Tired and wired.

Last night we were a nurse short for the shift. They couldn't fill the shift. In the rural hospital where I'm doing my final placement, we only have 3 nurses on at night. Well, now we were at 2. This means the ER nurses don't get a break. They have to work the full 12 hour shift straight.

I consider myself a half nurse. A psuedo nurse. An extra set of (somewhat skilled) hands during crunch time, but still slower then the regular RNs and still needing guidance. As a student I think I'm in the top percentile, but compared to RNs I'm low in the overall RN pool. I think I'm adapting well to the ER but I definitely have a long way to go.

Last night was a test of sorts. My preceptor really needed a break... she was having a hard time concentrating and didn't get much sleep before the night shift. She was practically falling asleep standing up, despite us being busy. The other nurse sent her to the back for a power nap and figured that between her and I we'd be fine, as there were only about 5-6 patients in the department and they were all very stable. The staff nurse would then be my supervisor. Well, all of a sudden there were 4-5 more people to triage, and as a student I cannot and should not be triaging. So that left me all alone looking after ALL the patients in the department. The staff nurse watched over me (popped her head out a lot and checked in) and the doc was there for questions if I had any, but basically, I was on my own.

I tried to prioritize, and managed to do quite well. I prepared Pantoprazole for one patient, hung some metronidazole for another, gave a little girl some trimethoprim/sulfamethoxazole, dispensed some medications for another, and then started an IV on the pantoprazole guy, started on the 2nd line (which i missed, twice, grr) and had to eventually call the other nurse in to start it ;ater (we only get 2 attempts if it's not an emergency). I was slow at what I was doing and the patients were getting.. ahem.. inpatient... (hee hee) but I managed to do ok.

Because I don't' know the medications sometimes, I have to look them up. That takes a bunch of time, and I wanted to make sure I didn't screw up. I kept chanting... 5 rights, 5 rights, 5 rights... to make sure that I didn't give improper medications to the wrong people!

Not only that, but there were crazy things happening on the other floors. Later on ICU needed someone to intubate, and the ER doc had to do it. Since I have yet to see an intubation (tragedy, i know!), I quickly ran up to the 2nd floor with her (my preceptor was working again so it wasn't a problem). I ended being the one who was bagging the lady (SpO2 hovered around 83 prior to intubation) until the RT on call came in and put her on a ventilator. The ICU nurses even stated that I could start tomorrow working for them! I'm not interested in ICU, but that was a nice compliment.

Overall synopsis: I must have done well. The staff nurse called me an "RN" today. Aww shucks (*blush*).