The ER was filled with people as the morning rush settled down and the people were treated. Brayden, a 26 year old, was nervous for her first day of surgical residency at Portland Oregon's hospital. She had just come out of MED school and was excited to be in the action. As a college and MED student, she was determined, driven and happy with where she was going in life. As her first trauma came through the doors her blood rushed through her veins and she ran to them. As Brayden accessed the situation she realized it was a bullet wound that had just missed the carotid artery. Just then, as she grabbed the gauze pads the power went out. All the monitors went black and the ventilators stopped working. The generators only took a few seconds to …show more content…
kick on so when a minute had passed the panic set in. At first the nurses and doctors were still as they waited in silence for the generators to turn on.
But when they heard the cries of their patients, their instincts kicked in. Now only relying on their fight or flight responses.
“All medical personnel, grab a hand ventilator and find the nearest patient that needs help!” screamed the attending on the floor. But as Brayden applied pressure to the wound, she froze in fear about what was to come.
The sound of screams was distant and muffled as a high pitched hum filled Brayden’s eardrums. For a moment the room went dark and she was the only one there, standing, unable to move. It was silent for a second and then the sound of her breathing consumed the room. It was fast and shallow, leaving little room to pause. Her breathing turned became rapid before coming to her senses. And just like that, she was standing there again afraid of what was to come.
Her patient, a tall, muscular man, was consequently bleeding to death. Brayden comprehended the situation and understood she needed to get him to an O.R right away. Ordinarily this would be a simple task, but considering the circumstances, it was going to be a challenge.
“Have we IDed the man?” shouted Brayden to one of the
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paramedics. “No, ma’am,” he insisted. “There seemed to be some sort of fight, but when we got to the scene everyone had fled. Looking for any possible clues, Brayden examined her patient. Meanwhile, a nurse attached a headlamp onto her head, and another grabbed the necessary supplies. She lifted his left shoulder, looking for a exit wound. His skin was bruised and cut up, but there was no sign the bullet had gone through. Her expression changed and a look of worry and frustration appeared. The staff looked at eachother, disappointed in the current situation. As a first year surgical resident, Brayden hadn’t performed a surgery by herself.
Although she had studied under many different specialties, Brayden was the least familiar with the cardiovascular specialty.
“Where is Dr. Howard?” Brayden screamed in panic. “Did anyone page him?”
The nurses looked at each other and nodded, holding their breath, waiting for a response.
“Dr. Howard is in emergency surgery with one of the trauma patients. He told me to tell you he will be there when he can but to start without him. He also suggested finding a attendy that is available to assist you during surgery,” explained an ER nurse.
“Ok, get me an O.R now and tell them we’re on our way,” Brayden explained urgently.
As they walked through the halls on the way to the ER, Brayden went through the surgery in her head. She told herself she could do it, that everything was going to be ok. Her hands were shaking as she pressed on the wound. This is it, she could do it, she just needed to stay calm. Walking through the doors to the O.R she realized this was the first day of the rest of her life. Her fears and doubts went away and suddenly it was just her and the
patient.
...amily that all is going to be okay. Just around the corner from a waiting room is an OR, a surgical techs “home away from home”, a place where miracles happen.
For my first clinical observation, I was assigned to the trauma unit and it was not what I expected it to be. I thought the trauma unit would be fast pace and there would be nurses and doctors rushing everywhere, however, I did not see any of that. Instead, it was quite peaceful and this was probably because my clinical observation was from 10-12 p.m. When I met up with my senior nurse, she showed me a binder that contained all of her patients’ diagnoses, lab reports, treatments, and vital signs, which was a lot to take in because most of the terms she used, I had no idea what they were. After looking at the reports, she showed me a patient who had gunshot wounds on his back and abdomen. I could tell he was in a lot of pain by the tone of
Nobody is perfect. We all make mistakes. Some of the best lessons in life are learned from making a mistake. But in the healthcare world making mistakes means losing lives. This has started to happen so frequently there has been a term coined – Failure to Rescue or FTR. Failure to rescue is a situation in which a patient was starting to deteriorate and it wasn’t noticed or it wasn’t properly addressed and the patient dies. The idea is that doctors or nurses could’ve had the opportunity to save the life of the patient but because of a variety of reasons, didn’t. This paper discusses the concept of FTR, describes ways to prevent it from happening; especially in relation to strokes or cerebrovascular accidents, and discusses the nursing implications involved in all of these factors.
The treatment priorities of the registered nurse upon admission to the emergency department are as follows; within the first 10 minutes of Mr. Bronson’s arrival to the emergency department begin a 12 lead ECG. Assess Mr. Bronson’s vitals heart rate, blood pressure, respiratory rate, oxygen saturation, and administer oxygen 2-4 liters via nasal cannula (Sen, B., McNab, A., & Burdess, C., 2009, p. 19). Assess any pre hospital medications, and if he has done cocaine in the last 24 hours. At this time, the nurse should assess Mr. Bronson’s pain quality, location, duration, radiation, and intensity. Timing of onset of current episode that brought him to the emergency room, any precipitating factors, and what relieves his chest pain.
patient is in terrible agony, and since he is going to die anyway, it would
He was an outpatient, who arrived at 8 am to get ready for his surgery. Feeling I was ecstatic and enthusiastic to get back into the field of work to do my clinical rotations. Although I was ready to have a new experience at the recovery unit, I was also extremely scared, because this unit was a specialized unit, where the patient needs vital care while recovering from anesthesia.
Her voice strangled with fear. All she could do was whisper the doctor’s unserten words, “If she survives” This is just one challenge she had to face threw the book.
The surgeon came in and they ended up taking her back to surgery immediately but this incident happened over the course of three hours. I manually held pressure on her groin to try to stop the bleeding with the intensive care nurses at the bedside to help if I needed. Eventually, after the two-hour mark, things started to slow down and I ended up getting pulled from the room to take a phone call. It was my supervisor asking me to take another patient onto my team of five that I already had and was not even able to check on during this incident. Needless to say, I told her no and she ended up sending the patient anyways. Thankfully one of the other nurses got the patient settled and as a team, they all took care of this new patient despite having five others of their own. This is a very good example of how dangerous it is to be short staffed. Acting in the spheres of influence is one way to try and prevent future problems like this one from ever happening again. Unfortunately, short staffing is a constant problem for nurses everywhere and doing the best we can do takes a toll on our health. Great job on your post and thanks
She had been crying in the dark, trying so hard to sleep but it just wouldn't come to her. It was then that she heard the door creek open, she saw Gus there, staring at her in the darkness. She could feel what he wanted, even from that far away. He moved
Imagine being a first year medical surgeon just out of the highest-ranking university in the nation. You are placed in the ER, in the Methodist Hospital building, as your days are spent saving people from the cruel realities that they are forced to live among. Day after day, you see handfuls of people coming in with a variety of gunshot, knife, and domestic violence wounds. Your troubles are easily compensated, however, by receiving over $200,000 a year, a brand new Mercedes, and a house upon the palisade shores. Suppose for a moment that one evening while you are on duty, an ambulance radios in and informs the hospital staff that they are bringing in a multiple gunshot wound victim and to prepare the ER for an immediate operation. You begin to order people around and dictate what needs to be prepared before the ambulance arrives. Finally the victim is present, only to show that he is not the average gangster or policeman, instead it is the near lifeless body of your own son. Your blood freezes; your brain shuts down, as you see every precious second slip away through the lifeless gaze of your child's eyes.
Many times, the nurses treated patients that had suffered from multiple traumatic injuries, it was a rare occasion to witness a patient with a single wound. A great deal of times these injuries were far worse. Due to the hostility of the war, these patients could have lost both legs, while also suffering from a head trauma. Furthermore, hospitals become quickly overcrowded as estrangement grew in the country of Vietnam, the number of causalities increased. A wartime nurse by the name of Anne N. Philiben, remembers one of the hardest times she ever wrestled with while serving in the army nurse corps. “One of the most severely injured was John. He had wounds to his face and lost one eye, one leg below the knee, the other above the knee, and one arm. He also lost some fingers on the other hand. Anne dubbed John as a ‘train wreck.’ Saying that his body was so savaged it was miraculous he survived” (Gruhzit-Hoyt,
Paramedics squeeze my arms, staining their gloves a deep red. Doctors and nurses scream at each other as they run across the hallways wheeling me into the operating theatre. I look over to my wrists as clear fluids begin their journey into my veins. My heart is in my throat, my pulse is echoing throughout the room, my limbs are quivering, and my lungs are screaming. Nurses force plastic tubes up my nose, as jets of cold air enter my sinuses, giving me relief. Inkblots dance before my eyes like a symphony of lights. A sudden sleepiness overcomes me and slowly my vision dims.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).
I found myself in a situation that required me to act quickly to save a patient’s life in my second year as a registered nurse. I received a direct admit from a physician’s office on this day. The patient was admitted for an upper gastrointestinal bleed with a of Hemoglobin 5 gm/dL, and a Hematocrit of 17 %. He was an alcoholic and had been vomiting blood prior to arriving on our unit. A few minutes upon arrival he started coughing and became diaphoretic as well. I
The teachers come, a large man begins CPR while the girl remains benevolent, in a matronly position, kneeling and cradling Al’s head in the cushion of her palms. Through it all she does not look up, even when spurts of blood from Al’s mouth reach her face and eyes, that blood built up within his orifice gurgling and geysering with each push of the teacher’s fists into his lungs. She does not turn from her grisly heroic task, though her arms shake from restraining and then supporting Al’s head, as she calmly reassures others that it will be all right. After seeing Al safely away with the EMTs, she takes only a few moments to collect herself, then, claiming no credit...