“16-year-old Johnny had a sudden onset of dyspnea when we arrived at his school. Johnny was playing soccer with his friends when his shortness of breath occurred. Temperature 36.7, RR: 25, HR: 89, O2 sat: 95%. ” The paramedic told me.
As I did my hand hygiene, many thoughts were racing through my mind. “Oh my god, this is going to be an interesting experience”, “Maybe the patient had an asthma attack”, “I am all set and ready to help this patient out”. Without further ado, off I went and saw Johnny lying on the bed, looking frantic and stressed out.
“Hello, my name is Lucius and I am a student nurse who will be helping you out today.”
I did what I was supposed to do – patient identifiers and gotten the relevant information from him – before I proceeded to call the emergency physician for advice.
“Administer salbutamol and Atrovent, 1:2:1 via nebulizer.” was what the physician told me.
I hurriedly moved to the preparation room to prepare the medications needed.
Being a bubbly and enthusiastic person, I was so excited that I am attending to a patient in an emergency setting, and I am going to help him out! With that, I started to uncap the medications, inserted the needle into the bottles and drawing out the relevant amount.
Then, in the midst of my excitement, I screwed up my technique of drawing fluids out from the bottle – air bubbles started pouring into my syringe! Air bubbles are a hindrance because they are there to prevent you from getting an accurate dosage of the medication. Thinking back now, I could have drawn in more air and then measure the volume inside the syringe, before flicking them out. That is a hundred times better than for me trying to get rid of the excess smaller air bubbles into the bottle of medicine – increasing the risk of contamination, creating a huge mess and also bending the needle from my poor technique.
My energy levels were synonymous with my anxiety and excitement. This is one downside of my personality I dislike. There are so many things that can go wrong when your body is unable to differentiate between anxiety and excitement and all you can feel is an intense urge to perform the procedure.
When everything was done, I moved to the patient’s bedside and set on the mask. Since the medication was still in the syringe and not in the nebulizer, I decided to detach the nebulizer from the mask and inject the medication in. Using the one hand technique, I tried to uncap the needle.
I felt a sharp poke into my little pinkie.
Turns out, the mess I have created (the wet needle) impaired my ability to properly uncap the needle. When I exerted too much force, my hand reflexed back into the spot where the sharp end of the needle was. It started bleeding and I told my colleagues who were there. One of them even saw me stabbing myself with the needle.
I went to wash my hand, then continued back with the procedure.
Thankfully, these were just simulations in the school where we are able to practice in a safer environment. An environment which we can make mistakes and upon that, reflect and not repeat it ever again.
One important thing I learned was to maintain composure. I should never have let my excitement taken over control of my actions. Otherwise, I would hastily perform the procedure without doing it slowly, and mastering the right steps.
Maybe this was why I can never improve, I am too focused to finish up things quickly.
Also, by being composed, I will not seem like I’m someone who is frantic. I am sure nobody wants to see their future nurses or doctors acting so panicky, not knowing what to do, or simply just being all over the place. This is something that I really can learn from, and I hope to carry this lesson into my future practices.
I guess the next time when such an opportunity arises to practice and improve my skills, I will tell myself to be confident and do things slowly. After all, it’s better to do it slow than to do it wrong and create an extra mess for others to attend to.