AZER

AAhhhh, shift work disorder at it's finest. I am lucky enough to be the "team player" that gets to bounce between day and night shifts when the nights are short for charge. I have a hard time sleeping at night normally! I went and saw my FNP and talked with her about what I could do besides the: sleep mask, ear plugs, supercharged fan blowing, ocean waves sleep sounds environmental stuff I was trying (and failing). She diagnosed me with shift work disorder and gave me a RX for hydroxyzine (vistaril) and Nuvigil. These are 2 medications that can be used PRN when you encounter trouble while training your body it's new sleep cycle (or in my case, just getting by for a shift or two). I had a long discussion with her about my concerns regarding taking the medications to sleep and wake up and together we decided to stay away from benzos (which I understand a lot of night shift nurses use to help sleep) and the understanding is that I only take the medications if I need them. If I work at 7pm and at noon I still haven't been able to fall asleep on my own, I take a hydroxyzine. If I feel foggy or am afraid I am not thinking clearly I can take a nuvigil. I will admit that it is not ideal and I don't like doing it, but most of the time I am less anxious because I know I have a back up plan and it is enough to let me calm down and rest. Because of this I find that I don't use the medication very often. Shift work disorder is a problem that needs to be addressed if that is what you are experiencing. Try all the environmental stuff and talk with your PCP.

Hey I just wanted to pass on some information I received from BCRS/Nurse Corps today regarding the loan repayment program. The guy I talked to was very helpful. He said that they are using rolling award periods so that everyone is not entering contracts at the same time. He said that this award period lasts until October 31st and that after that they will be sending out denial emails. He said that nobody should be calling to get banking information and that it is all done via email. He said that if your status is "under review" they have not attempted to contact you yet and you have not been denied. If it states "submitted" there is some reason why it was immediately denied and if it says "selected" you have been contacted or will be contacted soon. He also said that the award is not guaranteed even after you give your banking information, the application is moving into "final review" after that you receive your contract.

Altra, Thank you for sharing your story with me. I understand that everyone can't be brought back..... I guess what I am looking for from other nurses is whether or not they still find themselves at risk for hesitation or becoming flustered even after they have experience. I just feel like I should be beyond that feeling and the fact that I am obviously not is really concerning me. If you don't mind my asking, did the suddenness of the cardiac arrest on your young patient affect your response?

Thank you for your post. I appreciate your input. Yea, it all came together after the first 3-4 minutes (but as we all know that is a critical gap) and we worked on him for 45 minutes.

txerrn6942, thank you for your post. I have been telling myself repeatedly that I will do better next time.

Sun0408, Yes, it was unexpected. The patient had come in complaining of chest pain but the entire work up had been done and looked good, CE negative and EKG looked good..ect. No history, marathon runner. He had just been given a GI cocktail to see if it was heartburn. It was about 10 min into my shift. I couldn't find the pads on the crash cart, delay.. later the tech found the pads ON THE CRASH CART! How could I not have seen them? Can I trust myself?

Any experienced ER nurses had the occasion to be caught off guard during a code and felt like they underperformed? I did last week, I felt panicky and it seemed like I fumbled around for the first 2-3 minutes. This has never happened to me before, I have participated in dozens of codes. The code outcome was poor and I am having a hard time accepting that my performance was not as good as it should have been. I feel like I failed the patient, the doctor and myself. I have been having a hard time eating and sleeping since then. I just need to know that this sometimes happens, that I am not the only one that forgets to put on the cape and that it can happen even with experience. Does anyone have pearls for me?