tictac 3,571 Views
Joined: Jun 26, '06;
Posts: 83 (33% Liked)
; Likes: 64
I'm in my third week of orientation and just finished my third shift of caring for stable, intubated babies. While doing my assessment on one of my patients, after inline suctioning, his HR and sats dropped to the 30's. My preceptor had just gone to lunch and left me under the supervision of a podmate. I yelled for her help and she came in and immediately started bagging. Long story short, the baby got reintubated after several attempts and appeared to be stable immediately post procedure.
I was told repeatedly that it happens to everyone and to not feel bad, but I can't help but feel like crap and totally incompetent. It was my preceptor's first time EVER leaving an orientee by herself and she felt somewhat confident enough in me to do so momentarily. I really don't know what I could have done differently, as I wasn't trying to reposition him or anything. Externally, everything looked like it was in place and the tube didn't visibly come out. They did say the ETT must have been sitting very high because there was a 1.5 cm difference in depth with the new one. This baby was just over 1 kg and I believe it had been 2 weeks since the last chest X-ray. I keep trying to tell myself that this was the primary reason this happened, but whether that's entirely true or not, I'm not sure. I'm not very confident in positioning all the tubing.
What bothers me even more is that I had no idea what to do after calling the other nurse. I just stood there as everyone else took care of him. I didn't even know to start bagging him right away and observe for chest movement or listen for breath sounds. Although I don't complete NRP until next week, I feel like this is something I should have known, being a nurse. I'm completely paranoid that I'm going to do this again and my confidence has dropped to zero.
You guys are a tremendous resource and if anyone has any words of wisdom regarding these situations, I'd be eternally grateful. Thanks for letting me vent (no pun intended).
A sign out sheet is a great idea! I just consider the clothes I give out as gone the minute they walk out the door. I do send a note home stapled to the bag asking for them to be washed and returned. We get a lot of rainy days here and the minute the rain stops, they're out there for recess as if everything has dried up already. On those days, I've begun sending out school-wide emails that if any of your students get wet or muddy, YOU will need to call the parents for a change of clothing. We do not have the supply nor the time to accommodate a line of dirty students. It may sound rude, but I am fed up. One day we had almost 10 from one class alone. At what point do you exercise some common sense and realize it might not be a good day to go outdoors? Despite the warnings, there's still always a teacher who sends in their muddy students.
Do you also get the dress code violations? Every morning my assistant principal sends students straight to my office as they walk through the door. Why is this my responsibility? Arrrrrghhhh! This, plus a thousand other reasons is why next week is my last week as a school nurse. They don't pay me enough for this foolishness. God bless you all, you have the patience of saints!
I don't know why any teacher lets a student see the nurse during the last 10-20 minutes of school day unless it is an actual serious medical issue. This just seems like common sense to me. I, too, am trying to catch up on my documentation then - I cannot tell you how many kids are sent to me with a headache 10 minutes before dismissal. If you lived with a headache until now, you will last 10 more minutes, trust me.
Did I mention how much I HATE when anyone calls me "Nurse." Just "Nurse." None of the teachers get called "Teacher." The secretary isn't called "Secretary" and the principal isn't called "Principal."
Yik Yak was a (horrible) thing here last year and once word got out, the district quickly banned it and made it unaccessable at school. It died down pretty quickly after that, thankfully, and hasn't been mentioned since. Hopefully, the same will happen in your area.
My clinic assistant used to have cafeteria duty in the morning and would grab the cereals, bananas, milk, etc. that were left untouched. Someone from the cafeteria told her that she wasn't allowed to do that and it had to be thrown away. What?? She kept doing it anyway. The kids who throw away their untouched breakfasts are the ones who show up in the clinic hungry later in the morning asking for food. Guess what I offer them? I also tell them that next time they want to throw away perfectly good food because they don't "like" it. They will be hungry until lunchtime. Most of these students are on free lunch and it is insane the amount of food that is wasted. I also purchase plain animal crackers to keep in the clinic.
I had a dad call me yesterday morning to let me know that his daughter has an earache and she will be "coming in to see you all day because she's in a lot of pain". She can't stay home anymore or she'll have to repeat kindergarten. He didn't bother to even give a pain reliever because he didn't have anything. But he would go buy some, if necessary, and bring it up to the school for me to give it to her. Yeah... no. Come get your child.
I love it when I send home for possible fracture and not only do they NOT take the child for an x-ray, but the child reports to me first thing in the morning, telling me their parents said to go to the nurse if it hurts. Makes me want to scream!
I had 2 years of NICU experience before I became a school nurse. I wish I would've had a more well-rounded background, especially since we're expected to know absolutely everything medical by staff and parents. I also feel like the 4 years I've been a school nurse doesn't help my resume, now that I want to do something else. I guess so many people don't view it as real nursing, even though we all know that it is. I do use my knowledge from nursing school, but most of the time I think I just rely on common sense/educated guessing.
Our district provides free CPR classes during the summer for all interested employees. Nurses are required to take the instructor course and we are the ones who teach the classes. We check each other's skills off.
They just increased the starting pay in my school district to $50,000. I'm in Texas.
When I was in kindergarten, there actually was a lice epidemic in my school (though epidemic is probably the wrong word). All students were required to come to school with their heads covered. I went to a religious school, and most of the mother's already wrote some sort of covering as well. My mom ended up taking pictures of us because we liked so funny. All of 4 years old, and wearing her scarf.
I remember that they actually ended up with an issue because students were swapping their scarves, oh well.
This is my 4th year as a school nurse and I think it will be my last. I'm not sure if it's because of the environment I work in, the work itself, or a little of both. Our assistant principal is a micro-managing, administrative bully, and makes me (and everyone else) miserable. Our principal doesn't care about anything and never has your back when it comes to parent issues. I'm also tired of the silly things I deal with on a daily basis. I know teachers send them down to me because they have to cover their butts, but it's gotten so tiresome. It's as if kids aren't expected to experience discomfort of any sort and have no coping skills for things such as a common cold, old insect bite, or sore muscle. There is most definitely a need for school nurses, but I think the position is misunderstood and abused. I don't think switching schools will do me any good because I swear there is an overwhelming lack of common sense in a school setting. I just don't get it. I hate to admit it, but I'm just out of patience with this job and can't do it anymore. I hate to give up the schedule though. It can't be beat. I really wanted to stick it out until my kids are done with school, but I just can't.
Oh, how I wish I could enforce that! But the "nurse" around here is also the eyeglass fixer, the muddy clothes cleaner, the shoelace replacer, etc, etc....
Nice to know I'm not alone, but gosh it burns me that we get treated like this!
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