Learning Q DAY STAT!!

Not bad, not bad at all..week 2 felt better than week 1! Not like this is a surprise or anything! I am finally starting to get a hang of how things work in a Surgical ICU.. I am still trying to form some 'start of shift good habits' and 'save you step' techniques but it is on its way. Some highlites  for me this week included placing an NGT tube, a foley ((the joy!)) and performing a bedside procedure called an esophagogastroduodenoscopy EGD. An EGD is basically a diagnostic procedure, that can be performed at the bedside, using moderate sedation, to place a scope down the throat into the stomach to identify any gastric issues such as ulcers or bleeding. It's pretty cool to watch, click here to learn more about this procedure. Welp! The GIFS can tell you about the rest of my week better than I can:

"When my preceptor walks in my room"

Lesson learned: Always know what's going on with your patient! From their lines, pumps, continuous IVF and even their IV sites from the time you enter the room during shift report. That way, any discrepancies can be addressed before the shift change. 
     
"When I walk in the room and my lines are a mess"

Lesson learned: Organize your lines at the start of your shift! In the ICU, you can have as 8+ pumps running for one patient. If your lines are all tangled you can't see or know what access you may have in case an emergency occurs etc.. also label them so you can easily know what is running through your lines without playing the "trace it back to the pump"game.

 "The way ICU nurses react to ANY beeping pumps or alarms" 

Lesson learned: Beeping pumps are pet peeves in the ICU! And can be a serious matter if your have a pressor or sedation hanging that runs dry before your start a new one. Always keep a new bag in the room if the current bag is nearing the end so when it finishes, your patients BP won't tank or your sedated patient won't raise hell!


            "Charting my morning assessment"

                   
              ...and refreshing the page before saving...

Lesson learned: Yes it happened to me this week ugh! It only takes this happening to you once for you to learn to save before refreshing that page ever again in LIFE lol! Save your work as you go!



"When my preceptor leaves me in rounds with the critical care team"

Lesson learned: Be ready lol! This week I attended rounds and survived. Nothing to learn here, just know your patient and what's going on so during rounds you aren't clueless. This is also the time for you, the nurse, to make any recommendations to the team that you see fit. They aren't at the bedside so they may not know everything that's going on in the course of one day as you do.

     
"When my preceptor tells me now is a good time to break for lunch"

Lesson learned: It is very easy to fall behind in your day as a new grad, so when you catch a break... take it! It's much easier to break awat if you bring your own lunch instead of speed racing to the caf like I did this week lol. Also, NEVER leave the floor without someone covering your patients. You'd hate to be eating peacefully at lunch then hearing a CODE MET "your patient" being called.
                            


        "Changing my first surgical incision"

                                                  ..well..

Lesson learned: Changing wounds isn't bad and there is no 'right or perfect way' to do it. Gather the supplies according to what is already there and what you think works best and go to town! Always make sure the patient isn't in any serious pain before you begin. If they are, give pain meds beforehand.


"When both of my patients receive transfer orders at the same time"

Lesson learned: If there is a transfer order in place for both of you patients, always work with one patient at a time. You don't want to be juggling back and forth and learn the hard way like I did lol.


                   "In computer orientation like"

 Lesson learned: No lesson learned here lol it's just boring! I DO know how to navigate through my EeMR with ease now haha!

             (Disclaimer: The clinical suggestions, advice and recommendations described on sicunurse.blogspot.com are based on my personal opinions and are not medical advice. The content is for entertainment purposes only. I, surgicalnurse.blogspot.com, do not own, nor did I create any of the animations above. I did create the captions written above and below them, customizing them to my experiences along with learning tips I have found helpful in my practice).