Breaks in the ER

Repat · Sep 2, 2004

I have to say something here. Those of us who suck down food and don't take breaks but relish the adrenaline are doing us all a disservice. Sure, you are probably an employer's dream, as long as no errors are made due to exhaustion, or overwhelming numbers, or whatever. The American Medical Students Association spoke up loudly about unsafe working hours, and they won some concessions. We have to say out loud that it isn't right for people to run 12 hours straight without even going to the bathroom. It's dangerous. Period.

angel337, MSN, RN · Sep 2, 2004

I have to say something here. Those of us who suck down food and don't take breaks but relish the adrenaline are doing us all a disservice. Sure, you are probably an employer's dream, as long as no errors are made due to exhaustion, or overwhelming numbers, or whatever. The American Medical Students Association spoke up loudly about unsafe working hours, and they won some concessions. We have to say out loud that it isn't right for people to run 12 hours straight without even going to the bathroom. It's dangerous. Period.

you are absolutely right, it is dangerous, but it is also dangerous when you work in a high acuity, level trauma I ED and just about EVERYTHING that comes through the door is chest pain, gun shots, possible bowel obstructions and horrible GI bleeds and everyone is busy with their own patients. trust me, its one of those things where you have to be there to believe it. just when you think you can get a break, something else happens and this is why where i work, a break for us is only about 20 minutes. this is also why i know i only plan to stay a ED nurse for maybe 5 years, just to get the experience before i move on to a different style of nursing. some ED's don't have the same level acuity that we do and i have worked in some that were heaven compared to where i am now. but i do like my work and yes, nurses do need to speak up, but when patients are having acute MI's before your eyes its hard to say "ma'am i know your husband is having a heart attack, but i need to eat". or you have a febrile seizure 8 month old that the parents just drove to the front of the ED door. alright i better stop, i have to be at work in an hour and i 'm already stressing myself out :)

ednursedee · Sep 2, 2004

you are absolutely entitled to your breaks. i work a 7p-7a shift, and there are not enough nurses for someone to watch my patients while i leave the unit, but i usually do get to eat. if it's been a horrible night and i literally gulp a slim fast bar as i'm running down the hallway (yes, i've actually done this) then i make a note that i did not get my lunch so that i will not be docked 30 minutes for it. during the day at our er, the day shift has designated times for lunch, others on their team will watch their patients. same goes for evenings. we just don't have all the resources on nights to make sure that people are able to leave the units for lunch. our cafeteria closes at 7pm anyway, so it's not like we'd have somewhere to go, besides the breakroom.

[color=#2f4f4f]i was an er nurse for a few years before i finally developed this mentality. i've also gotten to where i go outside for "fresh air breaks." i don't smoke, but i have friends who do. when one goes outside for a smoke break, i follow on out after her/him and stand outside, chat, and just get away from the phones ringing, the call bells going off, and the monitors alarming. i think it's really incredible that we work in a field where we tell everyone to take care of themselves, help those who can't take care of themselves, and we are looked down on for taking care of ourselves. are there any other professions where you are expected to hold your urine in a full bladder for 12 hours and not eat the entire 12 hours you are on the clock? right now, i can't think of any. why should we feel bad or guilty or be looked down on because we are human and we have to eat and pee? let's face it, there are always going to be iv's to start, meds to give, people to discharge/admit, and orders to take. all those things will still be there after you get back from your pee break.

[color=#2f4f4f]where i work, on nights we tend to eat at the desk, yep, i know it's wrong, and we'll all get in trouble one day, but we do go back to the break room when we can. if you have a cafeteria that's open while you're there and you want to go to it to eat so that you can leave your unit, maybe you can develop a rapport w/ one of your co-workers. work out a system where you watch her/his patients and he/she can watch yours during lunch. we had to do that when i worked in memphis, because there was just no way for the charge nurse to relieve everyone for their breaks.

[color=#2f4f4f]as far as your co-worker getting upset because you were leaving at 7, and your shift had ended at 6, well, she needs to get a life. good lord, as someone else put it in an earlier post, "that's why we work in shifts!" i tell this to my co-workers when i get report from them and they apologize for something they haven't done. you do what you can while you're there and the next shift can pick up where you left off. it took me many years to finally learn this. i would always stay late...at least 30 minutes after my shift left...because i felt like i "just had to get this one more thing done." well, there's always going to be "just one more thing" to do.

