Day Fourteen

So, i had my first busy shift today. We had 6 pts in the hospital, and three people present to casualty with different conditions who ended up being transferred to larger hospitals in the city via the Royal Flying Doctor Service (RFDS). The first was an open crush fracture to his R) index finger, the second had a ? (query) bowel perferation causing them a considerable amount of pain and ? turning septic and the third, the one i was given, had had a ? MI (Myocardial Infarction). 

So i had the person who had a ? heart attack, and i jumped straight into MI mode by obtaining an ECG and drawing bloods for trops (a cardiac enzyme, troponin, which is released by cardiac muscles when damage has occured) to see whether they were positive or negative. I thought i was managing ok until a nurse way more experienced then me came in and asked about the pts vital signs, which i had forgotten to take as i had jumped straight into taking my ECG and trops. Opps, at least i will remember for next time...i hope.

Trops take 10 mins to be analysed by the little machince and it turned out they were positive. So now i was managing my first case of a MI, not just ? MIs, so i began to panic a tiny bit, i think it was expected. Anticoagualtion treatment was commenced, which involved giving the pt a Clexane injection (this just ensured that no clots could form which could potentially lead to further problems). I began to admit the pt (think a huge stack of forms that needs to be filled out) while the doctor contacted the cardiologist at the Cardiac Care Unit, located at Flinders Medical Centre (FMC) and it was decided that the patient would be transferred there for more care, since this was the pts second MI in 2 years. The transfer added a couple extra forms to the pile.

The pt presented at around 11am. By 1400(the reason it took so long was because we had already sent other pts over to Adelaide around 1230, and they needed time to refuel and everything before they came back, and the pts vitals were stable) we had been contacted by the RFDS for a handover to be conducted over the phone (which i can now say i have done :D) and so more informations, such as the pts weight and whether another person was flying with them as the pilot needed to calculate how much fuel would be required. At 1530 the ambulance arrived to take the pt to the airport, and i hope everything is going well with him and the other two people that were transfered to Adelaide.

I felt a bit stressed about the day, since not only did i have my own Emerg pt, but i was assisting with the other two emerg pts to learn a bit about the treatment for those conditions and jointly looking after the other 6 pts on the ward. It was an exciting shift and i learnt so much, but i dont think i want it to be repeated again in a hurry, i would definately like some more learning time before then. :)

So in the words of last yrs Graduate nurse.. "Its going to get easier, then a whole lot harder, before it gets easier again". Am i worried? A little, but all in all i say BRING IT ON!! :D x