Shift report can be a funny thing. Your patient assignment, even if you have had the group before; can go in many directions. You may have a patient whose vital signs are “circling the drain,” or lab results have just come back all wonky. Altered mental status, sometimes in the form of ‘sundowners’ can make a quiet evening a noisy/busy one. There have been shift reports where I felt like that last click on the first hill of a rollercoaster. Butterflies in the stomach. You know it’s going to be a wild ride, but you don’t know where it will go. This is where I came up with the phrase, ’embrace the chaos.’ You fight that new nurse urge to go in the opposite direction of the crisis, and step towards it. You tap into your spiritual center to remain calm, build upon your desire to help people, then tap into your skill sets and knowledge to work towards saving the patient.
However, those evenings that feel like all the little things spin out of control. You begin to feel like everything is closing in. Perhaps the feeling of being trapped in a strange medical game show. I think these are the moments that separate new nurses from experienced ones. As the saying goes, “new nurses run/old nurses don’t.’ Experience nurses work smarter, not faster. I was able clear my mind, take a deep breath, then attempted to use my best critical thinking skills to determine what I needed to focus on first. I also found out that all of the rituals I had developed to improve my time management skills, including those during med pass paid off. Reading this, I feel that I am making smaller events seem larger – which is probably the case. However, I think I had a glimpse into even more intense rapid response/codes in the future.
Not that I have had many of these moments, but I have had a couple. A few cases had to do with hypoglycemia. Another case, a patient I had just collected blood labs on, came back with a 7.2 Potassium level. The free charge was very supportive. There is a set protocol, listing everything to do – include contacting the doctor. The supplies were organized. The checklist was followed. Luckily, everything turned out well. It was scary, but a manageable, learning moment scary. I was able to ask questions while things unfolded. Since then, I have also seen other nurses go through crises with their patients. The sense of teamwork and commitment that my peers and I share reinforce the decision that I made to join this team. Nursing rocks.