Fack

It's crazy to say that I'm nearing the end of my ER orientation. After this week I have 20 more shifts left (I'm pretty sure) before I'll be on my own. Fucking terrifying. I think we've only had 15 or so shifts so far, but it still feels like it's been a while and like I haven't learned enough and not doing as good as I should be, especially in relation to my peers.

This week was pretty good, I got to hang with Nurse R on Monday, I've spent the most time with her and feel comfortable working with her, we have a good thing going and I feel like I can ask her all my dumb questions. I knew I wouldn't be with her Tuesday or Wednesday because it was her weekend, so I was nervous about who I would be precepting with. Both nurses were great, totally supportive. Tuesdays nurse let me go a little more on my own which was great. Wednesdays nurse let me go on my own by the end of the shift, but the beginning she was doing lots for me. Todays nurse, who did tell me multiple times about how tired she was, never let me stray too far on my own. I appreciate that, but also I have a tendency to rely too much on my preceptors, and I'm trying to push myself to be more independent. We definitely weren't communicating as easily as I had with the other nurses I have worked with. On top having a rough day with IV's, and doing a bunch of things for the first time and needing lots of guidance, or lack of communication was really draining. Today was the first day I've had where I left feeling actually shitty. I always feel like I don't belong, like I'm faking, and everyones going to figure out that I'm an idiot and kick me out of the ED sooner or later, but thats always a kind of benign feeling that I can ignore and brush off. Todays feeling was just of being totally stupid. 

Patient wise we had an interesting one, an actual cardiac case, wound up getting diagnosed as NSTEMI. We get lots of chest pain work ups that usually don't amount to anything. Or troponins that come back positive because of kidney issues. So this lady hadn't been complaining of chest pain for most of the shift, then she starts to. I get the doc, who orders nitro. I check her BP, its good, give a nitro SL. Her chest pains not budging, so I try to track down the doc to get her an order for morphine as well (she's also got bad abd pain that is bothering her more than the chest pain). I'm trying to talk to my preceptor but shes being a bit unavailable. Everything turned out fine but I guess I could have kept giving her nitro until her pain got better. I dunno, I'm too tired to right things out well, or even remember how things really went. All I know is that I'm finally back in bed, my happy place.