Thursday, March 4, 2010

Journal of ER - an assignment to do

we have to write down the journal and to submit to Pn. Waheeda for ER posting.
I didnt write down what are the procedures that I had done for that 5 days, so this is the "last-minutes-assignement-to-finish" that I only able to do. so I was randomly wrote anything I like.
tapi sayang if i just buang the soft copy of this journal so i put in here because one day I can read it again and again and again...

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For the whole posting at critical area (ICU, CCU, Burn Unit and ED),
I think the most challenges area was the ICU and ED.
ED or Emergency Department especially resuscitation and emergency room was the best place for students to gain much knowledge.
Eventhough I was only been posted there for only about 5 days,
I gain so much knowledge and information on how to working on that kind of place.
Before this if I only able to see how people works in the ER in TV series, and how much I really wanted to be like one of them, and posting at ER was really made my dreams comes true.

During first day of posting, KJ orientated us to the clinical area.
I really likes the ED KJ because at first day, I saw her doing staff nurse job likes taking blood, inserting branulla, take blood pressure, and I really kind of like the way she being friendly with the staff and students.
She really made my day on that first day.
For the whole posting, I able to do many procedures eventhough some of the procedures like ECG reading I had done it before during 2nd year, but I never regret because I was not only done the ECG reading but me and my friends able to learn how to interpret the ECG results and there was a lucky day that the doctor explained about the ECG to us.

I also did get opportunity to assisted doctors inserting long line for CVP and taking blood C&S. This one Dr, (I don’t want to tell his name), he gave me this free lecture about ECG and there was a day he babbling about why the SPO2 probe is not being checked by nurses because there was a time, the SPO2 of patient was 94%, and he try on himself and the SPO2 still 94%, than he called me why I didn’t check for the probe, he babbling to me that this should be the nurses’ job. He asked me to change to other probe and asked me to try it on my finger, but then the SPO2 of mine was 100%.

I called my friend to try it too, and hers was also 100%. Then I put back the probe to patient’s finger, and the reading was 100%. Then I called that doctor, I said there’s nothing wrong with the probe, he himself didn’t put it correctly. Then he just kept silence. Maybe he knows he was wrong. But then we become friendly again after I helped by assisted him to take the blood C&S and he signed my cross book.

At ER I also able to help out during resuscitated the patient. There was one night, around 4am during my night shift on Friday, one patient came into resuscitation, I was excitedly attended to the patient, put on the ECG probe, put on the BP cuff, give oxygen by nasal prong, and other things, then this one doctor said loudly, “ok everyone, put the mask on, put the glove on, put the gaun on, before you touch the patient”.

Then I stepped back and asked myself what’s wrong? I heard one of the doctor said this patient is IVDU (drugs user), came with labored breathing and severe cough with fresh blood, doctor asked him, “encik ada pnyakit apa-apa? Hepatits B? HIV?”. The patient said, he has no HIV, but do has Hepatits B and TB (Tuberculosis) and that’s why he came with severe cough with fresh blood and he looks very thin.

I looked at myself, thank God I was wearing the mask, but I didn’t wear gaun and glove, so I was immediately went to hand washing and washed my hand vigorously aseptic techniqually. Then there was one nurse also did the same thing too and told me “alamak, dia ada TB la pula”. Poor student nurse (me) and the staff nurse because we didn’t know but luckily there nothing’s bad happen like needle prick injury or else. After that tragedy, I keeps remind myself, I have to always wash my hand and put the glove on when new patient comes in and every before and after touch the patient, and the mask is always must to wear.

There was a day; one of the doctors asked me, “can you take the ABG?” I looked at the patient, she doesn’t have any art-line, I told the doctor, I only can take ABG by art-line. Then he told me, “you are a degree student aren’t you, so you should be able to take ABG at the artery. Prepare everything, and I’ll show you how to take the ABG”. So, I prepare all the things needed to take ABG: 1cc syringe, heparinol, blue needle, gauze, cotton, etc.etc, but then, doctor said, never mind, no need to take his ABG, his condition looks stable, and he babbling about this patient and that patient, and I just listen and keep being a good listener as always.

I also did get the opportunity of inserting the branulla, eventhough I failed on the first attempted inserting branulla on patient, and I was so frustrated because I failed and I was so regretfully on myself because I did hurt the patient. However, it’s ok; I have a year and half to practice perfectly before being a qualified staff nurse.

On the night shift, I also get the opportunity to prepare and give nebulizer to asthma patients and prepared and administered IV hydrocort to patient. There was a free time, me and my friend took blood on each other and sent to the lab for investigation. Actually, we were practicing on how to take blood from the vein, and how to fill the form and send to the lab, and how to trace the result. So we were successfully did it. I checked for my PT/APTT while my friend checked for serum cholesterol level.

So many things I did until I can’t remember what things that I’d done during ER posting and I don’t know how to write it down here. But what can I say, I learnt so many things. The KJ, staff nurses, specialist, MOs, MAs are so willing to teach us. What can I say, to me 5 days at ER was not enough. I want more. I want to learn a lot more about being an emergency nurse.

1 comment:

Anonymous said...

Good post and this enter helped me alot in my college assignement. Say thank you you for your information.