Rant about horrible shift

Specialties Emergency

Published

I'm a new grad in a small community ER. I've been on my own for about 1 month now and so far it's been pretty good. I know I have areas I need to work on but I feel like I've been able to handle the assignments so far with little difficulty. I especially know when to ask for help, or when to offer help if I have free time.

Last night was a cluster-**** of a shift. I showed up and was assigned Fast Track, so I started over there and within 30 minutes was told to shut it down because two nurses didn't show. I shut down fast track and pulled IVs out of patients and then went over to the main ER. By now it was 8 pm.

I literally walked into a code and spent the next thirty minutes helping with a code that had way too many people and very little leadership. The charge nurse and the pt's nurse actually go into a fight in the middle of the code because the pt.'s nurse didn't listen or agree with what the charge RN (who was running the code) was saying!

By the time I actually got my assignment and got to assess my patients, it was nearly 8:45 pm! All of my patient's were pissed because they had to wait, I had one complain that just because there was an emergency code didn't mean that someone shouldn't have given her pain medication! Then all the other departments started messing up.

I had a pt. who had been in the waiting room for 2 hours who called 911 to have a paramedic bring her in who was then entered into the system twice, and her various orders and tests kept getting messed up because in my system it showed them as ordered and in Ultrasound and other departments they'd been verbally told they were cancelled.

Then I had another pt. who kept desatting the ENTIRE night and I thought the chest x-ray had been done because the order was put in at 8pm, before I even got the patient. Then the ER doc told me it wasn't showing up in his system and I called x-ray and they said they couldn't find the pt. so they didn't do the order, and hadn't called to ask where the patient was!

It was just a shift where I felt behind the entire night, and just when I was about to get caught up something else would happen. I went on lunch and my charge gave a patient antibiotics but didn't check his allergies first (his list was something like 30 medications long) and luckily he didn't have a bad reaction. The same charge took orders and one of the orders was for another medicine he was allergic to, and the charge told me to give it anyway, just slowly. I called the doctor instead and got it changed, but still!

I know a lot of my frustration is because I'm a new grad and still learning, but this shift was just messed up from beginning to end.

The one nice note? Everyone offered to help me! The other RNs who had free time because they had less patient turn over (I had less acute patient's with higher turnover); the ERMD even pulled me aside and thanked me for my help! He said that he'd been behind the whole night too and he appreciated me looking out for my patient's and advocating for them. So, I feel really good about that. Just--it was an overwhelming night. It gets easier, right?

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Specializes in Emergency Nursing.

Hate to tell you, but no. Lol It really doesn't get too much easier. We all have bad days like that whether you've been a nurse for 30 years or for 3 months. It happens to the best of us.

Good job advocating for your patients! It's always nice when our hard work is noticed by the "higher ups" AND appreciation is voiced. Keep up the good work and pray for a better shift next time!

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Welcome to ER nursing! That is what we thrive on....chaos! You made it through the shift! You've done well!

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Is it normal to think I'm doing something wrong is all the other RNs are offering to help? I don't mind people helping when it's time sensitive or critical, but if it isn't I kind of like to do it myself because that's the only way I'll get faster/more experience--by doing it! But last night all the other RNs offered all the time to help (when they were free!) Granted, they each had an orientee who was doing most of the patient care but I kind of felt like they were judging me because (in my own mind) I wasn't moving fast enough.

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Is it normal to think I'm doing something wrong is all the other RNs are offering to help? I don't mind people helping when it's time sensitive or critical, but if it isn't I kind of like to do it myself because that's the only way I'll get faster/more experience--by doing it! But last night all the other RNs offered all the time to help (when they were free!) Granted, they each had an orientee who was doing most of the patient care but I kind of felt like they were judging me because (in my own mind) I wasn't moving fast enough.

To me, this is encouraging. It sounds like you work with a great team. You will get faster, and one day you will be the one offering to help your co-worker who is drowning. Accept the help, say thank you, and return the favor when you can. That's what teamwork is all about.

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Is it normal to think I'm doing something wrong is all the other RNs are offering to help?

I used to ask the same question because I'm also a new grad, but I've since discovered that this is the team approach that everyone talks about in the ED. I have seen some of our best nurses drowning and needing help because pts are so unpredictable. I had a charge nurse say to me once, "It is a sign of strength not weakness, to ask for help because it is hard to do, and it takes confidence to accept it." In the ED we have to work as a team to survive. You try to do as much as you can but if someone has the time to help, take it. It does not mean you aren't capable, it just helps with the flow.

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Is it normal to think I'm doing something wrong is all the other RNs are offering to help? I don't mind people helping when it's time sensitive or critical, but if it isn't I kind of like to do it myself because that's the only way I'll get faster/more experience--by doing it! But last night all the other RNs offered all the time to help (when they were free!) Granted, they each had an orientee who was doing most of the patient care but I kind of felt like they were judging me because (in my own mind) I wasn't moving fast enough.

I had a hard time accepting help, but have learned that if someone asks and I need it, take the help. It does not make you weaker, it means your co-workers are helping you, not judging you. There are times you get behind due to varied reasons, not necessarily you being slow. Sometimes one area is slammed while another is stagnant. A good nurse "not doing anything" should look to see if others need help, which is what your coworkers are doing.

And as others said, some nights just suck, regardless of experience.

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Nothing wrong with wanting to do it all yourself and get faster, so long as you realize when you need help. If I walk up to a coworker and ask if they're busy, they might help or not. If I walk up and say, "I need help" hey, they might need it too! But when I need help anyone will help. I've had social workers get an old unstable lady to the restroom, and there was no social work on the case.

Some nights, it does not matter how long you have been a nurse, or how fast you are, you are going to drown. Period. That's why we have to be so strong in reassessing, and task management. 4 sick pts? Start with the sickest and hope you wore your running shoes to work ;)

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A- Yes it gets easier. The load doesn't change, but you become faster. You are also able to better prioritize. And, when your skills get solid and you are overwhelmed, there is less self doubt, and a better understanding that it is just a bad situation in which you are doing your best. (By the way- when you get to this point, you actually get a heavier load.)

B- Offers of help are a sign that you work with a good team.

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Specializes in Emergency.

In my er, "need anything?" Is one of the most often said things you'll hear. We also practice the "dog pile on the rabbit" approach when the genuinely sick pt rolls in.

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Specializes in Emergency, Trauma, Critical Care.

I think that even an experienced nurse would have had a rough night with all the nightmares you were dealing with. Some nights are put out one fire and then run to another type of night. And that's when the teamwork is what keeps everyone surviving.

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Specializes in Psych.

I am sorry to say this, but welcome to the real world. Being a nurse requires the ability to change plans and adapt quickly! Because the one thing that you can count on is change

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