Public Service Announcement

[ThrowEdNurse, BSN, RN]

This is my public service announcement. This is directed primarily to non-medicals, floor nurses, ICU nurses, hospital administration and anyone who has an opinion on ED nursing who hasn't done it for at least 1 year. IT'S HARD!!! And, you know all these crazy stories you read? You know? The ones where the pts are attacking us, and ambulating to the nurse's station and popping their own eyeballs out, and the MDs are trying to kill our pts, and the families are bonkers, and the baby mama and the wife of the dead gsw started fighting in the conference room, and bed 24 has scabies head to toe and alzheimers, and the psych pt hung herself from the exam light, and meanwhile the other psych pt stopped masturbating long enough to attach the tech NAKED in the hall like a QB with a football, and nutritional services wants the dinner tray orders at 3 PM (as IF), and bed 3's neighbor is on the phone and wants to know all the medical info on the pt, and new nurse is about to have a panic attack and needs your help NOW, and Dr. Dependent needs you to hold his hand during the suturing of the lac, and evs won't clean the rooms so you have to clean them yourself, and every 500 lb female pt getting lasix refuses a foley, and everyone needs a come to jesus talk before they will let you start their iv, and the drug rep is here for an inservice, and floor killed somebody and is calling a code, and I can't resuscitate the 15 yoa gsw if you won't get off his body, and the tele nurse got attitude when the tech brought the pt up because he needed to pee as soon as he got there (okay??what??), and we are out of clean catches, and none of the rooms have bp cuffs, and the thermometers are all missing, and bed 19 is refusing xrays before pain meds, and security can't count to 1, and no one ran the quality controls on the accucheck machines, and the local no-nursing home is on the phone to give report again on a pt who has probably been dead since yesterday because after all it is friday and nh dump day, and ems is on the wall and tired of holding and bagging the vent dependent pt with a toe sore that won't heal (but that's ok he's bagging himself now to give them a break), and ems is waiting in your room for the pt in svt to be triaged (no it's only ST @ 170...do nhs ever treat fever or hydrate vent dependent pts?), and airmed is waiting on the roof with another burn because a mobile meth lab blew up because they called report to the house sup instead of the ED and she didn't have enough sense to call us and tell us, and a woman came in the front in labor (we don't have OB but she doesn't know that because she received no prenatal care), and bed 8 wants another blanket (geez we are sooo rude), and the dead gsw's wife and baby mama stopped fighting and are now trying to break into the morgue to see his body, and the fire alarm is still going off, and the triage nurse needs help with the high drama pt rolling around on the floor in the front because she is too busy to deal with it, and every stretcher is broken, and the severely demented pt in 11 won't stop screaming and we don't know why, and everything is lining up in a perfectly symbonic pattern just to make our jobs harder/impossible? THIS IS THE NORM!!!! These are every day events. It is more of a rare occassion to have a pt come in , only marginally sick, with great veins, get seen quickly, have an uneventful work up, not have some crazy demands, worse...family with crazy demands, have a full stomach, follow directions, and have manageable pain. Oh, and get a hospital bed quickly. Never, this never happens!! Maybe once a week. Do you people watch Grey's Anatomy or ER? Yeah, they toned it down!! This is what it is like! You think that's bad? Spend four hours in triage!! I dare you, just four! You have no clue. You just have no clue. That's it, no arguing. You can have all the righteous opinions you want, but at the end of the day YOU ARE CLUELESS! You think you know? You did some wimpy 8 hour shadow shift? You passed through on foot one day? You would cry! YOU WOULD CRY!!!! NO I DON'T KNOW WHAT THE STUPID CT SAID! NO I DIDN'T CHECK HIS SUGAR BEFORE LUNCH! NO I DIDN'T ROLL AND CHECK FOR BED SORES! IS THIS A JOKE? ARE YOU PEOPLE KIDDING ME? YOU'D CRY!! CRY!!!!

:madface::madface::angryfire:angryfire:angryfire:madface::madface::madface:

yes, I feel marginally better now.

If you disagree, allow me to direct you to the red x.

[prmenrs, RN]

OUCH!! I hoped that helped!

Truely, I feel for you, and, no, I haven't even done a "wimpy 8 hr shadow". I'm convinced. And it's too darn bad that the PTB don't get "it", and probably never will.

[pererau]

Do you feel better now?

