Experienced Nurses: Do You Still Panic When Something Goes Wrong With A Patient?

to all the experienced nurses out there: do you still panic when something goes wrong with a patient? i know all nurses experience the "adrenaline rush" when a patient codes or something goes wrong.

i've never worked in a hospital. i graduated with an lpn license in 2005, and have worked in a home care setting with the developmentally challanged ever since. i have always worried that the knowledge i acquired in nursing school would diminish overtime since i'm not using my skills on a daily basis. i actually fell in love with these particular patients and haven't even thought about going back to school to become an rn...even though i already completed all the pre-requisites required to get in the rn program.

it took me a good year to even feel comfortable working in a home care setting! i could imagine working in a hospital setting...where you have different patients daily with different needs.

i still get that panicky feeling when things go wrong with the patients i care for. for example...seizures (a lot of the clients i deal with have seizure disorders)! i deal with them a lot! i don't necessarily panic since i'm "used" to them by now...but i hate them so much. i love it when the patients have standing orders for diastat but not all of them do. so, i worry about the "what ifs" if a patient has a seizure that isn't diagnosed with a seizure disorder. i know...i would need to call 911, apply oxygen if needed, ect. but that's the thing i also hate about working in a home care environment. all we have available is oxygen, vital sign equipment, catheters, and a phone to call the doctor or nursing supervisor. our facility is so against just automatically sending someone out to the er based on his/her own judgement. you have to call the nursing supervisor first to get it approved...and sometimes he/she will tell you to call the doctor first (who usually does tell you to send the patient out to the er for observation:banghead:). i know that if a patient was in a life threatening situation...i would just automatically call 911 without calling anyone else first, i have done this several times in the past. most of the patients i work with are in wheelchairs and have a tendency to get aspiration pneumonia quite frequently. we have yankauer suctioning equipment but that's designated to only two patients. so...if i needed to suction a different patient, that would be too unsanitary to use someone elses suctioning equipment. thankfully, i haven't walked down that path yet. i guess i just hate feeling so helpless! i'm constantly thinking about the, "what ifs". it's just me (with other staff) and about 15 other patients with developmental disorders (some walk but most are in wheelchairs). on a good day, it's just assessments, passing medications, and treatments. it can get ugly at times though. patients falling, having seizures, aspiration issues, coming back from the hospital with tons of new orders...etc.

i've often thought about getting over my fear, completing rn school, and working in a hospital. i've even thought about the icu, where i could be more detail-oriented with two patients. i would rather do more with two patients than a small amount with 50 patients.

i'm such a nervous person though. other nurses tell me i'm very calm and collected and conscientious. on the inside, however, i'm extremely nervous, on edge...just waiting and ready for something to go wrong so i can try to fix it, and overly conscientious (if there is such a thing). i hide my nervousness well. my pulse rate is always over 100bpm while at work...even if i'm just sitting down and charting. my nerves don't ease until i see my relief walk into the door. it took me a good year to feel comfortable working where i work now...and it's just a home care setting!!! i could imagine my nerves in a hospital with a hundred different things going on at one time, new orders, family and/or patient interruptions, admits, discharges, codes, etc.

sorry this turned out to be so long. i guess it was more of a vent than anything. any insite, suggestions, comments?