Almost a heart nurse
Well it’s crazy to say, but now I have 5/6 first-day post-op open heart recovery orientation. After my next orientation shift I will be able to recover these patients from surgery on my own. It’s a thought that makes me quite nervous, but I feel as though I am ready. My last patient was an aortic valve replacement and I was able to work the patient towards extubation during the night. We successfully extubated in the morning on my shift, which was the second patient I was able to complete the weaning/extubating process with. I am pleased with the mix of patients I have had thus far. Two I received directly from surgery, which is an entirely different process all together. The process of initially getting them settled, figuring out the drips, covering the labs that need to be addressed, and getting the initial hemodynamic measurements, while being mindful to their blood pressure makes the first hour a complete hustle to stabilize them. The other three patients I took over from day shift, which is much easier, regardless of the patient’s acuity. Each one had different drips, some with a few and others with almost none. I have not had the dreaded bleeding patient yet. I was hoping to experience this while still on orientation, but unless my next patient has complications like this I will eventually have to deal with post-op bleeding on my own. I hope that won’t be until after I have several on my own, although I know I could handle the process if I had to.
It’s been a just over a year and four months since I started working. The knowledge and comfort of being a nurse exponentially increases at a certain point. For me I think the one year mark started to tie everything together. Once I became comfortable with the routine I was able to start noticing the similarities and differences with each patient situation. In many causes your past experiences help you predict or at least be prepared for what can happen to each person you are caring for. This intuition helps a great deal when caring for post-op open hearts. Predicting decreases in urine output based on cardiac output, knowing the possibility of covering lab values based on the patient’s trends, and being on alert for potential complications all play a vital role in caring for the sickest of patients.