"Cowboy Up"
I forgot which B-action flick I was watching where there's a scene where the gruff senior squad leader tells the young recruit to "Cowboy Up" when the shit hit's the fan and they're stuck or something. . .Anyways what I'm referring to are the times when all hell breaks loose and someone has to take charge. My worst fear being an intern(cherry-doc) was just that; a patient crashing and buring and I was the one who had to call the shots. In doctor speak that's called running "the code". I had been lucky up to this past week no one has ever gone south on me when I was alone. I remember working graveyard nights with the lives of over 150 patients in my hands and a busy supervising attending downstairs in the ER admitting. I would get random calls to fix minor things like decreased urine output, renewal of restraints, or high blood pressure. Nothing heavy. . .
I was finishing up my last week of internship in the ICU and usually I come in around 5-5:30 in the moring to see my sick patients. I even ran out of scrubs this particular morning so I did the unusual and wore slacks and a tie to work. As soon as I walk thru the double doors of the ICU and just when I'm about to check in on my first patients, three nurses rush into the room next to mine.
"Call code blue"
My heart froze and I wondered if the other intern was around. She was and she ran into the room and I followed. The monitor showed a flat line and a nurse started CPR already. The patient was already intubated so that saved me some time. That's when I "Cowboyed Up" and took charged seeing that the other intern looked like a deer in headlights. "Get an amp of epi in her stat; call the senior and hospitalist now,", was the last thing I remembered saying and the next 10 min was a blur. More drugs, CPR, checking pulses and we finally got a pulse. Luckily the attending downstairs and a senior overnight resident arrived.
"Hey sport, you want to finish running the code"
"No thanks. . .I've got other patients to see."
That particular patient left our ICU unit off life support back to her other hospital.
"Hey Doc, that's for helping out this morning" the night shift nurse tells me.
"You did all the work, you brought her back, I just stood there and barked orders."
"But you were there. . .Someone had to take charge in the beginning,"he says.
I consider myself lucky because I was already in the intensive care unit the patient couldn't get any more ill and most ICU nurses are awesome. I feel more confident now having faced one of my fears of being an intern. I realize I may not be so lucky the next time but I won't be afraid to "Cowboy Up" when the time comes.
I forgot which B-action flick I was watching where there's a scene where the gruff senior squad leader tells the young recruit to "Cowboy Up" when the shit hit's the fan and they're stuck or something. . .Anyways what I'm referring to are the times when all hell breaks loose and someone has to take charge. My worst fear being an intern(cherry-doc) was just that; a patient crashing and buring and I was the one who had to call the shots. In doctor speak that's called running "the code". I had been lucky up to this past week no one has ever gone south on me when I was alone. I remember working graveyard nights with the lives of over 150 patients in my hands and a busy supervising attending downstairs in the ER admitting. I would get random calls to fix minor things like decreased urine output, renewal of restraints, or high blood pressure. Nothing heavy. . .
I was finishing up my last week of internship in the ICU and usually I come in around 5-5:30 in the moring to see my sick patients. I even ran out of scrubs this particular morning so I did the unusual and wore slacks and a tie to work. As soon as I walk thru the double doors of the ICU and just when I'm about to check in on my first patients, three nurses rush into the room next to mine.
"Call code blue"
My heart froze and I wondered if the other intern was around. She was and she ran into the room and I followed. The monitor showed a flat line and a nurse started CPR already. The patient was already intubated so that saved me some time. That's when I "Cowboyed Up" and took charged seeing that the other intern looked like a deer in headlights. "Get an amp of epi in her stat; call the senior and hospitalist now,", was the last thing I remembered saying and the next 10 min was a blur. More drugs, CPR, checking pulses and we finally got a pulse. Luckily the attending downstairs and a senior overnight resident arrived.
"Hey sport, you want to finish running the code"
"No thanks. . .I've got other patients to see."
That particular patient left our ICU unit off life support back to her other hospital.
"Hey Doc, that's for helping out this morning" the night shift nurse tells me.
"You did all the work, you brought her back, I just stood there and barked orders."
"But you were there. . .Someone had to take charge in the beginning,"he says.
I consider myself lucky because I was already in the intensive care unit the patient couldn't get any more ill and most ICU nurses are awesome. I feel more confident now having faced one of my fears of being an intern. I realize I may not be so lucky the next time but I won't be afraid to "Cowboy Up" when the time comes.
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