nurse2033 16,384 Views
Joined Jun 6, '07.
Posts: 1,891 (46% Liked)
This practice reeks of the worst kind of bean counting BS. Especially in the ED, where by definition an MCI could occur at any time. At my previous job, we would be overwhelmed by a single full trauma activation because they would downsize. I believe they assume a level of liability for bad outcomes if staffing is low. Let's say a 5 patient crash came in, we simply would have to hope they wouldn't die. It made for a low level of stress I didn't like. This is one of the reasons I quit. Then they would call me to come in on my off days because they were short. I laugh at their incompetence and shortsightedness! Ha!
At my last, last job, they called me off so much I couldn't take a vacation after 14 months of never taking a day off because I had no PTO. I solved that problem and got my vacation- I quit! So all the money they "saved" by sending me home was spent on training a new person.
I believe I have a "contract" with the job for them to provide me predictable work, and me to do it. I'm a professional. I can't "downsize" my mortgage or health insurance payments. Calling people off is basically treating them like they are on call at all times, or, as an expendable component. This leads to zero loyalty. A better alternative, is to offer anyone who wants to go, to go home. Or, to offer you other work, such as administrative, so you can get your hours. It's a tempting solution for managers, but like other easy fixes, it creates a lot of problems like low retention, low loyalty, and low quality work.
What no Excelsior? They are one of the oldest, best, cheapest, and largest.
I find it interesting you that you got dinged for your user name... It is telling that you have received the same feedback from multiple sources. In my experience it's probably valid. I did a little research on know-it-all and I recommend you do the same. It's not about knowing, it's about how the other person feels. You can be smart and knowledgeable without making the other person feel stupid. This is where I would focus. Think back about something you might have said that was condescending. Good luck.
The standard of care in EMS should be the availability of ETCO2. This is measured with a special nasal cannula that can also deliver oxygen. This is the best way to measure ventilation. I personally have seen patients with SaO2 of 98% and a CO2 of 50+. EMS was mistaken to withhold oxygen because of SaO2, they should be guided by clinical presentation. An OPA or NPA should have been placed if intubation was deferred from some reason. Hyper oxygenation is not harmful in the short term, as one poster alluded. So when in doubt, in the ED, place oxygen. Studies have shown poorer outcomes when pressure of oxygen is >200, for example, especially in head injuries. But these are patients on 100% oxygen for long time periods. I agree the patient may not have needed oxygen, but you were not wrong to consider it. As for asking EMS their thought process, it is usually best to move forward and treat the patient the way you feel is appropriate. Good luck!
Online!!!! Big fan...
Dude: Buck up. It sounds like most of this is coming from you. Don't use the words murse, male nurse, or lowly. Perhaps because I became a nurse in my 40s, I haven't had the tiniest issue with being male. If your girlfriend doesn't support you, she's your problem not your girlfriend. Are you able to socialize with other groups than doctors? You're a team, you should be socializing with all your friends. Any friend of mine who intimated, or just stated, that I was a fool for helping the sick, injured and dying, instead of making big bucks, would no longer be my friend, just saying. You are right, all those money grubbers will never experience what we do in nursing. Women like a man who is confident in what he does, so leave your doubts crumpled up on the floor. Good luck.
MUST get blackout curtains, you can make them. This discovery was a life changer for me. This is for good sleep. Get to bed immediately after your shift, get up at 3 or 4, then exercise. Use white noise or ear plugs to sleep during the day. But seriously, there are only some people that can do it. Good luck.
Sometimes you bite off more than you can chew, then you just chew it and keep going!
Talk, Discuss, and Share your experience at your favorite Nursing School.
Advertise With Us