First shift off orientation.

I don’t ever want to feel this way again. Paralyzing fear mixed with nausea sprinkled with self-doubt. It’s bad enough that on the first day off orientation, everyone walks in with high anxiety, in fear of being given a patient assignment that is too complicated. And of course, that’s what the universe decides to give me.

My patient comes in intubated from surgery. Ok, a little more than what I was expecting for my first off-orientation solo shift, but I thought I could roll with it. They said we might extubate soon. Again, a bit much that what I was expecting, but I think I can handle it. And as we were retaping, he desats despite us bagging him. We ended up pulling his ETT (endotracheal tube) because it wasn’t in anymore. His O2 sats reached 7% and brady’d to 58 (which again, in Peds, is a code. CPR should follow). But he only reach below 50 for a hot second. He came back up as we bagged him. After multiple attempts, we finally got the right tube in and we finally were able to stabilize the tube without him desatting.

As I was pushing the sedation and paralytic drugs, all I could think of was, “Is this really happening to me right now? My first day off orientation and I’m freaking intubating a kid?” I wanted to run and scream and cry and hide and throw up and laugh at my misfortune. I knew what I was doing, but it doesn’t change the fact that it was overwhelming. It’s a very high-pressure situation. If things work out, this child can die. That’s a mind-blowing realization. And I know that’s in the nature of what we do, but it’s different when it’s a life and death situation and it’s MY patient, and I am mainly responsible, and I am expected to know him better than most people. That’s a lot of pressure.

Sometimes, I feel like I’m wayyy in over my head with this job. I only take solace in the fact that the other nurses and doctors felt bad that I had such an rough shift. That makes me feel better, not only because I could use the sympathy right now, but also because it reassures me that this isn’t what is realistically expected from a new grad. I probably wasn’t fully ready for an assignment like this. But it is what it is. I don’t know if everything turned out fine with my patient. I guess we’ll find out tonight. As for me, I need to get myself together because I’m going to do this all over again in about 8 hours.