I was proud of my nursing judgement last night!

[christvs, DNP, RN, NP]

I've only been an RN for 5 months now & although I feel like I know what's going on most of the time, I still have many times when I just doubt myself and my knowledge. Anyhow, last night one of my patients needed 2 units of PRBCs. So I gave her the first unit and kept monitoring her all through it for anything abnormal, signs of reactions, etc. but she was fine. Then when the first unit was finished, I disconnected her tubing, flushed her IV with NS, and then faxed for the second unit to be sent up from the blood bank. Once I got the second unit and did all the checks with another nurse, I again flushed her IV with NS to be sure it was working correctly, and I noticed as soon as I began to flush it, the NS came right back out the other end of the needle. I did it again to be sure I wasn't crazy, and yep, it was leaking out the needle, so I knew the IV came out of the vein. So I told the pt I had to remove her IV since it wasn't working anymore, and that we'd put in another one. It was a good thing I was watching her like a hawk all through the first unit of blood-I know she got all of the blood in the first unit, because I was checking everything. This may sound trivial to more experienced nurses, but I've never been the one to discover a leaking IV before and so I was so proud of myself that I knew what was going on and that I had to take it out and put in a new one. I was happy with myself because I realized my pt's Hct was only 24.1 so I knew she needed her blood transfusions, so I spent so much time with her making sure she was okay. Anyways, that made me feel more confident with myself, cuz now I can start trusting myself a little more when it comes to nursing assessment and judgment skills. :)

Oh and one more thing happened last night-this time with another one of my patients (boy they all kept me busy!) As SOON as I stepped out of report, I got called to a room to see a patient. It was a patient I had the previous night so I knew her well. Well when I got to the room she said she was having heart palpitations. !!!!! Oh my God, I tried not to panic, (I am on a med/surg unit that has telemetry patients and also many gyn surgery patients)cuz I've never had a pt. in chest pain or cardiac distress right in front of me before. So I asked the PCA (who was right outside the door) to grab the EKG machine and we did an EKG on her (it was normal thank goodness). Then I saw her VS which were normal too. Then I asked her if she had any CP, or other pain, or SOB, or nausea, dizziness, light headedness, anything I could think of. She had none of those. Then I asked her if she just received any bad news perhaps, or did she feel anxious? She said she was anxious cuz her husband just left to go somewhere and it was a snow blizzard yesterday so she said she was nervous with him driving in the snow, plus she hates being alone in the hospital room, and that she has some abd pain from her hysterectomy. And that she feels a little bit better now that I was in the room with her, talking to her. So I said ok, I'm going to get you your pain med now so the pain won't contribute to your anxiety. And I'll call your doc to let her know what is going on. In the meantime, press your calllight if you feel anything abnormal. So I gave her her pain med, and paged her doc. The doc did not seem the least bit concerned-I told her about the palpitations, I said her heart sounded normal, she had normal VS and an EKG, no other symptoms or complaints, and that she was anxious. The doc said "well ok, it's ok as long as it's resolved." !!!! So I said, yes but she says she is still anxious, don't you want me to give her anything for that? So she gave me a one time dose for ativan, which I gave the pt, and after that, she was much calmer and looked better. I was also proud of how I handled the whole thing. :)

-Christine

[NRSKarenRN, BSN, RN]

Sounds like you did a great job of nursing last night. Good instincts on asking re upsetting news/anxiety etc---often overlooked questions.

I'm sure your reasurrance, allowing her to vent along with the ativan is what calmed this patient too.

[jnette, ASN, EMT-I]

Sounds like you did a great job of nursing last night. Good instincts on asking re upsetting news/anxiety etc---often overlooked questions.

I'm sure your reasurrance, allowing her to vent along with the ativan is what calmed this patient too.

I agree. You did a super job assessing ! YAY for YOU !!!

And YAY for your patient who had an observant and competent nurse!!!

Doesn't it just feel soooooooooooooo good when you know you've done something well? Keep up the good work !

I love hearing these things. :)

[RainDreamer, BSN, RN]

Christine, how awesome!! Great job!! I can't imagine how high you were flying when you walked out to your car after that shift, wow!! Good for you!! :)

[Tweety, BSN, RN]

Great Job!!! Keep up the good work. You're making a difference in people's lifes and that's what nursing is all about! :)

[chris_at_lucas_RN, RN]

I don't know which feels better, seeing that we are competent after all, or the blessed relief that comes from not having to check everything fifteen or twenty times terrified we missed something.

Way to go!!! (Great name, btw! LOL)

[GooeyRN, ADN, BSN, CNA, LPN, RN]

Ww! You sound like a great nurse w/ good assessment skills. You are a great patient advocate. Keep up the excellent work!

[RosesrReder, BSN, MSN, RN]

Congratulations :)