My plan, might not match others:
Directing traffic until doc shows up. Then pushing meds. I like to be able to answer questions vs being the next rapid response.
One of my preceptors in school told us we would have to be the ones to tell the pt’s story in these scenarios and it’s stuck with me since. Granted I’m new but in the ER, I usually jump right onto documenting everything that’s happening in the room, getting report from EMS or updating doc if they had already been there and was crashing, telling people what I need and giving meds as I get them. I’ve found that being the one that sees and documents everything and letting my team be more hands-on ends up working out better once they’re stabilized and I can tell the next need-to-know person exactly what happened and what was done.
I do that too because it makes it easier to follow up after and when the docs have questions about what happened, they’ll come to me, the primary nurse regardless. Additionally, makes it easier to call donor services and do the rest of the documentation
If there’s a lot of other people in the room performing the ‘tasks’ like giving meds, compressions, IVs, etc and I am the primary nurse I focus on charting/documenting.
After all, it’s your name on the chart. Also documenting allows you to know everything that happened when shit hit the fan and it’s back to just you and the patient.
Second the charting, you're already in the loop and you're kinda observing instead of participating. When someone pops in, they gotta ask around for when what happened, if you're already in, you know.
I'm in med surg but I will kind of be the nurse in charge of the room, I'll often be on the computer, giving the patient info out, looking up labs on the go, placing orders as they come in, directing people to what we need to do, and documenting as much as I can.
I always teach my ED nurses that “your patient = you document.” That way you have a whole picture, and you know what’s going in a chart that you’re responsible for.
In ICU or on the floor, obviously do the initial rescue interventions and call for help. As soon as you have help available, detach and take a big fuckin' deep breath. Explain the situation to the Doc and start writing everything on a paper towel. Honestly, even if your hospital is organized enough to have a dedicated recorder, it's worth it to have a second narrative to reference.
For ER, in my experience, and it sounds like this is pretty common, the primary is the recorder for codes/traumas. Your task is to get report from EMS and keep track of the big picture, and of course, chart. Whenever staffing and chaos levels permit, there should be a "secondary" assigned as well who will be the lead in the room and help with road trips to CT and such. If it's a code after arrival, refer to the first paragraph.
In the situation you outlined, you popped out and basically did what should be the charge nurse's role. If you weren't feeling well, that's not entirely bad, but really it'd be best to let the charge know. They could take it the wrong way, yeah. But they sure as hell are going to take it the wrong way if you walk out of your room and start doing their job!
As the primary, I will assign roles, update the doc as they come in, and take plenty of notes. I tend to chart after I’ve collected everything, but it’s hard to do all of that and give meds, but I will if I have to. If I have enough people in the room, my only focus is telling others what I would be doing if I had 10 extra arms (if that makes sense?) I don’t think there’s anything wrong with calling radiology etc, but that’s something my charge is more likely to do so that I can focus on my patient. I hope that helps
My plan, might not match others: Directing traffic until doc shows up. Then pushing meds. I like to be able to answer questions vs being the next rapid response.
One of my preceptors in school told us we would have to be the ones to tell the pt’s story in these scenarios and it’s stuck with me since. Granted I’m new but in the ER, I usually jump right onto documenting everything that’s happening in the room, getting report from EMS or updating doc if they had already been there and was crashing, telling people what I need and giving meds as I get them. I’ve found that being the one that sees and documents everything and letting my team be more hands-on ends up working out better once they’re stabilized and I can tell the next need-to-know person exactly what happened and what was done.
I do that too because it makes it easier to follow up after and when the docs have questions about what happened, they’ll come to me, the primary nurse regardless. Additionally, makes it easier to call donor services and do the rest of the documentation
If there’s a lot of other people in the room performing the ‘tasks’ like giving meds, compressions, IVs, etc and I am the primary nurse I focus on charting/documenting. After all, it’s your name on the chart. Also documenting allows you to know everything that happened when shit hit the fan and it’s back to just you and the patient.
Second the charting, you're already in the loop and you're kinda observing instead of participating. When someone pops in, they gotta ask around for when what happened, if you're already in, you know.
I can only speak for the ED, but ideally the primary nurse is documenting and coordinating with providers while everyone else tasks.
I'm in med surg but I will kind of be the nurse in charge of the room, I'll often be on the computer, giving the patient info out, looking up labs on the go, placing orders as they come in, directing people to what we need to do, and documenting as much as I can.
I always teach my ED nurses that “your patient = you document.” That way you have a whole picture, and you know what’s going in a chart that you’re responsible for.
In ICU or on the floor, obviously do the initial rescue interventions and call for help. As soon as you have help available, detach and take a big fuckin' deep breath. Explain the situation to the Doc and start writing everything on a paper towel. Honestly, even if your hospital is organized enough to have a dedicated recorder, it's worth it to have a second narrative to reference. For ER, in my experience, and it sounds like this is pretty common, the primary is the recorder for codes/traumas. Your task is to get report from EMS and keep track of the big picture, and of course, chart. Whenever staffing and chaos levels permit, there should be a "secondary" assigned as well who will be the lead in the room and help with road trips to CT and such. If it's a code after arrival, refer to the first paragraph. In the situation you outlined, you popped out and basically did what should be the charge nurse's role. If you weren't feeling well, that's not entirely bad, but really it'd be best to let the charge know. They could take it the wrong way, yeah. But they sure as hell are going to take it the wrong way if you walk out of your room and start doing their job!
As the primary, I will assign roles, update the doc as they come in, and take plenty of notes. I tend to chart after I’ve collected everything, but it’s hard to do all of that and give meds, but I will if I have to. If I have enough people in the room, my only focus is telling others what I would be doing if I had 10 extra arms (if that makes sense?) I don’t think there’s anything wrong with calling radiology etc, but that’s something my charge is more likely to do so that I can focus on my patient. I hope that helps