Monday, February 17, 2014

A Day in the Life: Nursing Edition

I love nursing. I’ve wanted to be a nurse since age six. In school I toyed around with the idea of being a labor & delivery nurse, but have never regretted landing in the ER.

Here, for your consideration, is a random compilation of story bits throughout my ER days thrown together to make a day in the life…



9:30am – alarm rings. Snooze for 15. Wake up.  

11:53am – clock in. Because many have mentioned, yes, nurses make a decent salary, but probably not as much as you think! ER nurses don’t make more because our job has “the stress level of a soldier/policeman.” We’re there because we want to help, not get rich. If we wanted to make $$$, we’d go into research or become a nurse anesthetist.

12pm – hug my co-workers hello then take one’s assignment so he/she can go eat lunch. Check and makes sure one patient’s circulation is still good (since he’s in restraints for trying to hurt himself, others, and having, to put it delicately, “intercourse with the mattress”).

1pm – give discharge instructions to a guy who came for heart palpations after taking cocaine. He says now that he knows that cocaine can lead to heart attacks, he’ll never do it again.

2pm – two mothers rush in with infants in their arms, “My baby, my baby!” they scream. One child is awake, the other is limp in her mom’s arms. That one goes straight back to a room. Still breathing, praise the LORD, so probably in a post-febrile seizure state. Come back for the other baby. Call language line for translation help. Mom is concerned that happy, healthy baby has an infection “because that belly button thing fell off after a couple weeks.” Resist urge to ask if she still has hers.

3pm – triaging a man with tiny paper cut. Me: “On a scale of 0-10, with 0 being no pain and 10 being the worst pain you can imagine, where would you rate your pain right now?”  Patient: “I’d say about 50/50.” Me: “Have you been out of the country in the last 14 days?” Patient: “I’m not sure.”

 
4pm – car screeches up, man comes in, grabs our wheelchair, and heads outside. I follow and discover him dragging a not-quite-breathing person (turning blue) out of the car. “What happened?” I ask. “What did he take?” The companion refuses to answer and, as soon as I begin to wheel the patient inside, gets back in his car and takes off.

5pm – a woman presents to the ER stating she took an allergy pill and now the side of her face is caving in and her thighs are purple. Ruddy skinned and full faced, she admits that she is hearing voices speak to her from the toilet bowl and radiator, so we prepare a psych safe room for her.

6pm – a man storms to my ER triage window and yells, “Take me to see my brother NOW!” I pull up a list of patients on my screen and ask his brother’s name in order to find him. “No! Don’t ask me questions, I need to see him now!” I explain that we have many patients so I need to know his brother’s name so that I can take him to the right room. “Stop looking at that computer and get me to my brother!” is the response. I finally get a first name from him, locate his brother, and as I am personally escorting him back to his brother’s room he continues yelling that I need to take him to see his brother.

7pm – I see cocaine man from earlier being wheeled back to one of our trauma rooms. He told me mere hours ago that he would never do it again, so I put on my disappointed-in-you face and start walking towards him when I realize that he’s been shot in the abdomen and groin. He looked at me and said, “I didn’t do it! I didn’t do cocaine again!” He learned two lessons about cocaine that day: #1 it can give you heart problems. #2 that you need to pay for it.

8pm – pray with a woman who is grieving the miscarriage she is having then go to the next room where a woman is upset that she’s pregnant again and wants information on how to terminate it. “There’s just no way I can be pregnant. I pee every time after I’m intimate!”

9pm – an inebriated man comes in via ambulance stating he’s not drunk because he’s only had a couple pints of vodka. He informs me that when I start drinking I need to start with at least 5-6 liters because that’s how much it will take before I feel a buzz. You learn something new every day ;)

10pm – teenage boy comes in with right sided abdominal pain…appendicitis work up started! A healthy adult male visitor comes up to my triage window and asks me to open a bottle of Diet Sprite for him. I do so, silently taking his man card. He asks if we can fall in love today. I tell him I am too busy triaging.

