Is it really this hard?
Last week, I came back to work with 4 days off. It’s always said that you’re first night back is always the hardest. I knew that. I always pray before I step out of my car to to go to work. But for some reason, I prayed even harder that night. My prayer lasted more than the few seconds.
My night couldn’t have been anymore worse. I don’t want to get into too much detail, but it kind of elevated when I gave Tylenol for a temp of 99.4. At my hospital, you don’t do that.. it’s considered a normal temp. We don’t start treating until 100.4. Well, I knew that and had I justified why I did it to the Attending (at the time I thought she was a resident), then she would have understood. Well, let me have that chance now.
He had been spiking temps all day. When I took my pt’s temp, it was 99.4 and he was starting to get warm, from what I felt and what the relative thought. So I thought, ok, let’s get this temp under control now. By the time I got the Tylenol, it was about 15 min later and I came in and he was burning up! I wish I had taken the temp again but I knew it was in the hundreds.
Well he had also had an issue with low bp. We only take bp once unless otherwise ordered. I just randomly decided to take his bp again at the midnight vitals and it was 76/44…down from 80s. His hgb was already 7 point something and the docs didn’t want to transfuse him. So I found the number for the on call hem onc resident (had sickle cell) and when gave a report to the doc, she was like, “You gave Tylenol for a temp of 99.4? Why did you do that? That’s normal temp!” and she kind of cut me off and I couldn’t justify why I did it. I could have but that night I have had 4 peds pt’s with TPN and GT feeds and antibiotics galore and I was just at the end of my rope. I couldn’t just say, “you know by the time gave him the Tylenol he was already burning up. ” In my head I didn’t think it was a good enough reason. I thought I needed numbers. Had I taken the temp again….
But you know, he ended up having a another temp of 101 towards shift change anyway.
Huhm.
So that day I’m like is this really this difficult? And I’m not basing it off of this one incident. Overall I think I’ve had a great experience so far in acute peds but at the same time I don’t think I can handle it for that very long. I’m starting to get burnt out. I hear from my educators that other nurses are saying that I’m not afraid to kind of just jump in there and take care of things and thank God I have some wonderful nurses that have my back. I think I’m getting harder pt’s because maybe they think I can handle it? Maybe so? And yesterday I had a crazy night too and I thought our team leader/resource nurse said “You know this is a test.” and she kind of said it in passing. and I’m like, “did she say that?”
But yes, lately, I’ve been thinking of going back to home health. Slower pace. When I was an LVN, I was a home health nurse as a new grad, so early on I learned how to be independent and figure things out on my own so I not scared to go back as an RN. I think it’s just a matter of time.
