I have worked at Bayshore Medical Center in Pasadena Texas twice. The first time was because it was an ICU position near my home and I needed to be near my home to care for my invalid mother. The second time I worked there it was because they hired me after a 10 year hiatus after the death of my mother. I would not take my dog to be flea dipped there. I believe the ER is to treat, stabilize and dispense to either home or a floor in hospital. Many times I would receive clients there that had come in for severe illness like chest pain and after they had been in the ER for hours on end, would be transferred to my floor. When I would receive report I would inquire to diagnosis, labs, treatments etc, only to find out that they had done absolutely nothing. I once received a client that had come in the afternoon complaining of severe chest pain, that radiated up his jaw and severe shortness of breath. He had arrive there sometime in the afternoon about 4ish and was transferred to my floor at 0138am. I asked about his cardiac enzymes only to find out that they had drawn none. Also nothing had been done to treat this man for the classic symptoms of an MI. I told them in ER do not send this patient to the floor without drawing labs and telling me the troponin level. Well, they drew the labs but sent him to the floor without even looking at them, and when he reached the medical telemetry floor, he was in severe distress. After putting him on a 100% non-re-breather mask, I had the charge nurse call the physician, and get a stat EKG. The T-wave changes were indicative that an infarct was occurring. The troponin level was also elevated. The doctor never returned a call. I called the ER doctor and he became nasty and told me to call who ever. The doctor never returned any calls after many had been placed. Knowing what to do in such an instance, I put my license on the line knowing that time is muscle and administered first NTG 0.25mg x3 q 5minutes without relief. He began to vomit and his telemetry show tachycardia with an elevated T-wave and his 02 sats began to drop. I had to open the pyxsis and override it, got 4 mg of MS04, and 5mg of a beta blocker. I administered the MS04 first and although the client was still vomiting, he began to receive some relief from the severe chest pain. Then I administered 5mg IV of Metoprolol. His chest pain began to completely subside, but his next stat troponin level was 7.44 which was indicative of a severe infarct signaling that this man's heart had been irreparably damaged and it was only a matter of who knows how long before his now cardiomyopathy would downward spiral into CHF. When the doctor finally came to the floor I was relieved that he wrote for the orders of the measures I took to intervene. This is only one example of the ineptitude and severely poor care client's receive at this most despicable facility. Also, the nurse manager as is common of them all and others HCA facilities, uses a crack the whip managerial style instead of positive affirmations and teaching opportunities that would increase the likely hood of a positive work environment and lead to more effective client care. The above mentioned incident is only a smathering of many if not all the mismanaged care at this facility. When there was finally an investigation concerning this matter (root cause and analysis) the scapegoat that took the brunt of this incident was of all people the operator. They had to find someone to blame and they chose her because they stated that although the doctors were called for emergency stent placement and did not call back, it was her duty to continue to page them until the stemi team and doctors responded. My advice, avoid this place like the plague! You'll hate the work environment, become disgusted at the apathy of your co-workers and other medical staff and will dream of opportunities to strangle the nurse manager quietly in a room by shoving the "care bucks" they hand out occasionally when they deem you worthy. Several of those and a nickel will get you an "I Care" button. Oh, and the computerized charting system. You are not allowed to put in the actual findings in your assessments as you have computer generated choices to place in your assessment. And you are forever bending over to plug the damn thing in because the batteries barely hold a charge, and if you don't plug it in while administering your medications, it will shut down and everything that you documented will be lost and you will have to dig through trash cans to find the discarded medication wrappers so that you can re-scan your client and then re-scan the medication if it hasn't been thrown in the sharps container. Your back will suffer for it.