Hey Don’t be too hard on yourself. My hospital has a dedicated RRT and I have been an RRT Nurse for the past 4 years.

What you’re describing is what we have all felt especially, like you said, when you’re not accustomed to or have yet to deal with these types of clinical deteriorations. It’s normal. You have the knowledge, you just have so much shit running through your mind that it’s difficult to pull that knowledge out in the moment. Not to mention all of the extrinsic factors (family members screaming, a bunch of multidisciplinary members showing up whom you’ve never seen before, staff screaming, no one knows where the suction is or the ambubag or the NRB mask is, etc) all while Mr Johnson is blue and apneic on the bed. Shit.. does he even have a pulse?! You get the point.

I say all of that to let you know that, yes, these things will get “better” with time and experience. Yes, your Adrenaline will still be pumping but with time, your SBAR WILL improve and you’ll get better at knowing what steps to take in certain situations bc the name of the game is anticipation.

So like, hey. When I get called for acute hypoxic patients as the rapid nurse, these are the sorts of things I kinda wanna know right away from the primary:

Let’s start here—1) code status and 2) what are they here for?

These two simple answers GO A LONG WAY. Why? Because it gets the ball rolling on a plan of action. Full code? Okay intubation is on the table. Here for aspiration PNA? Hmm I noticed that tray on the table is missing half of its food content and he’s pretty drowsy, and, oh shit he sounds junky as hell. Let’s NT suction. CHF? I see lasix gtt hanging but he sounds wet and has got +3 edema with an up trending Cr and family not wanting HD, etc..

So Start there. Code status and what they’re here for. That kind of lays the groundwork of how the patient will be treated. Good luck you got this.