So I'm adjusting to working in the ED and really do enjoy what I do for the most part in terms of the actual job and the care I provide. I enjoy the fast paced and collaborative nature of ED work, and I feel like I've learned so much and now want my CEN and Trauma certification.
What's the problem, you ask? I'm normally a very relaxed person, but the last 3 months I've been overloaded with stress - experiencing nightmares, losing my hair and having my chronic psoriasis flare up all over my face and hands! It's gotten to the point where I actually dread going into work if I'm working the acute area and not trauma or critical (where the complaints are actually valid)
What I find extremely difficult about my ED in particular is the patients. 9 times out of 10 they are nasty no matter what you say or do. My ED is in an inner city hospital with a very low income patient population. We're a Trauma Level II hospital and see a lot of gunshot/stab wounds, sexual assault, drug overdoses, etc. ETOH and drug abuse runs rampant, a good 1/3 of our patients are prisoners who verbally abuse you or harass you while you're just trying to do your job. I get threatened or cursed out on almost every single shift.
Of course there are the regular complaints about wait time - people lying to my face saying they've been there 8 hours when I know from their chart they were triaged less than an hour ago. But then there are the drunks peeing all over themselves, screaming for a sandwich, calling me a ****** when I explain we don't have any food and then demanding I go across to Peds to get them some juice. Then the abd pain people who are no joke, sleeping or eating right there in no distress at all, complaining and complaining that they're in so much pain and, oh, they also need a Dr's note for work. Then the drug seekers who claim they have a history of sickle cell and are experiencing a crisis, then they get irate after you explain you can't give them more than the 6u of morphine and 4u dilaudid you just gave them... and then you get the CBC back and their WBCs are 100% normal and the pt is still saying they're in pain as they're nodding off in bed. the guy who comes in claiming he missed his methadone dose today, doesn't have his clinic card to confirm his program dosage, and after waiting an hour claims to now have chest pain as he's sleeping in bed (really knows how to work the system)... the people with asthma who come in reeking of cigarettes, they take a couple of treatments and walk out before even being seen by a Dr., the confused elderly woman who has no idea why she's in your ED other than her daughter just "dropped me off" right outside...
I have seen patients physically assault each other, elderly patients just abandoned there by their kids, patients lying about sexual assault to get people in trouble, drug seekers, the same ETOH patients every. single. night.
I know I'm a good RN, I don't have a lazy bone in my body, I know I do my job well, and I shouldn't have to require the patient's approval, but for some reason it just makes me wonder why I do what I do - why I voluntarily go into a place to work my @ss off and to only get grief from patients in return. ?!?
It's a large city hospital too, and I so don't want to end up like some of the other nurses - absolutely jaded. How do I not care enough to let the stuff get to me but still care enough to provide good care to everyone?