot with adjusting and venting and all of that.
Thank you again for your response though, it really did make me feel so muc better.
casperbjs
76 Posts
I've cried at work! I use to work for a wonderful doctor. I had a patient call and bless me out because the dr. that he was referred to didn't have a copy of his labs and x-ray results. The hospital was suppose to send them to him too. Then this patient hung up on me! Told me he went to see this dr. for nothing and that it cost him $125.00. Talk about being pissed! I went to the doctor and told her I had never worked at a place where I got blessed out so much, that I was going to quit and find another job. Needless to say, all the other dr. had to do was call the hospital and get them to fax him the results. (think that was asking for too much?) My doctor ended up talking to him about how he treated me. It's just not worth getting yelled at by so many patients for various things that they're not happy about.
I did finally quit because of getting yelled at by so many patients. I was the triage nurse, plus setting up appointments, giving injections, helping put patient's in rooms. So much to do, but not enough hours in the day to do it.
Now I work in a LTC facility, where the resident's are independent, but 11pm to 7am. So much less stress! The girls that I work with are wonderful!
nursenina
2 Posts
I just started at a new hopsital, and have only ben working on the cardiac telemetry floor for 4 shifts and I was floated to a different floor. I was crying in the lounge within one hour of my shift. I did not know where to find things and was not even comfortable with the policies and procedures of this hospital yet. I was in tears! I felt like such an incompetent. Luckily the charge nurse helped me all day and the rst of the staff was great. This has never happened to me before. Not a new experience I want to have anytime soon.
2banurse
593 Posts
Originally posted by New CCU RN And I just felt like if maybe a different nurse had him maybe things would have been better bc they would have been faster. Everyone I worked with last night told me I did an awesome job..... but I just felt awful about it all bc I know chances are slim that he will make it through this.
You mention that if a different nurse were taken care of the patient it would have been better...I don't believe so. It sounds like you did everything you could and it was the INTERN which should have been different. I don't believe that a resident with only about 6 months on the floor should call in orders but be there once you call him/her. I personally would speak with his resident about this. That is inappropriate and if the intern came when you initially called, a lot of what followed may not have happened. DO NOT BEAT YOURSELF UP! You seem to be a real caring person.
Thank you all for your words of support.
I am just a nervous wreck today for some reason about going into work tonight......blah
oldgirl, RN
56 Posts
SOunds like you done good hon, and I agree, the intern is the yo-yo on this one. My first year of nursing was on a tele unit in a small inner city hospital that was scary on a regular basis. Many days got in the car and cried with relief that no body died during our shift. Hugs to you, and just remember all nights will not be like that.
BBFRN, BSN, PhD
3,779 Posts
Originally posted by nursenina I just started at a new hopsital, and have only ben working on the cardiac telemetry floor for 4 shifts and I was floated to a different floor.
I just started at a new hopsital, and have only ben working on the cardiac telemetry floor for 4 shifts and I was floated to a different floor.
Originally posted by 2banurse You mention that if a different nurse were taken care of the patient it would have been better...I don't believe so. It sounds like you did everything you could and it was the INTERN which should have been different. I don't believe that a resident with only about 6 months on the floor should call in orders but be there once you call him/her. I personally would speak with his resident about this. That is inappropriate and if the intern came when you initially called, a lot of what followed may not have happened.
You mention that if a different nurse were taken care of the patient it would have been better...I don't believe so. It sounds like you did everything you could and it was the INTERN which should have been different. I don't believe that a resident with only about 6 months on the floor should call in orders but be there once you call him/her. I personally would speak with his resident about this. That is inappropriate and if the intern came when you initially called, a lot of what followed may not have happened.
rebelwaclause, ASN, RN
354 Posts
While I was in nursing school years ago, a nurse told me to do the best you possible can, and take care of one person at a time and include yourself in that count.
I've often said school was great theory - Teaches us heres the problem, here's the solution. They don't spend nearly enough time on death and dying (psych/Soc aspect), and nurse burnout from having so many stressful shifts like what you've mentioned here, New CCU RN. Then again, maybe if it was focused on a little more, there wouldn't be a nursing shortage - There would be NO nurses!
Hang in there, sounds like you did the best you possible could do. Its normal to "worry" about your patients during that drive home. Just make sure you take care of yourself as much as you do your patients.
sorry it is a little late but i jsut wanted to thank you all for your kind words