11pm –a woman and child walk in. Mother states she thinks the child might have an ear infection. Man walks in clutching his chest. I tell ear infection mom we’ll get her back shortly while I put potential heart attack man in wheelchair. Mother appears shocked and says, “but we were here first!” EKG done. Man is having heart attack. Draw blood, put in IV, and transfer patient to the cath lab where they will place stents in his heart so blood flow can return.


12am – “I think I might have an STD, but I haven’t had sex since The Blindside with Sandra Bullock came out.” I wonder in how many jobs googling a movie’s release date can actually be considered helpful. Sign in a patient who has no complaints but wants all her regular prescriptions refilled because “y’all here are a lot faster than going to my regular doctor.”

12:05am – my charge nurse comes to me,“I know it’s time for you to go home, but we have four discharges coming up, a patient transferring in from another hospital, a psych patient about to be transferred out, and EMS just called to let us know a code is coming in…can you stay for a few more minutes?”

12:15am – assist with patient intubation (breathing tube down her throat since she’s not breathing on her own), she loses her pulse again. Start chest compressions while my fellow nurse gives epinephrine. The patient’s heart starts beating again and we get ready to send her up to the ICU.  Getting a heart beat back is definitely worth staying over for :-)

 

1am – go home, eat a couple pieces of pepperoni pizza while watching Community, then fall asleep :)

Every day I see things that…

break my heart – families losing loved ones, abuse, neglect, people not knowing how to break out of generational cycles of addiction, ignorance, hopelessness.

annoy me – people taking advantage of the system, selfishly putting their own comfort and convenience literally in front of people in need.

delight my heart – lives saved and changed, people learning, co-workers (they’re awesome), people both and hurting and rejoicing with one another.

The ER can take you on an emotional roller coaster. The only thing that you can count on is that you have no clue what is going to come in next.  How can a person cope – even thrive – in such an environment? 

BY THE GRACE OF GOD.  

By trusting in Christ’s consistency and faithfulness, not flawed humans. We are able to return hateful behavior with love because Christ did that for us first (Rom. 5:8, I Jn 4:10). By acknowledging the pain in this world and agreeing with David that “I would have lost heart unless I believed that I will see the goodness of the LORD in the land of the living (Ps 27:13).” By never giving up hope that those who walk in darkness will see a great light (Is. 9:2, 2 Cor. 4:6). With minds fixed on our LORD, ER nurses can walk in perfect peace (Is. 26:3).

We’re nowhere near perfect. We fail to do the aforementioned over and over again. But by God’s grace ER nurses can say, “What? There’s a place where sick and hurting people gather together and I would get paid to come and help? Sign me up!” This is how we can walk into the craziness with a smile…

 

*Obligatory disclaimer* This and all posts about patients may be fictional, may be my experiences, may have pertinent information changed, or may be a combination of patient experiences.

5 comments:

Anonymous said...

I just started crying, while at same time laughing, in a public place! I could not Stop Laughing at some of this post, but it sure was good for my Heart! :-) I did get a lot of unwanted attention, from total strangers, though! DR

Nanette Ryan said...

Thank you for what you do every day! This gives me ways to pray for you when I pass by your hospital!

Cara said...

Nanette! That is so sweet! Thank you so much :)

Diwakar said...

Hello Cara. So good to know you through your profile on the blogger. I am glad to stop by your blog "Cara in America" and the post on it "A Day in the Life. Nursing Edition". I like what you said at the end of your post "There is a place where sick and hurting people gather together I would get paid to come and help?. Well Cara will you prayerfully think to come on a short / long term missions trip to Mumbai, India to work with us in the slums of Mumbai among poorest of poor to serve the sick and broken hearted. We reach out to the poorest of poor in the slums of Mumbai to bring healing to the broken hearted. I am in the Pastoral ministry for last 34yrs living in the city of Mumbai a city with great contrast where richest of rich and the poorest of poor live. We encourage young people like you to come to Mumbai, india to work with us in the slums of Mumbai. It would be a great experience for you as well as a great help to us in brining healing to the sick and sharing with them the love of Christ to bring spiritual healing. My name is Diwakar Wankhede and my email id is: dhwankhede(at)gmail(dot)com . Looking forward to hear from you very soon

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