Category: personal

My patient with the low potassium had a seizure yesterday right at the end of my shift, and a code was called. It was my first code to experience, and it was scary. I ran to the room because I knew they would need me there, as her nurse. The alarm was blaring. People were everywhere. I was being asked all kinds of questions. Someone yelled to me, “She needs Ativan now!” Her sister was crying and yelling.

Thankfully the patient never stopped breathing, and she slowly recovered. She hasn’t been the same since. She is either sleeping or confused and agitated now. But while all the commotion was going on, I realized that I cared for this woman and her sister, who I have taken care of for the last two weeks, and she could die at any time. It made me very sad.

Today I took care of her again, along with two other patients, none of whom will probably recover. One of them reminded me so much of David’s dear aunt, who is at the end of a fight with pancreatic cancer, that it was hard to look at her at times. I chose this path, and I know it will be hard. I think that I can handle it; I hope I can. I hope I can also retain my softness and compassion. It’s a fine line.

I’m so glad it’s the weekend. I’m ready for some distraction.

The day before, her potassium had been 1.8. I was with my preceptor that day, and she informed me that although it was low, it was best if we just waited for the doctor to make his rounds instead of calling him. She said that he is very particular and hates to be called about things like low electrolytes which he can take care of on rounds. Yesterday, my preceptor wasn’t there and so I was more or less on my own. I waited for awhile for the doctor to make rounds, but he didn’t come. Finally I consulted another nurse. She also told me not to call the doctor for low electrolytes. So I didn’t.

I recorded my report, and in it I said that her potassium was 1.5 and so the next shift should keep an eye out for the doctor. When the nurse from the next shift heard my report, she came flying out of the room. She asked someone, “Is her potassium really 1.5 and nothing has been done about it all day? Did I hear that right?” And all of a sudden I was being bombarded by nurses asking me what was going on and why I hadn’t done anything about it.

I told them what my preceptor had said to me the day before, and what the other nurse had told me that day. Apparently I asked the wrong person. They wanted to do a formal patient safety report, so they went and talked to the nurse who gave me the advice. I was really upset because I like her, have to work with her frequently, and it was not my intention to get her in trouble. I was also given a “talking to” by more than one person.

They ended up asking the nurse practitioner on our floor to write an order for potassium replacement. The nurse who gave me the advice caught me before I left and said that she had put the patient safety report in her name. She said, “I personally still wouldn’t have called him. That’s my professional judgment. Reason being her potassium is low every day, the doctor is aware of it, and he is expecting it to be low again today. But anyway, I’ve been a nurse for 12 years and I can take the heat. Don’t worry about it.”

Everything ended up being ok, but it was very frustrating to have such an incident happen to me right at the end of my shift, when I thought I had had a good day. But I learned to never take one person’s advice if I’m not comfortable with it, and to always be an advocate for the patient even in the face of grumpy doctors.

Today her potassium is 1.6 and I had someone else call the doctor for me!

I had a wonderful weekend, slept great, and was refreshed all day Sunday. I was ready to start the week.

Well, last night I could not fall asleep for hours. My parents keep the house way too hot to be sleeping upstairs, and yet for some reason I didn’t think to go down and lower the thermostat. Therefore I tossed and turned, kicked covers and twisted sheets. Cleo was restless too; someone somewhere was setting off remnants of Independence Day firecrackers, and that got her trembling and needy for my attention.

I think that today wouldn’t have seemed so bad if I weren’t so tired the whole time. But I was and it did. It was the first day at this job when I actually felt inadequate, and thought, “What have I gotten myself into?”

First, I made a mistake by not flushing a patient’s PEG tube when I unhooked it for him to take a shower, because then it got quite clogged and my preceptor had to work long and hard to fix it. (Sorry for the jargon, I’m too tired to explain.)

Later I was helping transfer a patient to a stretcher and the Patient Care Assistant (PCA – like a nurse’s assistant) told me that she had better take my place because I wouldn’t do a good job. Now, I know I’m small and don’t look strong, and no I haven’t had years of experience like she has, but that doesn’t automatically mean that I don’t know what I’m doing or I won’t do a good job. I don’t enjoy being looked down on.

Then, about an hour before the end of the shift, one of my patients had a period of unresponsiveness, change in vital signs, and copious amounts of bloody stool. I am leaving out many other details that I’m sure you don’t want to hear about. We were in a frenzy taking care of him, so I didn’t have time to get my thoughts together before giving report to the next shift. On our unit, we tape record our reports. I hate doing it in the first place, because I picture all the nurses sitting around listening to my voice and whatever stupid thing comes out of my mouth. But giving report isn’t something you’re really trained to do in nursing school, and I always feel like I’m just bumbling through. If I have time, I like to write down everything I’m going to say. But a crashing patient equals no time, which equals a really embarrassing report.

After the long bus ride home, I finally had a few hours to myself. I wanted to get some things done, but I couldn’t move myself from the couch. David stopped by to see me on his way home from playing golf, and we hung out for a total of 15 minutes. Then I told him he had to leave because I need to go to sleep (hopefully) in order to do this all over again.

My days aren’t all like this, and I hope that tomorrow is better. Sometimes I do wonder why I didn’t choose something easier. I think I have a pretty good idea, though. It’s going to be worth it.