Very Scary

  1. OK...I have only worked in one ER, so I need some feedback on this. Last night we had 4 nurses call out which left us with only 4 nurses in core at 7pm. Well I realized there was a crit that NO ONE was following with a BP of 70/32, which was dropping. So I begin following her and her BP drops further and gastric lavage is positive. She has a hgb of 6, INR 17 and she is completely yellow with hepatic encephalopathy. I need orders like yesterday. Except that the entire staff of the ER was at the bedside of a pt who was " seizing" (normal vitals, normal CT scan, normal labs, psych history). So in my opinion my pt was way sicker but for some reason everyone freaks out when they see a seizure. The ER doctors already endorsed the pt to the residents so they won't give me orders and the residents are ALL at the bedside of this seizure guy. The remaining 3 nurses are at the beside of the seizure guy, I am at the bedside of this yellow lady and no one is following the other pts. Call me crazy, but something seems very wrong. :angryfire
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  2. 8 Comments

  3. by   petiteflower
    That's when you grab the doc by the collar and drag him in to look at the patient---or do as I did and look him in the face and say very calmly--are you going to let this patient code before you do something? Usually that will bring them running.
  4. by   veetach
    I would have also said "this patient will be going into cardiac arrest unless I get some orders and a doc over here, NOW!"

    I am lucky I guess, in our dept when an RN shouts she needs help everyone drops what they are doing and runs...
  5. by   RNin92
    Quote from petiteflower
    That's when you grab the doc by the collar and drag him in to look at the patient---or do as I did and look him in the face and say very calmly--are you going to let this patient code before you do something? Usually that will bring them running.
    I LOVE that...speak calmly...

    :chuckle

    We are pretty fortunate here, too.
    Most of our docs come pretty quickly when I ask them to join our party!
  6. by   NurseJacqui
    In my opinion, an ER should be able to handle more than one emergency at a time!!!
    Last edit by NurseJacqui on Feb 25, '04
  7. by   2ndCareerRN
    You know, you had me with until you made this post:

    But the problem was that the stupid charge nurse who doesnt know her ass from her elbow was interfering with my getting the docs to the bedside. In my opinion, an ER should be able to handle more than one emergency at a time. What would Little Miss Charge Nurse have done if a code come in???
    If "Little Miss Charge Nurse" is interfering with getting the docs to the bedside of your patient, it is up to you to drag one of them to your patient. Being assertive is one of your best friends in the ER setting.

    You ask, what would she have done if a code came in? What would you have done if a code came in? I would be willing to bet she would do the same as you. Hopefully you would have become a team for a short while and provided the care to the code. Maybe not, perhaps your ER is one where teamwork is more of a phrase than a practice.

    I may be reading more into this post than is there, but after working in a whole lot of ER's as a traveler I have seen a lot of personal feelings towards each other spill over into the professional arena. When that happens, everyone loses, even the patients.

    bob
  8. by   NurseJacqui
    I DID drag the docs by the collar, so to speak. Thats what caused the problem. And I am a team player. Most of the nurses I work with are. And I would never interfere with another nurse trying to get a doc to the bedside with a pt that critical. :angryfire
  9. by   NurseJacqui
    The nurse I am referring to by the way has only been a nurse for about 2 years.She is one of those people who always looks busy but never does anything.If she doesn't know how to do something, she avoids the task by delegating it, instead of learning how to do it. It's a problem, especially when the rest of us are working so hard. So please forgive my animosity, for she is a nice girl, but if you are assigned to work with her it is like doing the work of 2 people. I know what it is like to be overwhelmed but if I don't know how to do something, I make it a point to learn how to do it. Everyone assumes she knows how to do things because she is always with a senior nurse and she is never " alone". Well the other night, she WAS the senior nurse. I asked her to check blood with me and she said, " I have never done that before....maybe so and so can help you," Like I said, scary.
    Last edit by NurseJacqui on Feb 25, '04
  10. by   RNin92
    I feel VERY lucky to be working with the crew I work with.

    For the most part everyone works as a team...healthcare IS a team sport after all!!

    And like veetach said...

    in my ED when a nurse yells for help EVERYONE comes running here, too!!

    And by the way, the doc is included with that group of "everyone" :hatparty:

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