Assignment Task:
I need 150 words to reply on my discussion board. Please put 1 reference. Thank you.
One day at clinical, I was assigned to the Emergency Department, alongside one of my classmates. I was tasked to a nurse who was receiving a trauma that morning-XyoF from an outside facility being admitted for acute respiratory distress and was unresponsive to the staff at the facility during their final rounds. Upon arrival to the trauma bay, the nurse and respiratory therapist began working on the patient as the doctor started her initial assessments. All listened to the emergency crews as they were giving their report, "weak pulse, soft pressures, sats in the high-70s to mid-80s". The nurse started a bolus of fluids, using the access placed by the EMTs, while the doctor and the RT began intubating the patient. Once intubated, the patient was placed on a ventilator by the RT. All the while the nurse was drawing labs and inserting a new peripheral IV into the patient. Once the patient was relatively "stabilized", I asked the nurse how he was so quick to do the interventions he had done. "Oh, I don't know, just reactionary at this point." Was his initial response. After some time, he noted that he had worked as a tech for at a hospital where he was originally from and as a CNA in a nursing home (although for a very short time). "You just notice things as they're presented to you. I made quick recalls of patients I had seen in the past...and it helps to know the doctor that I'm working with, as it makes knowing what they typically order for patients a bit easier." As I was witnessing all this, I recalled my past experiences as an SICU PCA in one of the Methodist Hospitals and as a traveling team nurse in a Houston ICU, as it bore similarities to the situation unfolding before me. Though I noted that the patient's blood pressures were very low, I wasn't all too sure on what to have started fluids-wise...or even where to begin for that matter. It had been a great while since I'd been in an acute situation such as this and it took me some time to get a grasp of all that was going on. But I did recall that one of the top priorities was to establish an airway for the patient, as she was admitted for ARDS; a quick physical assessment of her showed pallor and cyanosis of her fingertips and lips, along with very cool-to-the-touch extremities.