small victories of an ER nurse

Sometimes you have to celebrate the small victories in ER nursing, 'cause Lord knows they don't come that often. So here are some things that make me want to high five somebody:

1) When I give someone activated charcoal for an overdose and they drink it down and do not vomit. Score one for me.
2) When you give an old person an enema and they make it to the toilet in time. Yes!
3) When someone tells you they are a VERY HARD IV stick and you get it on the first try. In your face!
4) When you get an inpatient room that is ready and the nurse can actually take report. Miracles do happen....
5) When that drug seeker comes in and there are twenty people in the waiting room.
6) When the equipment works, the supplies are there, the pharmacy is fast...
7) When that drunk finds a relative to drive him home and you don't have to try and find him a bed at detox or keep him overnight to sleep it off.
8) When it snows so deep, is so cold, that no one ventures in except real emergencies. What a concept.
9) When the female docs or NPs are on and you don't have assist to with pelvics.
10) When that unstable MI makes it out of the ER and to the cath lab before they go into V fib.

Getting better at this nursing thing

Last night, step-down unit. Elderly patient admitted with sepsis. Around midnight she became hypotensive, confused, and agitated. She pulled at her lines, her oxygen, she yelled that the blood pressure cuff was too tight. She kept moving her arms and occluding the IV delivering her fluid bolus.
"If you can't keep your arm relaxed and stop pulling at your lines, I'm going to have to tie your arm down," I told her. In a calm voice, really!
"Just because you're pretty doesn't mean you won't go to hell for that!" she said.

She got more cooperative after we started the dopamine drip.


I've been working on my own now, without a preceptor, for just over a year. Finally! The details are coming together! My understanding is starting to gel. This month I've had a lot of complicated patients and I've been working in the step-down unit quite a bit, which I'm really enjoying even though there's a lot of suffering back there. I feel like I'm a better nurse: When my patient is vented, I feel there's more emotional connection. I like the details! I like the charting! I like it when I can fix my patient's problem. And I like playing the supportive role to the patient and family through the dying process. It seems like something changed almost overnight, and I'm not sure what it was, but I'm glad it happened.


In other news, the City of Berkeley passed this fabulous resolution supporting RNs in negotiations with Sutter Health. To see it, go here, scroll down to "This just in..." and click on "Berkeley City Council Resolution." It's really touching! I love Berkeley. Berkeley loves nurses.