AND! There is only 82 more days until I'm officially graduated!! (: Totally insane!
The ICU is definitely intense. But as crazy and hectic as it is, it feels like home. I find comfort in the chaos. Looking back at the month I've spent here, it's crazy how much I've learned!
To name a few (in no particular order of course) ...
- Bring your lunch - always! Even when you don't feel like packing a lunch, pack one anyways! As a nurse, you never get a lunch break. Most days your lunch is split in 5-minute increments of you scarfing down something before Patient Z needs something and another 5-minute session before Patient Y needs something else. AND it never fails that the ONE DAY you don't bring anything, you get caught up with a procedure or a patient crashing and the cafeteria closes before you get down there.
- Critical patients don't always appear critical - pay attention and do your assessments accurately and thoroughly.
- Monitor your patients! This may sound like an easy-peasy thing to learn, but I'm so serious. As a nurse, you get so caught up in what you're doing that it's easy to forget you have another patient. Always set your monitors to view both! (:
- Alarm fatigue is something serious! Just pay attention.
- Family members are meaner than the patients. Don't let them get to you! Remember it's THEIR mother/father/husband/wife/son/daughter/friend that's critically ill. They get to be a little rude.
- Confused patients are aggressive. And strong! Deal with them early and get help promptly from the mid-levels. Ativan is wonderful. Versed is even better!
- Versed is for sedation. Fentanyl is for pain and sedation.
- Quiet patients aren't always better! Again, assess thoroughly, adequately and frequently.
- When performing oral care, be sure to suction the patient's mouth! This may sound like a "duh!" thing, but I totally didn't do this the first time and almost choked my patient. So. Seriously. Suction y'all!
- Always assess drains and dressings ..and change immediately when about half full/saturated. No seriously. Watch those things! It's a NIGHTMARE to clean up if you don't!
- Never give Vancomycin and Zosyn together! They're not compatible - make sure you have a separate lumen or another IV site and DO NOT use a Y-connector!
- EVERYONE has lots of monitors, lots of wires, and lots of IV lines. Untangle them frequently - trust me, it's a hassle but it makes life easier.
- Label all of your lines - the day it needs to be changed AND the medicine it's used for!
- Never let your lines run dry. It takes so much more work to re-prime lines because of an air bubble. So...just don't do it!
- Always get help when turning patients. Seriously! Don't kill yourself over that 300lb man! Just find a team of people - or hell, get a sling and let the machine do it.
- Chart everything and frequently! This totally covers your ass when and if something goes wrong!
- You never forget the first patient of yours to die. Never. Ever. And you'll have nightmares about it. But please remember, you did all that you could.
- Nothing...and I mean, NOTHING beats the feeling of seeing a patient that was crashing and on total life support a week ago sitting up, talking, and telling you that he/she appreciates everything you've done and are doing for him/her.
- I have yet to meet a healthcare member in ICU that doesn't believe in God. I don't know how you couldn't believe after seeing the miracles we see every week.
4 weeks and this is what I've learned.
I feel like a "nurse" now! Which is absolutely crazy. I'm still a student and there is a mountain of things I don't know yet or how to do yet, but things are familiar now. Things are clicking now! And that's a level I questioned achieving. I doubted time after time that I'd get the hang of it. But I am and for that, I'm entirely grateful. There is nothing in this world I'd rather be doing.
Peace and Love,
V
