Ageta

My first time seeing ACLS was in ICU working as a caregiver at first year in nursing studies. I just looked and didn't to anything. Next one and the one I think as my first was a month after I started working in an ambulance. It was a long ride to go, so at first the EMT asked our team leader what he is supposed to do, as it was his first ACLS. Right after him I asked the same. We had 92yo man wth lots of diagnoses but the relatives had been doing CPR so we continued for minimum time and then called it. I've worked in ambulance for two years and have had 7 ACLS, only one we resuscitated.

We are doing our clinicals also with the nurse we are signed to. But it'not possible to put all your shifts together, so some we do with other nurses. I have had a lot of different nurses to work with. Good, bad, and really bad instructors. Plus I hate it when nurse treats me like a kid. If I say I know how to do something, then come on, let me do it. You'll see if I'm doing it wrong and can stop me then. Then there are nurses who want you to do evreything exactly like them. Once I had a woman giving birth and i had to start an IV. I was inserting cannula, it was in the vein and I was about to pull the needle out of it when she whispered no, touched my hand making it and cannula to move. Well, of course the needle punctured the vein. She was angry at me for messing it up, although she was the one that messed it up. And all I did was that I put a gauze under the cannula wings because I saw she had thinner blood and I didn't want to ruin the bed sheets. Other situation I remember really well was in ICU when I had to do an ECG. I was placing the electrodes and one nurse came to tell me their on wrong positions and moved them by a centimeter. I assured her I know how to to an ECG but she still repositioned the electrodes. When I finished she took the machine and went to the next patient. She started doing ECG but then ran out of paper. She tried to put new paper in but failed to figure out how it was supped to go in so she called help. Two nurses went to help her but no use, still turning the paper all around. I mean, how hard is it? Black boxes go to bottom edge and pink line shows paper is finishing, meaning it goes downward. I gave them couple of seconds more, then stepped closer and asked if I could help? Took the paper and put it in. Oh, you should have seen her face. A student-nurse knowing something she doesn't. I mean, i insert cannulas, do injections and ECGs daily at work so if I say I can do it, then why can't you let me to such basic things? When I'm at work I love to have students. I love to teach them and I enjoy if they like the job and want to do things. I mean, I just stand next to the student and watch him/her do everything. One shift I got a good laugh at myself. I just came back from vacation and during that time I did my clinicals in pediatrics. So that first day I had a student who did everything by herself. She went away at 8pm and next call for us was 9pm and it was a real AMI. I started to put the IV, EMT gave me a cannula and when I looked at it it was like whoa, that huge? I already was used to using 24G cannulas and that 18G cannula seemed way too big. I mean, by that time I had been 13h at work and that was literally the first thing I did during that shift. So yeah, I love having students. And if I have someone who does't show iniative, I put him/her do things because what else is he/she going to do?

Well, where I am from we change dressings every day. It is even required by the fact that every day you have to evaluate the wound. If doctor wants a longer period, then it will be written into the documents but otherwise, you change dressings every day. All our patient documents and papers have a line for describing the wound and stating you have changed dressings. Plus, if you don't know something, you ask. For example, if we have a patient in ICU who has had face trauma and her upper and lower jaw are hold together (I really dont remember that diagnose even in Estonian but believe you get the picture), teeth have some kind of elastic bands on them and no one of the nurses knows or dares to remove those bands by themselves. Every time we call that wards doctor and nurse to do it. Today I injected Adenosine to a patient. My partner didn't know how it is done because he hadn't done it before. He told me that and asked me about it. The point is that if there is something you don't know you ask about it. Well done for that nurse, she asked. Everybody has to take care of the patient. If that would have been in our hospital, every nurse and every doctor who were assigned to that patient would be held accountable. And if the only thing that follows is educational, then that is real good. You can learn from the mistake. That is not throwing under the bus.

I agree with some previous comments. Changing dressing is a basic thing and it doesn't need orders. It is a known fact that all dressings have to changed daily. And as a family member I would be upset with everybody in the hospital if my family member haven't had his/her dressing changed over a week. And then you say that being educated about that is throwing you under the bus? No way. If you don't know how and when to do it, it is correct that every nurse in your ward should be educated about it.