“Code Blue In The Emergency Department, All Personnel To

“Code Blue, ER. Code Blue, ER”. I can still hear that calm, unalarmed voice over the intercom. Seconds later, John Doe, a 50-year-old male, is rushed in through the double doors of the Emergency Room with an EMT pounding on his lifeless chest. Although the medical staff had been preparing for some time, it still appeared like a scramble to resuscitate this man’s life. It was my first shift as a medical scribe; I had no idea what to expect. While paramedics shouted the jargon-filled report, the surrounding chaos was quieted by the physician who maintained the room's composure. The instant the pulse was obtained, I was overcome with a foreign feeling that can only be described as pure exhilaration as if the epinephrine injected into the patient manifested its effects on me.

Nearing the end of my shift in the Emergency Department, I was requested to accompany a patient while the nurse readied the discharge papers. Upon entering the bay, I met a very small and fragile patient who was anxious to go home. Conflicted between my primary duties and responsibilities to complete training for two inexperienced volunteers, I decided to put forth my interests in teaching by demonstrating compassionate care to my trainees. Although the patient repeatedly refused my assistance, I gave my best effort to calm her as I cloaked a warm blanket around her. As I listened to her confide in me of all of her hospital anxieties, I was shocked from the lack of quality care she had received which made her feel more sick after the first

Pulling off the ramp, we turned onto Church Hill Road responding on a priority one for the cardiac arrest. I tried to review my field guide en-route to the call, but all I could see were flashing lights reflecting off the guide’s pages and crowds of cars moving over for our wailing sirens. Within three minutes we had arrived on-scene and it was clear that our patient was not in cardiac arrest; however, his 12-Lead EKG and oxygen saturation were marginally reassuring and pointed to an active heart attack. At this point in my EMS training I was a BLS provider, but had adequate knowledge to assist Kathy. Instinctively, I went right to work and loved every second of it. The concept of formulating a differential diagnosis in the field and testing that theory is one of the principle factors that kept drawing my back to EMS. In addition, I developed an unparalleled appetite for knowledge, stemming from my desire to get every differential diagnoses right. Coming to this realization early in my EMS career, we [healthcare providers] frequently forget that patients often lack the medical knowledge provided to us through years of training. Behind CT Scans and MRIs are patients with questions. Having the ability to provide compassion, sympathy and reassurance to a patient is a central part to their recovery and survival; therefore, we [healthcare providers] need to be able to care for our patients on a holistic level, focusing less on the disease and more on the

When I arrive to the Trauma ICU 4800 unit, all of the nurses were already being followed by other students. The nurse in charge had me follow several different nurses, so I was able to observed several different patient cases. The first patient had received a triple bypass open-heart surgery. The patient had received a creatinine blood test. The patient had a dialysis machine next to them, which was used to function as the kidneys since the patient’s kidneys were not functioning correctly. Also, the patient’s body temperature was lowered from having a taken cool liquids so the nurses were keeping him warm with a bair hugger, which was a machine that helped regulate the patient's’ body temperatures.

Clipboard and stethoscope in hand, I walked toward the double doors that flashed emergency in bright red letters above. It was my first clinical shift as an EMT student, and first day jitters flittered around in my stomach, I had no idea what to expect. However, I was not expecting to witness the fragility of life. About a half an hour into my shift the rapid response alarm blared through the emergency room. I turned to my preceptor and quizzically asked what this meant. “A rapid response is a patient who is in need of immediate medical care and intervention. As an EMT who is part of the rapid response team you will be expected to assist with vitals and chest compressions. Let’s head toward the recess room, and I’ll explain more there.” Eventually, we reached the recess room, and the rapid response team was already there preparing for the arrival of the patient. A nurse was on the phone with the firefighters that were bringing the patient in. Seconds later she announced “It’s a STEMI”. Then fright ran through my veins. A STEMI is medical jargon for a segment elevation on an EKG. In other words the patient’s coronary artery is completely occluded. The patient is suffering from a heart attack. Prior to this, I had never seen someone who was having a heart attack. However, the thing that terrified me the most was that I knew I would be expected to perform chest compressions. I had only ever performed chest compressions on a dummy.

Meanwhile, elsewhere in Habersham County, Tom was feeling slightly nervous as he exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin his first shift as an RN. The first few hours of his shift passed slowly as Tom mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. He realized that the attending physician, Dr. Greene, who was rather “old school” in general about how he interacted with nursing staff, wanted to start him out slowly. Tom knew, though, that the paramedics could bring in a trauma patient at any time.