[color=#2f4f4f]just continue to do your best and stand up for yourself. i hope they will soon stop rolling their eyes at you and making you feel bad. good luck!

tiredfeetED · Sep 2, 2004

Im charge in the ED..7-7p. I make sure everyone gets a quick morning break..because..lunch sometimes comes late.. The float nurse (if we have one) covers lunch and I usually break some nurses too for there 30 min lunch. If we are slammed..Ill call out the clinical sups. to help cover..Afternoon breaks rarely come unless we are not busy. I seem to go last to lunch, got to make sure my staff is content first! Ohhh and for your Code situation...takes a Doc, 1 RN maybe 2, RT and someone to do compressions...and someone to chart. Unless your relief is not there..Go home, your 12 are done!

Rena RN 2003, RN · Sep 2, 2004

our dayshift RNs have a designated 1 hour lunch and very rarely do they not take the full hour. it's good to get off the floor and regroup.

i work nights and we have no designated 1 hour lunch period. we haul *** until things slow down and then we break to eat (usually at the nurses station even though we know it's not the most appropriate thing to do). rarely do we ever not get to eat. that being said it also may take us 3 hours to finish a burger and fries.

i smoke so it isn't that important to me that i get a full uninterrupted 1 hour lunch. i would rather take it in 5 min incriments and my cohorts in crime go along with me. at the same time, i will stop one of my nonsmoking peers and say "hey, it's beautiful out tonight, take 5 or 10 and i'll watch your people." sometimes they take me up on it and sometimes not but at least the thought is there for them.

it doesn't sound like your problem in your ED is related to taking breaks at all especially since you stated that your peers are getting their breaks too. i would look somewhere else for the cause of the eyerolling.

have you ever thought about just asking them what the problem is when they do this? the best way i have found to cure a problem is to go directly to the source and ask questions (in a nice calm manner indicating that you would truly like to fit in with the ED crowd). ER nurses are a mouthy bunch (in my experience) and the don't often hesitate to tell ya how they feel.

best of luck in the ER.

MrsWampthang, BSN, RN · Sep 2, 2004

In our ED, we automatically get paid for the full 8-12 hours with no docking us for any type of lunch/dinner break. I guess because it's considered that we won't get those breaks. Other floors do get breaks for lunch or whatever and it is built into their time, they work 8 and 1/2 or whatever so they get paid for the full time they are supposed to get paid for. On days one of our charge nurses is really good about telling us to go get something to eat, even if we may not get to eat it right away, plus they started letting the food cart stop in ER so we could grab something from it instead of having to go to the cafe. Our cafe is open on nights with a limited menu, but again, we go down, get our food and come back. We always eat at the nurses station except when JACHO or the health department is in house. I guess I am just used to not clocking out to eat, since I have worked in EMS in one form or another since 1987, although at least when I was on the ambulance we could go out to eat, even if we did have to get up and leave to go on a run. (don't miss those days at all :chuckle ) I wouldn't know what to do if I worked in an ER where you actually got to leave and go eat for 20 minutes or more. I would be in HEAVEN!!!!! I have to admit, there are times. especially at night when we will go an hour or more without a patient, so we do "get breaks" per say, (last night was NOT one of those nights however, left dayshift with almost a full ER! ) Again, good luck in the ER. Keep chugging away and I'm sure you'll be fine.

Pam :)

TraumaGuy · Sep 2, 2004

I understand i work @ a Level 1 Trauma Center and i am always either in acute care or on one of the trauma sides. But one thing i must say good about where i work is that the charge nurse and/or sec. will page overhead for first lunch, second luch and so on till everyone goes on break, it is a great system.

needsmore$ · Sep 3, 2004

you are absolutely entitled to your breaks. i work a 7p-7a shift, and there are not enough nurses for someone to watch my patients while i leave the unit, but i usually do get to eat. if it's been a horrible night and i literally gulp a slim fast bar as i'm running down the hallway (yes, i've actually done this) then i make a note that i did not get my lunch so that i will not be docked 30 minutes for it. during the day at our er, the day shift has designated times for lunch, others on their team will watch their patients. same goes for evenings. we just don't have all the resources on nights to make sure that people are able to leave the units for lunch. our cafeteria closes at 7pm anyway, so it's not like we'd have somewhere to go, besides the breakroom.
[color=#2f4f4f]i was an er nurse for a few years before i finally developed this mentality. i've also gotten to where i go outside for "fresh air breaks." i don't smoke, but i have friends who do. when one goes outside for a smoke break, i follow on out after her/him and stand outside, chat, and just get away from the phones ringing, the call bells going off, and the monitors alarming. i think it's really incredible that we work in a field where we tell everyone to take care of themselves, help those who can't take care of themselves, and we are looked down on for taking care of ourselves. are there any other professions where you are expected to hold your urine in a full bladder for 12 hours and not eat the entire 12 hours you are on the clock? right now, i can't think of any. why should we feel bad or guilty or be looked down on because we are human and we have to eat and pee? let's face it, there are always going to be iv's to start, meds to give, people to discharge/admit, and orders to take. all those things will still be there after you get back from your pee break.
[color=#2f4f4f]where i work, on nights we tend to eat at the desk, yep, i know it's wrong, and we'll all get in trouble one day, but we do go back to the break room when we can. if you have a cafeteria that's open while you're there and you want to go to it to eat so that you can leave your unit, maybe you can develop a rapport w/ one of your co-workers. work out a system where you watch her/his patients and he/she can watch yours during lunch. we had to do that when i worked in memphis, because there was just no way for the charge nurse to relieve everyone for their breaks.
[color=#2f4f4f]as far as your co-worker getting upset because you were leaving at 7, and your shift had ended at 6, well, she needs to get a life. good lord, as someone else put it in an earlier post, "that's why we work in shifts!" i tell this to my co-workers when i get report from them and they apologize for something they haven't done. you do what you can while you're there and the next shift can pick up where you left off. it took me many years to finally learn this. i would always stay late...at least 30 minutes after my shift left...because i felt like i "just had to get this one more thing done." well, there's always going to be "just one more thing" to do.
[color=#2f4f4f]just continue to do your best and stand up for yourself. i hope they will soon stop rolling their eyes at you and making you feel bad. good luck!

