My First RRT

September 3, 2020

Hi! I am nurse Jaea.

I was the incoming nurse for morning shift awhile ago at COvid unit G west of the hospital where I work at. It is my second day of immersion at a progressive care unit usually intended for cardio patients. However, due to the pandemic, it became a progressive unit for Covid positive patients.

I have never had any code blue nor RRT as the bedside nurse within my entire nursing career. But then, I was assigned and immersed at G west, where I can most of the time hear code blues and RRT announcements.

I was donning on my bunny suit, preparing for duty when the announcer said, “RRT G West”. I was anxious. My stomach felt uneased as I approached the station.

I don’t know what to do. Since I told Maam Val, the nursing unit manager of the area that I have not had any code blues and RRT before, I felt like the charge nurse will assign me to the patient, so that I would be able to observe. The good thing was that I am still a buddy nurse to my preceptor, Maam Ivy Jasmin. I am so amazed with my preceptor awhile ago. I witnessed how she talked to the patient and calmed the patient by ‘whistling breaths’ and how the equipment needed were prepared. I tried to help. But I was frozen. I don’t know how should the process go. The other nurses were helping us too. Thank God.

While preparing, there is the presence of the respiratory therapist too who maneuvered the machine (I forgot the term), where the patient was hooked to breathe oxygen. There was a plastic drape on top of the patient from the Operating Room or delivery room? Not sure. I witnessed how the Anesthesiology consultant injected via slow IV push Propofol (if I am not mistaken) into the heplock of the patient. The Anesthesiology doctor intubated the patient with a guide machine. Mind you, I was really anxious even though it was just an RRT and not code blue. My anxiety somehow lessened when the Anesthesiology consultant talked to me and when he handed me the posi flush for flushing before he injected propofol.

When I am anxious, sometimes I cannot hear clearly what the person beside me is saying. Do you feel the same? Then, I got back to my senses. I needed to learn about this. So that I would be able to know when it happens again in the future.

I have a different level of anxiety in stressful situations, but then I am learning how to keep myself calm, which was the advice given to me by sir Jay, the Assistant Nursing Unit Manager of the area. “Stay calm” that’s what he texted to me before the day transpired. I am glad and grateful with the presence of my preceptor Ma’am Ivy awhile ago. I know that I still have a lot to learn.

After the patient was intubated, the patient was inserted with nasogastric tube (by MROD). He was inserted with indwelling foley catheter and was hooked with fluids such as Precedex 400 mg (2 vial) in 100 ml NSS and Fentanyl in 50 ml D5W by ma’am Ivy.

The patient was breathing with the use of the machine.

I just observed the RRT, then I was assigned to my other elderly patient that is quite stable enough, I was a buddy to ma’am Val afterwards. She is amazing and assertive. I am amazed that she is already a nursing unit manager at a young age.

While I was with my elderly patient, I told him my name. I said that my name is “Jaea”. His hearing is not quite well, so he validated if my name is “Julia”, because that’s what he heard. Then, I told him again, “No sir, I am Jaea po”. Then he said, “Julia?” Hahaha. Simple joys of being a nurse. I inserted an IV line to him on his left hand and administered a “to start” medication. I am glad that he can eat independently. Then, I asked my patient if he would allow me to pray for him. Then he let me prayed for him before my shift ended. I was worried if he could hear my prayer. I held his right hand and spoke the words, as the spirit led me. After that he said, “Di tayo papabayaan ng Panginoon” (God won’t abandon us). I was touched when he said that to me. I learn from my patients too, you know. Sometimes, I question myself why am I a nurse in the hospital, when it is so difficult..

Just like with my case, I was diagnosed with depressive disorder by the doctor since 2013. Right now, I am stable with low dose medication compared from years ago. Don’t worry, I am cleared by my doctor that I am fit to work. Sometimes, I still feel lonely, especially now that I am living independently in Manila. I needed to realign my thoughts every day, to battle the negativity in my mind. I would read the bible in the morning and in the evening before I sleep, just to be reminded of God’s promises to me. God is faithful forever and ever. I believe. You know, the good thing about being a nurse is that it somehow distracts me from my negativity whenever I enter my patient’s room.

I have not reached the level of an expert nurse yet, but I am hoping and praying to be a nurse who has already mastered the skills that a safe nurse should possess. Every time I commit a mistake, I pray to God to help me accept it all with humility, even when it hurts. If I will evaluate myself, I feel like I have already improved from before. Little by little everyday. Thank you God.

I am learning everyday. It never stops. Battling the unseen war, the unseen enemy. I believe God is with me in this journey. He knows everything: the past, the present and the future.

Good night.

Nahum 1:7 ” The Lord is good, a strong refuge when trouble comes. He is close to those who trust in him”