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

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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? :confused:

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Specializes in ICU/Critical Care.

I work in SICU. I don't panic anymore. I did when I was a new nurse but it wasn't a big deal because I had more experienced nurses to help me and guide me. My first code in SICU, I ran the crash cart and I wasn't nervous and shaking. When I worked on stepdown before, I shook. When I was going through my orientation in SICU and something went wrong with my patient, I was calm and didn't panic. Apparently, this concerned my preceptor but as far as I'm concerned I know what to say to get the doctor in the room. There's no need to "spaz-out".

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Specializes in ED, ICU, PSYCH, PP, CEN.

It took me 4 years in the ER to feel comfortable. Several people I work with have said it took them about that long too.

I work with some people who have been nurses for a long time and they still "spaz out".

A little nervouseness never hurt anyone and it keeps you sharp. In the hospital there is always other nurses around to help you. Depending on where you work it can be a great learning experience

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My first day off orientation in ICU 20 years ago, my first patient on my own..the end of the day... a patient that was considered stable 12 hours earlier... sedated on a vent with a Blakemore tube, Swan Ganz cath, 16 units of blood, pressors galore on his way to surgery and survived later on. I have never had that bad of a day again. Now I feel the "rush" but I know I have to get things done or else my patient is going to die. The doctor may order the stuff but I am the one doing the stuff and I have to work fast.

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Specializes in ED, ICU, Heme/Onc.
My first day off orientation in ICU 20 years ago, my first patient on my own..the end of the day... a patient that was considered stable 12 hours earlier... sedated on a vent with a Blakemore tube, Swan Ganz cath, 16 units of blood, pressors galore on his way to surgery and survived later on. I have never had that bad of a day again. Now I feel the "rush" but I know I have to get things done or else my patient is going to die. The doctor may order the stuff but I am the one doing the stuff and I have to work fast.

Not to thread jack, but nice work. That's a rough patient for a seasoned nurse to have.

To the OP, I've found that freaking out does very little good to anyone. Just pretend at first to not freak out (or be freaking out on the inside) - and it will come. I think that working in a non-acute area just makes the possibility of something bad happening more nerve wracking than being in the unit sometimes.

Then again, even with every bit of equipment and staff you can think of needing, it just doesn't have a happy ending. If I can look back and determine that I did the best I could for those who needed it, then it was OK.

Blee (who had a really bad week and freaked out, but well after the fact)

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Specializes in Telemetry & Obs.

I remember my first patient that was circling the drain...there was myself and two docs in the room. The patient was a DNR/DNI and his wife was frantic. I calmed her down, made the patient comfortable, and followed orders stat. Later one of the doctors mentioned to my charge nurse how calm and collected I was and how impressed he was. He was doubly impressed when she told him I was a new grad and only off orientation about 3 weeks.

That's my nature, though. I'm cool and calm during a crisis and only break down AFTER if I break down at all. Getting all bend out of shape doesn't help the patient, the family OR yourself.

For what it's worth, I've been told that you perform better under a *little* stress....maybe that 100 bpm HR is doing you good :D

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