AHHHH!! I hate when 4 patients is still overwhelming. like last night. maybe i should make my list before the narrative this time:

1. 1st seizure patient

2. did an admission at the beginning of my shift using the paper profile

3. a transfer to ICU

4. set up a transfer to an outside facility

5. got a lot of practice DARPing. ugh

6. gave a flu shot for the first time since nursing school

So I got there, and my new admit started seizing. Or "began experiencing seizure activity" rather. Whatever. I was told to "take charge" of the situation, to which I basically said "um i need direction- I've never had a seizure patient before." Once that stopped, I assessed him, did his patient profile and was pretty on top of my game in tackling my other assessments. I then called pharmacy for a MAR on him, and I tried to start pulling meds. In the midst of this, I got a call from Lab saying I had a critical Ca (6.8) on a pt, a BP of 220/110 on another, and a blood sugar of 418 on a third. The BP lady was also having pain in her legs and was generally a grouch (until I gave her morphine, and suddenly I was the best nurse ever), the Ca patient was confused and whiny, and the blood sugar patient was a little nervous I guess. Oh I also got yelled at by a PCT in front of a patient, which was awesome. not. Lets see what else... I had to talk to a scary doctor about my patient to be transferred, I couldn't get anyone to like sit down and show me how to fill out the form (surprise surprise) so I hope it was ok. I didn't see the lab tech before she drew my pts labs, who had a PICC so she didn't actually need to do them so I felt bad about that. The transport people called to lecture me about the patient being too early to drop off at the facility, then later called back to ask me who the doctor was who told me to have them there that early. My seizure patient had a second seizure around midnight, I called the dr, he said just to watch him, but then his bp fell to 80/50, so we transferred him to the ICU. All that was well and good accept for the fact that i got snapped at by the ICU nurse for a couple things. By the time I gave report, I only had 2 patients, but I was just beat up after that shift. sigh. i just want to feel integrated into the staff more.