Being only a measly volunteer for my high school HOSA (Health Occupations Students of America) program, I am not allowed to participate in much, leaving a lot of down time. I hear the sound of rushed feet pacing up and down the light brown, wooden floors, and the white, florescent lights blind any who dare to gaze up. I am only here to observe surgeries and injuries, yet so far I have only managed to observe impatient nurses streamlining up and down pallid hallways. I glance upward to a clock staring at me from right across the room. It glares 8:48. I moan, realizing I have another thirty minutes before I have to head to school. I turn my head when I hear in the distance an unusually loud herd of frantic feet. Moments later the double doors blast open, paramedics, doctors, and nurses all surround one speeding bed. The transition from utter silence to sudden action throws off my relaxed and daydreaming mind, as I see the ominous bed hurdle its way into an open room down the

Monday morning and I oversleep, I have 30 minutes to get dressed and get on the unit, ready to receive report. I fly into the hospital parking lot, run to the Intensive Care Unit with three minutes to spare. I sit down to receive report from Hazel the hospital hag. Hazel looks at me up and down in her usual haughty fashion and said, "You know your uniform is on wrong side out and your shoes don't match." I looked myself over, smiled and said, "I know." She looked at me like I had thrown bed one's dirty brief at her. I was pleased with myself. I made it through report, ran to the locker room, reversed my scrubs and scurried on to bed one. I walk in the room and noticed Hazel the hag left all the intravenous bags dry. I go into the supply room and collect the necessary intravenous bags, while going back to the unit I hear "Code Blue room 352, Code Blue room 352." I am on the code team so I drop everything and rush to room 352 on the opposite side of the hospital, only to find a code blue had been called in error.

On September 28, when we went to Tripler Army Medical Center, I was placed in the Cardiac Ward. At that time, I was able to learn so many diagnosis dealing with the patients. The nurse had briefly explained what was going on with each individual patient and the type of treatments they are doing to help. She had also neatly clarified each medication she was giving them and told me exactly what it was used for. I was able to get an experience of hands on by taking a patient’s temperature. I had shadowed as she did so many things to make the patient feel comfortable and did everything to the best of her ability to make them happy. She had taught me how to record every piece of information about the patients on the computer by showing me what

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

This Friday, September 15th, I had my clinical observation experience in the ED. I was there from 7:00 am till noon, viewing the flow and duties of the nursing staff on the unit, as well as practicing the skills I have thus learned in school. Throughout most of the morning, I followed Jessica, who had been a nurse in the ER for ten years. It was an insightful experience that broadened my previously limited knowledge of the roles and experience of an emergency nurse.

During my clinical experience, I encountered an unforgettable situation which holds significance to me as a nursing student. My patient had an intracerebral hemorrhage, subarachnoid hemorrhage, as well as dementia. As a result of her conditions, she was a two- person assist. While researching my patient’s health conditions the night before clinical, I became concerned about how I was going to take care of my patient due to the anticipated immobility. When I first met my patient, I began to feel apprehensive because I realized that it was a patient who I had seen on the unit two weeks ago. This patient was groaning and crying at night, disturbing other patients who were trying to sleep. Due to her restlessness, the nurses moved the patient to the nursing station every night and then moved her back into her room in the morning. Looking at

The case that I have chosen to reflect on was a patient that was already staying on a ward within the hospital, the patient was rushed to the emergency theatre late at night from the ward with a suspected internal bleed, the cause and exact location of the bleed was unknown, the patient presented a complex case for the theatre staff as the patient 's condition was largely unpredictable along with the amount of blood loss that the patient could lose. My role within the theatre team was on the anaesthetic side, I was supported by my mentor who I feel I have learned a vast amount of

When I woke up, I was surprised to find a weird, padded board with red and green stripes on it, wrapped up onto my arm so it would stay. I was told that they could not get my elbow back in and I was transferred to a different hospital. I didn’t enjoy the presence of the people in the second ambulance with me nearly as much as I liked the first two people because, they weren 't nearly as good at comedy. Although, second ambulance made me feel a bit safer because I had already experienced what riding in an ambulance was like. I was familiar with the white interior and the medical equipment with bright red crosses on the cover hanging on the walls. I had already known the pain in my arm as the vehicle bumped into the

It was an unpleasantly early morning in the hospital waiting room. Nurses buzzed around, busy attending to their patients while a faint beeping sound could be heard in the background. I was starting my second shift of the day at the hospital, just finishing working a shift in the dark, grimy morgue. Groggy, I sat down at my desk to begin another four hours of labor. My position was to assure that the paper work was properly completed and that all patients were attended too. While being a supervising nurse was a great responsibility, it left time to day dream.