My First Day In The Ed And I Feel Like The Unit Idiot!!!

hikernurse · Jan 30, 2008

Let it go, there was a lot of tension in the room due to the code and once cooler heads prevail (if anyone is thinking about it at all) they'll realize it's your first capstone day.

You're definitely not an idiot :); you shouldn't have been asked to participate so quickly in a code--at least watch one first.

Tough day and it won't be the last where you feel like you know nothing, but it does get better--really.

angelwingsamy · Jan 30, 2008

wow i feel really bad for you. i would have been terrified thrown into your situation.

ICRN2008, BSN, RN · Jan 31, 2008

I suspect that most reasonable people, realizing that you are a student in your first code situation, would excuse the fact that you don't know what to grab and where to find it... Your preceptor was probably stressed out, but be aware if that blaming type behavior continues. If it does, I suggest that you ask for a different mentor.

As a student, you should not be expected to do anything but watch during a code. Congrats to you for jumping in and trying to help- that takes guts!

The biggest favor you can do for yourself right now is to give yourself a break and allow others to cut you some slack while you're learning. If some nurses are rude, impatient or otherwise unsupportive, seek out the ones who like to work with students. There are plenty of us out there :)

Dempather, RN · Jan 31, 2008

LOL. You sound like you have the same ER preceptor I had when I was an extern in college!!!!!

Man, she screamed at me for everything. When I "wasn't thinking" or when I moved too slow (because I forced myself to think about what I was doing.. which was taking longer!) She demanded I get stuff, and yelled even more when I didn't get it in time because I didn't know where it was (Because I didn't really work there for that long, it was a summer job!)

Anyway, I thought I was retarded until, during a hypoglycemic situation, the charge nurse on the floor asked me to grab her an amp of D50. I, of course, had no idea where it was and took a while to find it. When I returned, she looked impatient but said, "I know how difficult it is to find something you're asked for when you don't know where things are...". From that point on, I realized my preceptor was just really uptight and the charge nurse (and pretty much everyone else in the ER) was cool.

Just try to allow this to roll off your shoulders. Yeah, it's embarassing, but if this preceptor is the way you describe her.. I guarantee you're not the only one with a problem. :) Tomorrow will be a better day.

BTW: Being proactive is great, just maybe sit back on your heels and observe for a bit. Of course, that's completely up to you, though :)

berry · Jan 31, 2008

Then we had a code...my preceptor yelled at me to grab supplies (I've only been in the supply room twice to grab ice for a couple of patients) one of the things she wanted could only be found in the Pixxus (sp?) which I don't have access to. I took so long that she threw a fit, grabbed a zillion supplies threw a bag of NS on a desk and told me to prime the tubing stat. Which I did. When I got in the room to attach the tubing, I realized she didn't grab a butterfly clip (am I supposed to be psychic?) and the whole team rolled their eyes b/c she made it sound like I'm the one that forgot it. Now I'm the unit idiot that forgot an alligator clip.

To hell with her....

First off grab a crash cart, I assume that almost anything she could want should be in it(a personal pet peeve of mine people running for stuff we stock in a crash cart just for the explict purpose that you have it on hand when you need it and dont have to look for it).

Second any good ER RN should be able to think on their feet so It is sad if a whole team of people sat waiting for you to retrieve a clip instead of starting the iv without one and giving the needed meds.

I would guess you preceptor lacks confidence in her abil;)ity and feels better by making you and others feel like an idiot. Keep your head up

Dolce, RN · Jan 31, 2008

I did my senior capstone in the ICU. I "helped" during the first code (getting NS) but was never considered a part of the code team. The staff that I worked with were sensible enough to never ask me to run complex errands. In fact, they were so calm that they still had time to teach me things, even during the code.

AirforceRN, RN · Jan 31, 2008

2 Things...

First...as posted above, you should never have been asked to participate in a code on your first day. Watching is fine, but even being gopher on your first day is too much, you have to learn what first before you need to know where and how.

Second...in my personal opinion, you can't jump into ED so quickly. Taking patients on your first day without knowing the way things work, the layout etc can be dangerous and potentially fatal to someone. I know you want to dive in there (believe me, I know) but take a few days to ORIENT! If they expect you to take patients from day one there is something wrong...frankly I'm surprised they allowed it.

loricatus · Jan 31, 2008

You did nothing wrong----It was your preceptor who didn't know what she was doing!

You stated it was a level III, so I suspect that she was not that well trained in codes. A good code team will pre prepare and function in sync as a team. Once you learn ACLS, you will find out that some of a code leader's responsibilities are to communicate properly and respect all members of the team. Assignments are to be made for each member of the code team based upon the knowledge and capabilities of the particular members of the team. Basically, everyone should clearly know what their role is and that role must be within their scope of capabilities. It is also a team member's responsibility to be honest in their knowledge and capabilities. It sure seems that this code did not even come close to ACLS guidelines. You should have had no responsibilities put upon you for that code. However, you should have been told to watch and learn. Except, in that place, I don't think there was much you could learn other than what not to do during a code :sstrs:

Now, there are times when people snap out in frustration; but, an apology is usually made/received after the code. If no apology was made, I stand behind what I said earlier-your preceptor is the one with the problem, not you. Please, don't let this place's actions make you think that all ER are like that. A properly run code can be a fantastic experience and help get you through the tedious days until the next one comes along.

Trauma Columnist · Jan 31, 2008

Sounds like your preceptor isn't used to codes! In a busy ER, codes should run very calmly with all supplies in all rooms so that if ANY patient goes down the tubes, things can be addressed in an orderly and calm fashion.

You did fine, your preceptor did not. Sorry for your frustration and embarassment. However, they are the ones who should be embarassed - you are a student, not a trained staff nurse. Keep going. It gets better.

Anagray, BSN · Jan 31, 2008

don't feel bad, because you have done nothing wrong. First of all, I really don't understand why everyone was so tense, riasing their voices and rolling their eyes.

During our codes the ONLY yelling that happens is when someone yells : Help.

From there on it goes pretty quietly and smoothly. People calmly delegate what needs to be done to people who KNOW where things are and can get things. As chaotic as ER seems, it is actually well organized and runs very smoothly.

Funny story - here is an example not to delegate code things to new people-

we have a really great new nursing assistant, a med student. Good kid, very hard worker.

We had a code in a small room and ambubag was not there. While someone ran for the code cart CN asked the kid : " get me an ambubag" (conveninetly it was missing from the tiny supply rack in the room". 2 minutes later (after the patient was already intubated and saved) the nurses' aid showed up with a urinary legbag.

We all had a good laugh. :lol2:

hang in there - in a bout 6 months you will be sending people for stuff and rolling their eyes at them.

Nat

MissERN · Jan 31, 2008

I'm a new grad whose been in the ED for about 8 weeks now, and from what you described I would say that you did an excellent job in getting supplies! I still sometimes have to ask questions about where to find meds/supplies that aren't used a lot. I remember my first day in the ED...scary because it's so fast and different, but now I just love it! I agree with everyone else...you should have only been required to be an observer!

I'm off orientation now and just waiting for the day that I get my first code while "flying solo"...thankfully my co-workers are great and I know I won't be left alone. Being a new nurse there is so much to learn, and that's especially true is the ED because of the variety of patients and conditions seen. I agree with another poster that it may not be time for you to take on patients all by yourself...that's the great thing about a good preceptor, you learn a lot working with them. Don't be afraid to talk to your instructor if you feel like you are being asked to do things you aren't ready for. I hope the rest of your time in the ED is wonderful and that you learn a lot! Hang in there...you certainly are no idiot! :specs: