My first thought was “holy moly what have you got yourself into” – We were shown around the unit and given about a week buddied up with a nurse to see how things worked before we were on our own.
ICU is a whole new world – we were told to forget about everything we learned before this. There are mechanical ventilators, arterial lines, central lines with 5-10 lumens, central venous pressure lines, a christmas tree like pole with up to 7-10 pumps infusing different drugs, PICCO cardiac monitoring, a list of drugs/fluids that nurses can just give the patient based on the nurses clinical assessment, ECMO, CRRT and so so so much more – its actually insane but I love it – I love using my brain to critically think and care for the sickest patients in the hospital.
I used to hate washing and toileting patients (bad nurse yeah yeah yeah) but since working in ICU and when I have the time I really enjoy giving my patient a thorough clean. Sometimes they are sedated and paralysed and under the spell of a lot of machines and drugs to keep them going (I just realised that might sound really creepy and weird to non medical peeps) – its a special feeling being able assist in someones basic needs while they are so critically unwell and unable to leave the bed – it makes their family a little less traumatised when visiting, you know a little less hospital smell and a little more Dove or Pantene hair wash kinda smell is familiar for them.
From day 1 everyday my heart would sink and I would constantly sweat, which has thankfully eased off a bit now 4 months in but I still have my days and have SO much to learn.
I will never forget the very first mechanically ventilated patient I had. I remember walking into the unit checking the allocation book and turning my head to have a quick peep at who it was and all I saw was AN ETT AND THE GODDAM VENTILATOR – my eyes literally filled up with tears and I began to profusely SWEAT I knew if I blinked I would be a sobbing mess.
I walked over to the bed space thinking pull It together Jami your going to have a ventilated patient sooner or later why did you even apply for this job. I received handover thankfully from my preceptor who went through every little detail with me. What a superstar!
I had no idea what 2 drugs being infused were even for not to mention if that ventilator alarms WHAT WILL I DO? I didn’t understand all of the settings on the ventilator then and to this day I am still learning. Lucky I was surrounded by support, it made a huge difference.
The entire 8 hours I was so unbelievably nervous, shaking and praying I make it out of the shift with everything being ok.
So the first doctor walked into the bed space I remember my shaky voice introducing myself “Hey, my name is Jami, this is my 5th solo shift in intensive care and my first ventilated patient – If there is anything I am unsure of today I will make every effort to follow it up with my educator and I also apologise now if I ask 1000000 questions”. This doctor was a legend and replied “Please don’t be afraid to ask ANY questions just ask as many as you like you’ll be fine”.
My shift ended at 4:15pm, I was still at work at 5pm and other nurses were telling me to go home and stop documenting such an essay – I of course laughed it off and kept typing away but then this same doctor from the morning came up to me and said “great job today, great team work” and shook my hand! HA I nearly cried of joy – I must have had this nervous freak out face on all day. I felt good leaving work that day, I was SO supported it really boosted my confidence.
Being thrown in the deep end is a great way to sink or swim – In my case I swam (really blood fast). Ive also learnt propofol is generally your bestie.