During our senior semester, we do a preceptorship in a specific unit at the hospital. Kind of like an internship, we spend 56 hours with a nurse, working their shifts with them, and becoming more and more independent. I chose to do my preceptorship in the Emergency Department (ED), and it has been a fantastic experience. I wanted to share a few of my experiences there - hopefully you'll find them as crazy as I did!
My second day in the ED, my nurse and I had a patient who was complaining or continuous nausea, vomiting and diarrhea. In order to replenish her fluids quickly, the doctor ordered a liter of normal saline to run wide open…which meant she needed an IV started. Since I had never successfully started an IV on a patient, she sent me in with the IV supplies by myself – and told me to return to her if I thought I couldn’t do it.
This was my second attempt at an IV start in the ED – at the first one I was aiming correctly, but was afraid to hurt the patient and didn’t push far enough into the skin. Thankfully the weekend prior to the clinical day included a visit with my mom, who had promised to be a pincushion for me as I practiced IV sticks (she is a saint). AND I got the stick on the first try – so I had slightly more confidence than I had before the weekend.
As I went into the room by myself and examined the patient’s arms, I talked to her about if she had ever given blood and asked her which arm they used. She pointed to her left, but I had just seen a large vein in her inner arm. I asked her if that vein always stuck out like that and she assured me it did. This was like a giant bull’s-eye on her arm. She seemed really calm – I’m not sure if it was from her nausea or her natural state – but I was grateful, because I was a wreck. I tried my best not to show how nervous I was, especially that my hands were shaking! I had a hard time starting the IV without getting blood everywhere, but I did my best to recover and start the bag of saline. Once the IV was started and a medication was pushed, my preceptor came to check on me. She asked me if I got blood, and thinking that she meant the blood flash when starting an IV, I said, “YES!!!!” Actually she meant if I had pulled blood for the lab. Oops. I had been so nervous about the IV that I hadn’t read that she needed a full workup on the order sheet.
All's well that ends well, right?