Having worked the floor and ER as a CNA and now the ER as an RN, I have seen both sides of the picture, and I agree with you in principle, though I wouldn't take it quite so far. Working in the ER is worlds different than the floor and, I have to say, considerably more difficult. Honestly, ER nurses should be making more money, but unions will never allow that.

With that said, from the other side of the coin, the floor nurses are not just sitting around smoking cigars and playing poker. One thing that a lot of ER nurses don't realize is that the floor nurses have 4, 5, or 6 (or even more at night) patients, many of whom are the crazies that we sent their way an hour ago, and while they don't have as much hands-on drama, they do have a load of paperwork and red tape hoops to jump through that makes their jobs pure misery. They want to know about the CT results and bedsores, because they have 3 double-sided forms to fill out for every little problem so that the hospital can get reimbursed/accredited/not sued.

I've come to terms with the fact that there will never be the perfect transfer. Every time I take a patient up to the floor, either they find something that I didn't do, or I sit and wait in the room for 10 minutes only to find that the assignment was changed or the nurse didn't think to get an IV pole or a tele unit, or they tried to put my female in with a male roommate or some stupid business that keeps me away from my other patients in the ER. One day I'm going to take a patient to the floor and the nurse will be right there ready to go with all the supplies needed and magically I will have had time to do all the I&Os and skin assessments and fall risk scores and I will have detailed information about all the labs and radiology reports and will be able to quote, from the top of my head, the patient's meds and allergies and last 10 blood pressures.

Until that day comes, we just do the best we can and try to remember that although we are busy with some of the people that even Jerry Springer wont accept, they are busy with the paperwork and guidelines created by even crazier people in the joint commission.

[ACRN06]

Ah! So true! From both ThrowEdNurse and Pererau.

To Pererau: I too have worked both sides but I don't think this was as much saying "Other floors/units aren't working as hard as me" as it was saying "don't pretend like you know the HALF of what its like down here until you're in it for long enough to understand, and to have realistic expectations-- esp during report" You do put it well in describing the different kinds of hell each deals with. I think some of my fellow ED nurses that haven't worked on the other side don't have as much sympathy/understanding because of it.

To ThrowEdNurse: I feel ya girl... I really do. Hang in there. Great summarizing of the...lets call them "challenges" of a day at a Level I Trauma ER. I specify "Level I" cuz I've worked in others and its a big difference!

I like how you have a 1 year requirement for even ER nurses to be considered able to understand. Its so true. If you're not stressing too, you obviously have no clue whats going on!

[Larry77, RN]

ThrowEDNurse....I think I love you :)

[Medic09, BSN, RN, EMT-P]

ThrowEDNurse....I think I love you :)

+1

But you are going back on your meds before next shift, right?

[Penelope_Pitstop, BSN, RN]

floor killed somebody and is calling a code

Or the ED did a great job of keeping the "no one dies in the ER" rule and the patient died as he or she arrived on the floor.

[ThrowEdNurse, BSN, RN]

+1

But you are going back on your meds before next shift, right?

Geez, was just so busy yesterday, completely forgot to take them!!!

[ThrowEdNurse, BSN, RN]

Or the ED did a great job of keeping the "no one dies in the ER" rule and the patient died as he or she arrived on the floor.

I prefer my pts to die in my room as I don't find calling the coroner and organ donation that arduous of a task. Sometimes, the physical stress of moving the pt upstairs is all it takes for them to follow the light. Sorry you have to fill out an extra piece of paper, but while you are doing that, I am saving your next pt's life down stairs. That said...RED X, RED X, REDX !!!!!

[ThrowEdNurse, BSN, RN]

ThrowEDNurse....I think I love you :)

Think???? Oh, come on! I swear, men and commitment...

[Purple_Scrubs, BSN, RN]

I have one question for the OP. . . do you love it despite all the *****? I love you ED nurses - no BS, tell it like it is. I wish I could do what you all do.

(Just re-read my post and I am not being sarcastic, just in case it read that way, I really do have 100% respect and admiration for what you guys and gals do.)

[ThrowEdNurse, BSN, RN]

I waffle. I love it sometimes and sometimes I hate it. The days that I hate it though are influenced by factors beyond my control. Other people aren't doing their jobs properly and making my job even harder or other stuff like that. It's hard enough without other people not doing the minimum their job requires. Or days where it's ridiculous. We may be unsafely short staffed and there is no help from hospital administration. I guess I love it more than I hate it though. It's just real easy to burn out.