Part of what made me know I was ready for something new was my comfort level in CCU. When I first started there I used to drive into work wondering who I was working with. Hoping that certain people would be on with me knowing that if they weren't there it could be bad......real bad. This was because I couldn't handle just anything that came through those doors. I could handle the basics. My patient would tell me he was having chest pain......ok, check to make sure his o2 is in, do an ekg, give him some morphine, turn his nitroglycerine up, etc....I had my check list to run through. Situation handled. Someone's BP was in the 70's.......either turn the drip causing it down/off or give a bolus of IVF or start a pressor, etc. Situation handled. Someone went into flash pulmonary edema........oh crap this was a REAL crisis!! Or someone went into severe resp distress, or was in cardiogenic shock, etc. Those were things I was unprepared to handle.
But give me 7 1/2 years under my belt and for the last several I could care less who I was working with except for the friendships that were there for the shift. I could also care less what came through the doors, in fact the sicker the better in my opinion. I always volunteer to take care of the sickest patients in the unit. The best shifts are ones that involve some sort of crisis situation. Don't get me wrong, I do feel bad for the person involved and I do my absolute best to give them the best but I live for the intensity of it. I've moved from being a scared green CCU nurse to being in charge about 50% of the time that I work. People actually look up to ME!! Never thought when I came to CCU that would happen!! It's a good feeling though.
About 18 months ago our hospital started a MET. It stands for medical emergency team. It is a team made up of an ICU or CCU nurse and a respiratory therapist that respond to the inpatient floors when a nurse from there calls for an acute change in their patient's condition. It's purpose is to prevent inpatient deaths. I really like being a part of this team and teaching novice nurses to critically think etc.
But all along we have complained to management that the problem with the team is that it takes us away from our own critically ill patients. When a MET call goes out I have to leave my 1-3 critical patients anywhere from 20-60 mins to evaluate this other patient and give my recommendations on how to handle the situation. Sometimes these patients are able to have some treatment and stay there and sometimes they are moved to the ICU or CCU. The entire time the team has been in existence we have asked for a nurse to be dedicated to this position.
Finally...............they listened!!! And created a position called a resource nurse. It is only on the off shift so I will stay the same hours 7pm-7am and still 3 days a week. But since there isn't a MET called every night there will be other responsibilities too. I will also respond to all code 8's in the hospital (our call for an inpatient death) and all BAT's which is our brain attack team or acute stroke to evaluate whether a patient having an acute stroke can receive the clot buster drug to lessen the severity of the stroke. Then in my downtime I will be rounding on the inpatient units and helping to "put out fires" and trying basically to prevent bad outcomes for patients. Nurses can call me if they are unsure of a situation or procedure etc.
I'm sure there will be some grunt work involved and some aspects I won't like but all in all I'm excited and looking forward to it!! It's a great change. I love bedside nursing but at the same time there is a lot of bedside nursing that I'm sick of and won't miss. Doing this I'll still be doing bedside nursing but not to the degree that I do it now. I'll be starting in mid-July.