My last day of preceptorship was this past Sunday. I think I really liked the ER! But I never can tell with hospital nursing. This whole having more than two patients, many of which can be actively trying to die or become seriously disabled is rather stressful. But I loved the patients, I loved starting IVs, I loved starting to make connections about patho and symptoms and labs and meds. I even loved simple triumphs, like having the confidence to just put some 02 on a patient with CHF whose sat was hovering in the low 90s, I didn't even ask my nurse if it was okay first! Baby steps over here.
There was such a high population of ETOH/behavioral issues/SI/homelessness, most of which were really sad cases and I had a hard time reconciling how the staff treated them with my own personal beliefs. I'm sure you get jaded pretty quickly in that kind of setting, but jeeze...
Anyway, some less sad highlights:
Gentleman in his early 20s with crappy tattoos and a bad attitude was shooting up and I guess a bystander called PD saying he was trying to OD which the kid denied. Anyway, he's been in the ER forever at this point and is getting super agitated, and wants to go home, but he was 5150'd so he's stuck there. He spends most of the shift trying act tough "I could kick all your asses if I wanted to." And then at some point peak frustration yells out "I want to talk to my fucking mom" and I couldn't help but laugh.
Did my first NG tube which brought up almost a liter of nasty dark brown liquid.
Pt who did a ton of coke, cut off a police car whilst flipping them off.
Charge RNs response "is that not okay?"
Also, had a pt who presented with cough, recent h/o flu like symptoms. BP was 80s/40s but he wasn't symptomatic, we were giving fluids and he was getting a septic work up. All of a sudden a tech calls us in and the guy is totally restless and his 02 sats drop, so we get him on some 02, call the doc over, and just then the lab calls to say the guys troponin is 4.somthing, repeat ekg shows ? of st elevation, so a code stemi gets called! I got to follow the pt to the cath lab (he turned out not to have any blockages, but the cath lab rn was hilarious and called everyone including the pt "bro").
Now all I have to do is a Kaplan review with my school and then wait for the BRN to give my date to test.
Job wise, there is a job at the clinic that I work at, Tues-Fri, 8-5, PTO, full benefits, great pay, with people i like, that my boss pretty much said I could have. But I dont think Im gonna take it. It does feel incredibly idiotic to turn down a set up like that, particularly in todays job market, but I think I gotta get that hospital experience in now or I never will. Unless no one ever hires me. :/
