Today was the last day of clinicals for the semester. In reflection, the highlight this semester was definitely the ICU and the ER.
ICU was so intense and there was always something happening even though I had only one patient and my nurse had two patients at the most. It was totally fascinating to see the major complications you read about in the text books but don't usually get to see on the regular floors. It was quite a let down to return to floor nursing when there would be long periods of time when I had nothing to do despite the nurse having 6 patients. If I hadn't been able to help with all 6 patients, I would have gone stir crazy.
My ER experience was last week. I haven't really decided if I'd want to work there or not. It's certainly different when you have patients who have signs and symptoms, but no formal medical diagnoses. All the regular clinical rotations we have patients assigned and you must prepare, prepare, prepare. You go in knowing the patho of the medical diagnosis intimately, so it's a switch going into a situation where there is nothing "known" about a patient. It's like solving a mystery. I think after I've got some experience under my belt, I might really enjoy working as an ER nurse.
Several things stood out in the ER. I had my first opportunity to start an IV. I was 2 for 2 and so elated about it. Of course, when I started the first one, I was so elated that I forgot to occlude the vein when I withdrew the needle and blood just spurted everywhere. Fortunately, my patient was the coolest. She said she had to learn to draw blood herself, and she didn't mind a bit being my first stick because she knew what it was like. She just laughed at my blunder. She kindly said I was really good because I didn't hurt her at all. She hardly even felt it. The second one was an African American so it was a lot harder to see the vein, but I got it on the first try and even remembered to occlude!
The second thing that stood out for me was being in the trauma unit when 4 traumas came in at the same time or within minutes of each other. I now know what it means to "fire" on a patient. It was amazing how they can scrounge up so many doctors since each patient has a team. It is so intense from the time the chopper arrives. I went to help bring down a patient from the first chopper which brought in 2 patients. We had security to ride with us and hold our elevators. We had to stop once in the hallway to reassess a patient's lungs, and nobody had a stethoscope except the student (me)! DUH! Since I had the first patient, I got to watch the chaos get even more chaotic as each patient came in. Everybody was shouting this or that and the nurse had to be charting everything that was going on while the doctors were assessing and other nurses were drawing blood from the femoral. I still haven't figured out why the femoral. Maybe it's the most easily accessible artery. Then there were all the x-ray techs with their machines hovering in the background and then pouncing as soon as they were given orders on what to x-ray. I got to see some really cool fractures. To sum it up, it was quite impressive.
It's sort of sad that my clinicals with my classmates are now over. Next semester will be preceptorship (assuming I get past these exams).
