your first "patient emergency"

Esme12, ASN, BSN, RN · Jun 9, 2013

Well done! It's kind of fun when it all makes sense doesn't it?

pinkiepieRN · Jun 9, 2013

Well done! It's kind of fun when it all makes sense doesn't it?

It IS! On my way home from work, I was like, "Do I even remember learning this in nursing school?" It just clicked today. :nurse:

Esme12, ASN, BSN, RN · Jun 9, 2013

((HUGS)) good for you......see critical thinking eventually clicks. Congratulations!~

Morainey, BSN, RN · Jun 9, 2013

Yes... I was about to start a topic just like this! I had two cases yesterday where I've wondered, should I call a rapid response right now?! However in each case we managed the symptom, the patients recovered, I never lost my cool (most amazingly of all!), and I felt like each was handled well, IMHO. *sigh* such a good feeling!

LandD_RN_chica · Jun 9, 2013

There was a nurse who gave a pregnant patient indocin on the floor and she was allergic to aspirin. The nurse didn't wait until pharmacy cleared it and the patient went into anaphylactic shock. I was so calm cool and collected while in the situation and did all I was told and did things I didn't even know I knew as well. The baby and the patient fully recovered after some epinephrine, Benedryl, and the rapid response team, but after the situation was all over I was a shaky mess. But I held it together while in there. You never truly know what you are capable of until you find yourself in a situation like that.

nurseprnRN, BSN, RN · Jun 9, 2013

I don't remember my first, but I remember one of my orientees' first. We were in the ICU and the patient started to report chest pain and shortness of breath. She listened to his L chest and said, "I don't hear anything on this side." I saw the tracheal shift, thumped on his L chest (hollow) and called the stat response, while sending the aide to the storeroom for the chest tube tray and a new pleurevac (we had pleurevacs in those days) and had it all set up by the time the resident flew in the door. Patient had his chest tube in for his spontaneous pneumo in about four minutes flat from the time he had his first pain.

It is fun when it all comes together, ain't it? It's what we stay for sometimes.

PaxRN · Jun 10, 2013

I had my first patient emergency a couple weeks ago. My patients sats started dropping so I entered the room figuring the monitor had gotten partially dislodged from his finger or he had apnea. His sats were 75% and I called his name, rubbed his chest...noticed his sats continued to plummet. I hit our staff assist button and grabbed the ambu bag and lowered the HOB. He was in agonal breathing; charge nurse and additional staff came in and a code was called. He had a pulse and began breathing again. Tons of people responded and he stabilized; then passed the next day on a different unit. The experience was surreal and I remember thinking in slow motion, yet moving quickly. It made me very thankful for the incredible team I work with and the training I've gotten. A good plus is I feel more prepared for the next emergency. Great thread; interested in hearing from others.

calivianya, BSN, RN · Jun 10, 2013

I very clearly remember my first emergency - it was during my externship in the summer between my junior and senior years of nursing school.

The day nurse for this particular patient had an extern with her and I was extern with the night nurse who was getting the patient in report. The patient called out to say that he had to go to the bathroom, and the CNAs were busy so they sent the externs in alone. We had maybe been on the job 3 weeks, and neither of us had ever worked as CNAs before so we were very inexperienced. When the patient was finished voiding we transferred him back over to the wheelchair from the toilet. We started to roll him out of the bathroom and he slumped over and was incontinent of urine again. The other extern froze, but I shook him and tried to get him to respond, and when he didn't, I told the other extern to stay with him and I hit the code button and got help in the room. The nurses and the code team got in the room around the same time; they had apparently been helping another patient. The nurses of course had no idea what had happened so I was the person telling them the story of how he went down, what he looked like, etc. The code team leader stated that he needed someone to push meds and he looked at me first, I guess assuming I was the nurse because I had my stuff together while my preceptor was freaking out on the other side of the room, and I had to explain that I couldn't do it. I even got to do chest compressions for a couple of rounds.

I had thought I wanted to be an ICU nurse before, but that rush I got being the person who recognized the emergency and called the code, talked to the code team, and actually did compressions reinforced it. I LOVED that feeling. The guy lived through the first round of CPR, but he coded later in the ICU and died. I am still proud that I helped save his life once, even if it was only for a few hours. I know all of nursing is important, but that feeling of recognizing that emergency and literally pounding the life back into someone is awesome.

That Guy, BSN, RN, EMT-B · Jun 10, 2013

Mine was as a intern in a cardiac stepdown unit. Guy was going in for cath that morning so we were starting his second line, he was a horrible stick and his first one went bad too. So right as I am about to start his IV I tell him ok here it.........asystole. Pt went slump stopped breathing no response. I got bugged eyed looked at my preceptor, he yells out for one of nurses in the hall, I manage to get the IV just as the seasoned nurse comes in, we tell him what happened. So Mr seasoned as the earth is old nurse comes in looks at him and WHAM hammer fist to the chest. Pt wakes up and says "where did I go just now?"

Thank god it was at 630 in the morning and I was about to go home. Great learning experience about how to keep calm under pressure though

ChristineN, BSN, RN · Jun 10, 2013

I don't remember my first rapid response. The first one that sticks out in memory though was when I when I was a fairly new grad working pediatrics and my patient came out to the desk and calmly asked me to come into her room. I went in to find her mother sitting in the chair having a grand mal seizure and barely breathing. I started freaking out and grabbed my charge nurse who grabbed one of the pediatricians at the desk. We ended up coding her for a while. Found out the mom hadn't taken any of her meds for seizures, blood pressure, or diabetes during the several days her daughter was in the hospital. We got her back and transferred to the adult hospital. I was worried the kid would be freaking so after it was all over I went to ask her if she wanted to talk about what had happened. She was like "nope, mom does this sort of stuff every week.".

CodeteamB · Jun 10, 2013

My first and second patient emergencies were with the same patient, 2 nights in a row. The first night I had just finished rounding on my rooms and was sitting down to chart. About 15 minutes in I got super restless and had to get up, I went to my patient's room at the other end of the unit, where I noticed a dark puddle on the floor. She had pulled off the line and cap to her large gauge IV and was quietly exsanguinating in her sleep. I'm not sure how long she had been bleeding (less than 15 mins obvi) but it was bleeding really fast so probably not long. EBL was 1500ccs in an already post-op patient. I had the sense to pull the line and apply pressure but shouted for help waking half the floor instead of using the call bell.

The next night on my initial assessment she had an acute abdomen; she died later that night of a post-op complication. I still remember her name, age, diagnosis, face, nightgown. I learned a lot about how to stay calm under pressure from this lady, I will admit at one point on the second night I thought "well, it's a lot better for me that I caught it last night, but maybe I didn't do her any favours."