Wednesday, 12 May 2010

My WOW Moment

My WOW moment! Had to share, sorry if it sounds like bragging, it is sort of, but not really, just had the most amazing experience. Have de-personalised info, so as not to be breaking privacy rights of the patient.

On a previous practicum placement in an Emergency Department assigned to an older RN who wasn't too happy to be lumped with a final year student RN, amongst doing a really wicked wound packing/dressing & other things, I picked up on a patient being not quite right. A lovely person who had been so bright and chirpy when I started my shift, was now lying scrunched up, apparently sleeping, but it just didnt feel right, couldnt explain why, it just didnt.

So seeing as I could, I did the most obvious thing to me, I stood there while they appeared to sleep (and everyone else had thought they were sleeping) and counted the respirations (how many times their chest rose/fall for a full minute). Now the average adult breaths about 12 - 18 times a minute, generally closer to 12 when lying down in a bed, and this tiny little adult person was breathing 31+ breaths per minute - first alarm bell!!! & I could see some tracheal tugging, just faintly, but there - second alarm bell!!!.

So I checked oxygen sats and they were 88%- third alarm bell!! (you need to be above 95%, preferably closer to 100% ). So put oxygen on and sat person up a bit more in the bed, got another pillow to help prop person up a bit better, and person told me inbetween their lungs was hurting and so was their back - 4th alarm bell!!!.

So I put 2 and 2 together and instead of getting 4, I got a window of clarity!! All that study paid off!

So talking to the other RN I was attached to (being still a student myself I am limited to what I can do without supervision, but this RN didn't mind having me in her space or bugging her to come do something), I said I wanted to do an ECG, was told patient had had one earlier thatmorning, but yes go do one for practice, will be a good learning tool. So I do the ECG, and dig out the earlier one, and go show the RN, cause my patient wasnt just a good learning tool, they had just had a very obvious infarct!!! (my window of clarity). So then i go get the doctor involved, and now the doctor is talking to me like I am a very important person, rather than just another student.

Then I get to use the brand new, noone ever used it before, new monitoring equipment, and modify it to suit my patient, and by then the patients designated RN (the one who isn't so happy to be lumped with me and is now even less happy about it) is back, only to find out all of this has happened and all this stuff has and is being done by the student, so I spent the rest of the day doing obs on this patient every half an hour, doing all the documentation (there is lots of that!!), the doctor kept coming to me to ask for information and to get things done for the patient (some of which I cant do yet as a student, so then I had to go round up the RN - total role reversal there lol and no RN likes it when the student is doing their job better than they are!!). In the end the patient, who before I counted her resps was being readied for discharge, ended up being admitted to the HDU instead, so I got to do all the admission and ward transfer paperwork as well (paperwork is endless, good thing I don't mind it too much lol).

Oh yeah and somewhere in there i got to do other stuff for other patients as well.

At the end of the day I got praised by the RN infront of the afternoon staff, thanked by three staff members, had two doctors talking to me as if I was an equal, and then praised by my clinical teacher (who was informed by the doctor!! about her wonderful student) at debriefing, who told the other students infront of me (and I am not good at accepting public praise) saved a patients life today. Then the other nursing student staying here in the accommodation told the med students how I saved a life today.

Yet at the time it didnt seem such a big deal, i was just doing what needed to be done. It was just so obvious to me, like second nature (which it isnt, most of the time I feel like I am a bumbling fool learning my way around in a new and strange world). So I was feeling a little dazed when clinical teacher and the other student were making a fuss over me.

So after a celebratory meal with the other nursing student, and a small celebratory drink (i dont drink beer, so I had some Green Ginger Wine - Stones of course), I am sitting here doing my daily "reflective practice log" thinking WOW I DID THAT!! BY MYSELF!!! I may very well have saved that persons life.

Considering my career path its pretty certain this is the first of many, but WOW!!!!!

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