excellent post dee- couldn't have said it better

anne:)

LMPhilbric · Sep 4, 2004

ER is team nursing at its finest. That means we all help out when an EMS patient comes in, we all help with traumas/codes and we all cover each other for breaks. Yes, there are some nights when no one gets a break. If no one gets a break, then we get paid for not getting lunch. If other people are getting a break, then you should too. Sometimes you just have to say, "I'm going on break." When it's a really bad night, our docs feel sorry for us and they buy pizza for us. The only thing that has a shorter life expectancy the pizza in the ER is a fruit fly! When I first started in the ER, I missed a lot of breaks because I was usually waiting until I got rid of all my patients. It didn't take me long to figure out that if I waited until everyone was gone, I would probably never eat! You have to stand up for yourself. Good luck!

veetach · Sep 4, 2004

I work in a union hospital. We DO get breaks, by contract we are supposed to have 75 minutes worth of breaks divided throughout the 12 hour shift. Those people who work days get their breaks. No one has a problem with it, those people who work nights usually take their dinner break (probably 30 minutes) and then, if there is down time they dont take any more. If there is no down time however we make sure everyone gets their breaks, it really helps with the stress level and fatigue of the staff.

I have been called off of my break and had to take it in increments of 10 or 15 minutes but I seldom miss a break. If we have to work through them, we get paid for it.

TinyNurse, RN · Nov 6, 2004

When I first started as a nurse in the ER, My preceptor taught me that "it is important to take a break and get away from the ER for a few minutes" We never took a full break, but took one nonetheless. I moved on to a very busy hospital where everyone took breaks and other nurses covered for them. I still like my first preceptor's advice...............

my first travel assignment and last one.......... I worked 12p-12a......... I would go to work... and cover EVERYONE'S lunches. no big deal. But when it came time for me to take a break around 5 or 6pm( whenever my patients around that time were worked up/taken care of) Everyone forgot about me. I was not "allowed" to take a break. So I would end up working 12 hours without a break. This completely sucked since I totally believe in my very first preceptor's philosophy of "everyone needs a few minutes away from the ER" NOW,,,, I've moved onto a level I and I just finished the sit down orientation ....... but this hospital has an initiative to "TAKE YOUR BREAK". They have a whole program about taking your break... I know this is in sit down orientation, and I haven't been on the floor yet, but I like the idea and I hope the floor also lives this philosophy.

yeah, i've stayed late to get my patient up to the floor, yeah i've stayed late to give that first dose of pain meds to a patient i've built up a rapport with.......... that's just understandable. I most likely wouldn't stay an hour over though.

Thanks for letting me tell my story. xo Jen

Victoriakem · Nov 8, 2004

I agree with smokers & their breaks. They always have time to go out to smoke while the non-smokers keep on working. One place I worked had a solution. When the smokers would all go out en masse for their "Marlbuterol" tx, the non-smokers would time how long they were gone & then announce when the smokers returned, that they were all taking a break too & stay off the floor just as long. It didn't take long for the smokers to complain that they were left with all the work to do while the others took their break. Ahhhh. Really!?! It is frustrating but then I don't have a habit harder to break than heroin. Wonder if I started a firestorm here.....

During my ED orientation, an old ED nurse said to us, "Now you're in the big time. No potty breaks, no lunches, maybe a little water but that's it."

My advice is to get off the floor whenever you can to regroup. When I worked nights, I rarely left the floor & would eat at the desk. I still do now that I'm on days, because I can't be bothered to leave the floor or am too busy.