Nursing Firsts

 So far this summer, I have felt the nursey-posts have almost written themselves. I have not had to look very hard for inspiration or relevant anecdotes. But I've hit a little writers block these last two weeks and I think I'm finally ready to publicly admit why. That is... that I really f***ed up for the first time with a real live patient.

I'm a little (a lot) reluctant with the details but suffice it to say it was a perfect storm of my novice judgment, the nurse I was assigned to being wrapped up in a different patient's emergency (seriously a crisis... we figured out he was having multiple brain hemorrhages), and feeling so so bad that such a nice man was stuck with me and my unpracticed technique. So, I screwed up... did some due diligence with RN-informing and charting... texted my go-to friend and also a heart-group-nursing-student buddy for immediate intercessory prayer (CRB and Dailey - you did good... thank you)... and went home utterly dejected and terrified. I crawled under my covers with a glass of wine and cinnamon puffins and spent the whole night indiscriminately tossing them into my mouth and praying for God to cover my ASS until I could get to the hospital the next morning and ensure everything was fine. And it was to be fine, so... God? Thanks for covering my ass.

And also another shout out to God for redeeming my mistake SO much that I ended up doing my very first SQ injections on this same patient (yes... he still let me touch him the next day!). Injections... oye! Such a rite of passage. I actually also didn't do the best job on the heparin SQ either but... what can you do? I'm learning and sometimes (most times?) with nursing, you have to learn the hard way.

I feel like I want to say more about this patient because I will remember him for a long, long, long time to come. He was Spanish speaking and NOT ALTERED MENTAL STATUS (!!!) - such a treat to have patients who aren't AMS once in awhile (right Alyssa and Camie!?). He had a bunch of things going on with his health, but they all boiled down to diabetes-related amputation of his toe not being enough to fight the gangrene and he was facing a decision to amputate below the knee. His son never left his side and served as his dad's interpreter to the point where the son went through a medical interpretation program to better assist in his dad's care. They just... ugh... are wonderful people who wanted me to learn, appreciated my effort to speak Spanish and laugh at all my gringaness, and reinforced the valuable lesson to ALWAYS listen to your patients and include them in their care process. It was a life-giving student nurse opportunity - one that RNs can't always enjoy because of the constraints of having four patients who need intense individualized care. (For any curious readers, the patient declined the amputation and went home with heavy antibiotics and great hope they would work miracles. Barring a medical miracle or a mind change, it is likely he will decline very rapidly over the next few months and ultimately die from the gangrene and other co-morbidities). 

So maybe this is a post about nursing firsts. Over the last two weeks, I gave my first meds (literally about 50 tabs to a non-complaint AMS patient who I ultimately won over by the end of the day - WIN!), gave my first IM and SQ injections, did my first central line dressing change, gave like 20 meds through a G-tube, really felt like I took care of a patient semi-independently with nursing process and goals for the day, had a patient die before 9am, had a patient who asked me to call him "Romeo", and as mentioned.. really screwed up for the first time.