shortsteph12. . .one of the problems I saw with stepdowns is that they are dumping grounds for patients who either can't get into the ICU because there are no beds available, or the docs aren't quite sure exactly what's going on with the patient to begin with, so they stick them on telemetry and "watch" them (actually, the nurses end up watching them). When the defecation hits the ventilation, it's usually while they're on the telemetry unit. As I said, I worked on a stepdown for 5 years and then was promoted to supervision in the same hospital, so I was also able to see what was going on in the ICU and ER as well that contributed to these kinds of situations. We had doctors who would refuse to transfer their patients out of ICU when they no longer needed to be there, as well as doctors who refused to release telemetry on patients who were stable and their EKG status not even being addressed in the doctor's progress notes! That left patients in Limbo Land over on telemetry. And, the real wild card is that you just never know who is going to go sour on you.
I forgot to ask, did any of the other staff nurses come running to help you out during these crises?
Honestly, kiddo, I'd hate to see you walk away from the months you've already put into this job. On the other hand, I do understand the panic you're feeling right now and the fear of making a fatal error. Is this the first time it's been this bad in the last 4 and a half months? If so, that's probably a good sign. I don't like that you were screamed at during a code by a doctor. If anyone should have their crap together, it should be an ER doc and there is no reason for that kind of behavior. It gives the rest of the people in the code a reason to get nasty as well. The most laid back codes I ever saw were in the CCU where, as an observer, you would never know a code was going on, it was that calm and controlled.
Well, you are the one in the situation. Was this typical? Do you think it's likely to recur again and again? What's going through your mind about this?