I'm a new grad in a small community ER. I've been on my own for about 1 month now and so far it's been pretty good. I know I have areas I need to work on but I feel like I've been able to handle the assignments so far with little difficulty. I especially know when to ask for help, or when to offer help if I have free time.
Last night was a cluster-**** of a shift. I showed up and was assigned Fast Track, so I started over there and within 30 minutes was told to shut it down because two nurses didn't show. I shut down fast track and pulled IVs out of patients and then went over to the main ER. By now it was 8 pm.
I literally walked into a code and spent the next thirty minutes helping with a code that had way too many people and very little leadership. The charge nurse and the pt's nurse actually go into a fight in the middle of the code because the pt.'s nurse didn't listen or agree with what the charge RN (who was running the code) was saying!
By the time I actually got my assignment and got to assess my patients, it was nearly 8:45 pm! All of my patient's were pissed because they had to wait, I had one complain that just because there was an emergency code didn't mean that someone shouldn't have given her pain medication! Then all the other departments started messing up.
I had a pt. who had been in the waiting room for 2 hours who called 911 to have a paramedic bring her in who was then entered into the system twice, and her various orders and tests kept getting messed up because in my system it showed them as ordered and in Ultrasound and other departments they'd been verbally told they were cancelled.
Then I had another pt. who kept desatting the ENTIRE night and I thought the chest x-ray had been done because the order was put in at 8pm, before I even got the patient. Then the ER doc told me it wasn't showing up in his system and I called x-ray and they said they couldn't find the pt. so they didn't do the order, and hadn't called to ask where the patient was!
It was just a shift where I felt behind the entire night, and just when I was about to get caught up something else would happen. I went on lunch and my charge gave a patient antibiotics but didn't check his allergies first (his list was something like 30 medications long) and luckily he didn't have a bad reaction. The same charge took orders and one of the orders was for another medicine he was allergic to, and the charge told me to give it anyway, just slowly. I called the doctor instead and got it changed, but still!
I know a lot of my frustration is because I'm a new grad and still learning, but this shift was just messed up from beginning to end.
The one nice note? Everyone offered to help me! The other RNs who had free time because they had less patient turn over (I had less acute patient's with higher turnover); the ERMD even pulled me aside and thanked me for my help! He said that he'd been behind the whole night too and he appreciated me looking out for my patient's and advocating for them. So, I feel really good about that. Just--it was an overwhelming night. It gets easier, right?
