Monday, August 16, 2010


Two weeks ago I had my regular Thursday Med-Surg clinical. ( I know, I am WAY behind on writing about it! I tried to block the day out of my mind) I made the mistake the day before of not preparing. You see, not all of us were going to be assigned to pass meds on our clinical day. Since I have passed them every week, I naturally figured I would not be chosen. Therefore, while I briefly looked my meds up, I did not prepare for giving them that day. 

Go figure that the first name called to pass meds was me. Awesome. Not only that but all of my medications were new. Sweet. Great way to start a 12 hour day. I had IV piggybacks to hang for both patients (which I have never done before), an IV push for each patient ( again, something brand new), 2 sub-q injections ( drawing up Heparin, which yes, I had never done before), and care of a PICC line. My friend Lillian, who is a superstar when it comes to the clinical setting, came into my patient's room with me to walk through the steps of hanging an IV piggyback. I was nervous. I mean sweating, nauseous, and unable to decide if my nerves would be coming out the rooter or tooter. ( My stomach was churning) I finally felt prepared and I went into my patient's rooms with all my supplies to wait for my instructor. Since I was giving Bed 1 a dose of Digoxin, I needed to check his apical heart rate for a minute. I was taking a good listen when I noticed his under arm was wet. I checked closer, thinking it may be sweat, to find that the bed sheets along with his gown were soaking wet. I called the RN in because I had a hunch his PICC line was leaking. And it was. 

This is where it all began. Now I was assigned to give meds at that time but we needed IV access to a patient who had a bad PICC insertion. My teacher had to wait while the RN discontinued the PICC and found a new IV site for a peripheral IV. By the time my teacher came in to pass meds, I was a bundle of anxiety....a pure hot mess. I fumbled through my preparation with extremely shaky hands. I could barely get the needle into the Heparin bottle to draw up the amount. While preparing my first IV piggyback, I was shaking so bad she commented on it saying, " You are really nervous today. This is unlike you. I hope you're not planning on injecting the patient with those shaky hands." Awesome. How did my body react to that? I shook more. My only response was, " I"m very nervous." She told me to take a deep breath and I responded with," That's fine, but it's not going to stop my hands from shaking."

I was set up to give meds to Bed 2 first who was a feisty but tiny Vietnamese man. And, I do mean feisty. He had already hit me twice that morning when I was performing his initial assessment. So naturally, when he saw me walking towards him with two needles in my hand he started yelling out loud in his language. Did my instructor help to hold him down for me? Nope. But she did comment that I needed to move fast with him. Yea, not happening with these hands. After injecting the meds he continued yelling at me. I may not have been able to understand what the words were but I know he was saying some not so nice things about the blonde, white girl. Hanging my IV piggyback could have gone alot smoother but my anxiety along with nerves clouded my thought process. Lesson learned there!

Both beds required that their tablets be crushed and given via G-tubes. When I reached this part on Bed 1, I figured it was homeward bound from here. I love giving g-tube meds. I'm quick and good at it. I feel totally comfortable. Except for that day. Go figure. I was fine until my tubing clogged. I could not get it unclogged and had to step back so my instructor could step in. Of course the flush went right in for her making me look like an idiot. As I was drawing up the meds and inserting them, she commented on my technique while insinuating I do it a different way. Well, you really shouldn't have someone change what they are used to when actually inserting the meds. Do you know how tricky it was for me to attempt to draw up the meds the way she recommended? It took me forever and I couldn't figure out my fingers. Again, looking like an idiot. I was given a response of ," Wow, you are really right handed!" Yes mam but I will get to work on my ambidextrous skills.

After my awful medication pass, I was down, beating myself up for my mistakes. I wanted to dig myself a hole and crawl into it. Or go to bed and wake back up with a fresh start. Oh well, you live and learn. I learned alot from that day. Plus, a lot of nursing is trial and error. Will I ever make the mistakes I did that day again? Sure won't. The day finished out with being evaluated on assessments. I was taking my time, trying to make sure I remembered everything, when, as I was listening to lung sounds, my instructor says, " Stop. Time's up." What?!?!?! Well, you see, she wanted a complete head to toe in 5 minutes. Strike three for Emma....she is out of the game! At least I now know what to work on for next time. 

It was just one of those days. Early in the morning I hopped on a train, headed downhill with no brakes and there was nothing I could do to stop it. But, a day like that was bound to happen. And, I know I will nail my IV Piggybacks next time as well as perform an awesome assessment in under 5 minutes. Days like this one keep me on my toes and from becoming too relaxed with my skill.s

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