Wednesday, July 7, 2010

Rite of Passage

This week has been monumental for me in my nursing life. I think I can fairly say "new grad" is no longer a term I can call myself anymore. This post explained just a tiny snippet of what I experienced during this crazy week....particularly one specific day.

I had a horrendous assignment... two intubated patients. One on multiple drips (5 to be exact) that needed to be titrated at least every hour if not more frequently. He was agitated, confused and labile, having PVC's...trigeminy and bigeminy... jumping out of bed and being combative. My second patient was an admit from the OR. Rolled in around 3am. General abdominal case, ex-lap turned open for ischemic bowel. Intubated and not sedated, hypotensive, vomiting around her ET tube, massive amounts of the same GI fluid coming through her nasogastric tube simultaneously.

Like I said...a horrendous, awful assignment.

It was completely unmanageable and to top it off, I was not getting the support I needed. People were coming in and out trying to offer help, but in the end, I was in charge of them both and I ultimately was responsible for taking care of them and keeping them stable.

I was angry and frustrated and overwhelmed. I was irritated by the way the doctors sat around and had no sense of urgency when my patient literally had a blood pressure of 69/40.

A few times I flat out said, "I can't do this!" to my charge nurse and resource.

I left work in tears and laid in bed for hours replaying my awful morning... Stewing over how unfair and unmanageable it was. Angry that I felt defeated, but more than anything....

I felt unheard.

When I went back to work that night and ran into my manager, she told me she had sent me a note about what had happened.

"Next time, if you don't like the way your patient is being managed by the ICU team, go above them. Page the fellow, page the attending."

I explained my situation and my frustration. How I had hardly any help and no one was listening to me and how my charge nurse and resource who were way more experienced than I, didn't think to go above our doctors. How I felt totally unsupported and that it was completely unreasonable for someone who is as new as me to take on an assignment like that. know what she said?

When code bed is part of your assignment, anything can roll through those doors and we have to be able to handle anything that we get. Getting an assignment like that is a rite of passage...everyone goes through it. Now, you know what to you know how to handle it.

Basically... in summary...

suck it up...this is the ICU.

I couldn't believe it... here I was, angry as all get out and frustrated to the hilt...
I thought surely...when I explain the situation people will take my side, they'll tell me I shouldn't have had to do that... They'll tell me that was a completely horrendous assignment and yes, even our very experienced, and one of our strongest nurses that day could not manage that assignment alone. The assignment had to be split up within minutes of the day shift starting.

It was wrong and it was unfair... end of story.

I heard that from some people... a few people came up to me and validated how I felt, agreed that it was insane and that I did the best I could.... still I couldn't get what my manager said out of my head and I realize now that what she said to me was incredibly valuable and in many ways much more impacting for me as a nurse.


Because, now I know. Now I know how to speak up and not be a victim. Now I know that I need to trust my instincts. Now I know that getting frustrated won't change a damn thing if I don't learn how to communicate to people with authority. If I don't like what is going on and I am yelling for help with no response.... I will yell louder.

Well my friends.... lesson learned.

This morning I was resource nurse and around 7am, I hear...

I run to the patient's room it was called on and ended up being apart of the code along with the patient's bedside nurse and the whole slew of other people who responded to the blaring announcement over the loud speaker.

And instantly...something changed in me.

I was no longer a scared new grad who didn't trust herself. I was no longer the nurse who did not have a voice. My hands didn't shake like they normally do in codes. I wasn't afraid to jump in and do chest compressions. I wasn't afraid to push people out of the way when I needed to get through and I sure as hell wasn't afraid to ask for what I needed, when I needed it.

I was a certified, no nonsense, ICU nurse...
and you know what? It felt good. If anything it toughened me up and at the very least I have gained a voice that I did not have before.
Rite of Passage?
Yes, indeed.


  1. Wow - that sounds like a pretty horrific rite of passage. I'm glad you got through it and got something out of it!

    And go you! Sounds like you are really progressing!

  2. Way to go, lady! You CAN do it and you are. You should be proud of yourself! :)