Not the ambulance type...

I think I average a post a month... but it is better than nothing!

Life is going great! The past month has been another great one for us. I was able to spend the past month doing day shift orientation on the ICU. Our ICU is small. 9 beds. There are always three ICU nurses scheduled. I have been a "third" nurse since I started floating there in the Spring. All of this extra orientation is to help me become a "second". A second nurse is also called the code nurse. Which means they are the code nurse for the ENTIRE hospital (minus the ED). So although I have had some good experiences I don't yet feel competent enough in my abilities to run a code by myself. I went through ACLS and have been trying to get experience. Honestly I am always kinda wishing for a code... (For those not of the medical-type, a "code" is when someone either goes into cardiac or respiratory arrest. You know on TV -CPR, the electric paddles, mouth to mouth etc. ) It will be great experience when I get there, I don't know too many places that would give a recent grad this kind of opportunity!

Anyway, so recently I had the chance to go on a transfer. Because our ICU is small and we don't have pulmonologists or interventionalists we ship a lot of patients south. Usually it is by Lifeflight. Well this particularly morning it was starting to snow in Logan. So Lifeflight had turned around and the decision was made to transfer by ground. I came on shift at 0500 and we were gone by about 0630. The patient was on a vent, and had 6 pumps to manage. So in the back of the ambulance it ended up being the paramedic, respiratory therapist, the nurse I was orienting with, and myself. Most nurses don't get to go on a transfer orienting and so they are the only ones when they go for the first time. Well hopefully I never have to go again, and this is why...

I have to admit it was cool speeding through Logan with the flashing lights and blaring sirens, but that is where the "cool" part ended. The other RN and I split the jobs, she was in charge of vitals and recording and I was managing the six medication pumps on a 2 ft pole. Driving down Sardine canyon the pt starting moving, which required some Propofol and Versed boluses. Well with all the standing up and moving around while the ambulance was cruising down the canyon I started to feel sick. I had no window on my side of the ambulance, and I had a mask on. The heat was blowing and I started having cold sweat drip down my face, back, legs. Not a pleasant thing. Meanwhile the pumps start beeping low battery (in the rush of getting them all set up, they hadn't been plugged in for awhile apparently) well we then discovered that this brand new ambulances' power outlets weren't working. So I was freaking out, trying to decide how I could switch the drugs around so that the ones most needed ended up with the longest battery life. I asked the other RN how long the pumps last after they are beeping no battery with a red screen. She had no idea, and I didn't either because I have always plugged them in a that point.

Well I was trying really hard not to vomit all over. I didn't want everyone to have a reason to make fun of the "rookie." (Of course after the ride I find out that they have Zofran that the crew pops when they need it) Well then we couldn't get a good blood pressure reading 259/205, then 80/32 etc. None of us could get a manual pressure either. So I was just praying that we could at least make it to the hospital without having to code the poor person in the ambulance.

Well we finally made it to IMC in Murray. The freezing cold air and stable ground felt so good. The pt made it to their ICU without dying, so I guess it all turned out okay. On the way back the crew wanted some breakfast at Betos, they offered to get me some, but I warned them that it would probably end up all over their new ambulance. Anyway, the lesson I learned from this experience is that I won't go again. What if I had been the only nurse, it was hard enough with someone else! Or if I did go I would have Zofran and a pink bucket...