I work in a Level 1 Trauma Center in a growing urban area. Our nurses can be separated into two groups: Newer nurses (Less than 3 years of ER/Nursing Experience) and Experienced Nurses. Our manager has this belief that that newer nurses should be exposed to the harder assignments like Charge, Triage, and Psych. I fall into the newer nurse category, I've worked in that department for 2 years and before that I worked on Tele/Long Term Care for 2 years. None of my experience prepared me for this. However, management keeps assigning me to Charge or Triage and my peers/management keep saying I'm doing a good job.
I don't feel like that at all, every day I come back mentally exhausted looking back at every choice I made thinking I could have done it better. Every time I have to assign one of my nurses their 5th or 6th Patient it kills me inside because I know it's unsafe but we simply have no nurses. I've at times taken an assignment only for upper management to tell me I can't take an assignment as ER charge (bizzare as hell). I try rounding on all my nurses to make sure they aren't drowning but sometimes I can't leave the high acuity section because the staff need me there to make sure things don't fall apart.
Two questions for the folks that managed to get through my little rant there:
1. How do you improve as being a charge nurse?
2. This is a scenario I dealt with as a triage nurse. I had a 37 y/o Male no prior medical history come in with a complaint of left arm numbess/chest pain with an onset of 1 hour prior to arrival with no causative event. On examination he totally had paresthesias on the left arm along with a decreased grip/shrug. But his chest pain wasn't chest pain, but a left shoulder pain with no real aggravating factor. I ask one of the ER attendings to screen the patient to rule out calling the stroke team, my gut instinct was leaning towards a shoulder impingement due to the pain with a lingering possibility being a stroke. The attending flat up told me, up to you to call the stroke alert, because of the lingering doubt I called it. The stroke team after their workup wrote it off as a radiculopathy. If you were in my shoes, would you have called the stroke team at that time?
Kuriin, BSN, RN
967 Posts
I wasn't telling you to call a stroke alert for simple paresthesia. I was simply stating that paresthesia would be minimally a 1 on the NIHSS. =P