Wednesday, September 9, 2009

The Hard Part

They say (our all-knowing instructors) that the hardest part of nursing school is learning to THINK like a nurse- to assess WHILE performing all the other tasks set to you, and keep assessing at all times. To prioritize ALL of the things you have to do, and re-organize your priorities on the fly.

I am only just BARELY beginning to get a handle on this. When I'm on the ambulance, my priorities as an EMT-B are pretty straightforward- Airway, Breathing, Circulation, Get the patient to the hospital in a timely fashion. If all of these things are being accomplished, it's considered OK to actually just sit and look at the patient for a minute or two (40 minute transport times, yo). In nursing, (floor nursing at least) sometimes it seems as if you never FINISH doing ANYTHING, even while your basic priorities (Airway, Breathing, Circulation) remain the same. The difference is that there are innumerable other things to do, even for a rock-stable patient. Today was assessment during bathing and changing the patients bedlinens, interrupted several times to suction the patient's trach tube, and once to help save the patient in the other bed, followed by putting her tube feeding on hold, helping give meds, restarting the tube feeding, changing the patient's gown, changing all the wound dressings, MORE suctioning, several bedpans, et cetera. And I only had that ONE patient. AND I had a partner.
I think this is why I like the Emergency Department/Room so much- patients come and go, and I always feel more accomplished after doing a stint in the ED.

Maybe this will change as I gain my time management and mental listmaking skills...on the bright side, once again I made it through a clinical day WITHOUT killing anyone!

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