Breaks in the ER

[chellet98]

I have a question for all you ER folks.......will I ever get a full breaK in the ER???!!!! I transfered to the ER in July formerly from Med/Surg and postpartum. It has been quite a transition and I am still adjusting. My main concern is that I rarley get a break and when I do the staff usally rolls their eyes or makes a comment like "you will be the only one getting one". What is up with this? It is only 40 min in a 12 1/2 hour shift and I personally need it to re-group and be able to take care of more patients. I understand sometimes it just isn't possible but I feel like that is a staffing issue, not me being "weak". This morning when I announced I was leaving @ 7am (my shift is 6pm to 6am) I was yelled at by fellow staff and the charge that "you can't be seroius, we have a cardiac arrest coming in!" My goodness if I waited around long enough there will always be something!

I am very frustrated and do not feel comfortable here yet, I love the pace of the ER, I work hard and want to stay, any advice here

Chelle

[snoozie]

Unfortunately, the hospital I was speaking of was union...it didn't seem to help.

[Brotherbob, BSN, RN]

I do get at least one break per shift, day and evening, because shifts overlap. When I work night shift, it is worse. Less staff and no overlap means I often go without a full break.

[vampireslayer]

I'm brand new at my ER, big, busy level 1 trauma center, but so far, (a couple months now) I've ALWAYS gotten my break, and it's almost always an hour! I've had many many other nurses at my ER stress to me the importance of taking my breaks. Our paychecks are docked for the time too...so it's assumed you will take it. Everyone's break is scheduled for a fixed time, we don't just take one when things are slow...but we do try to wrap up all loose ends, blood draws, cultures, whatever, before going on break. Then we just look around for someone who'll agree to take our patients for the hour. I have NEVER had anyone roll their eyes at me or refuse to take my patients for my break, never. If I'm giving some high acuity patients to someone, then I might make an effort to come back a little early...just out of courtesy, but it's not expected.

I think it must be something that has to start with management...it's just policy in my ER, everyone does it. One thing is that if we leave to go get food, we are expected to come back and eat in the employee breakroom, so that we can hear the overhead paging system...in case something happens with one of our patients, we'd be able to come out and help.

VS

[teeituptom, BSN, RN]

Unfortunately, the hospital I was speaking of was union...it didn't seem to help.

Unions seldom help, they talk a lot but seldom help.

[teeituptom, BSN, RN]

I also work in a level 1 trauma center and I find myself getting breaks on some days and not getting breaks on others. When I work 7a-7p I always get a break when afternoon shift comes in at 11:00. When I work 11a-11p, I usually get a break when night shift comes in at 7p, but the cafeteria is closed and it is usually vendng machine food unless I packed my lunch. On night shift it is rare to get a break as there is no relief to overlap shifts. On the several occasions where I have worked 8 hour shifts I have never been able to take a break. I usually carry packs of crackers with me to eat and run. I do get docked 1/2 for lunch. If I don't take one, I mark it down as no lunch and get paid for it. I don't really see it as a big deal, just part of the job. Yes sometimes it is my choice. Just the other day, I had just started 1 patient on a nitro drip, 1 patient on dopamine and 1 patient on nipride. I chose not to take a break, just because I wanted to watch my patients myself since I was the one that started the drips, so I just ate my crackers and continued to monitor them. I will however, sit down to start IV's, go to CT scan as often as I can when my legs are really tired, and sit down to chart or when I call report. My preceptor told me, "Sit down every second you get a chance," and I listened. I am usually too busy and wrapped up in my own patients to worry if others are going on break or not. If I can go I do and If I can't go I don't. When I do get a break I usually stay away from the department for no longer than 30 minutes. I can't enjoy it because I am wondering if someone is titrating that drip I just started, so i want to check my patient. I am just anal nd I can't help it. Talk to me in a few years and I am sure my opinion will change since I am a new nurse and just starting out.

My age sitting can be hazardous, and its just to hard to get up, hurts. I usually do everything standing up

[Rio, ASN, RN]

When I get hungry enough I get grumpy. When I left staff (I really never left) and went into management I saw to it that people were fed. Including the staff (tic). Granted there are times when you won't get dinner BUT if you don't you should be getting paid for that extra 3o mins. of work. Back to the food, if the staff, MD/RN/Lpn/PCT/Unit Clerks are not able to get to the cafeteria or get to the break room to sit down and eat a meal in a respectable amount of time then I had the cafeteria send lunch or dinner to them. They then could grab a few bites here and there. A few caveats : the unit had better be busy, no... absolutely NO abuse was permitted. If it was glaringly obvious then all would be chastised and it only took once. If it was not so obvious then the charge nurse was called aside and made aware as they had the authority to order meals. The cost of the meals came out of the budget and staff was aware of the cost. Typical meal was a sandwich/chips/drink and desert. Once an ED attending made a stink "he deserved "better", that happened once and not again. We got what we budgeted for.

There are enough martyrs, we need nurses.

[carachel2]

Gosh....I feel like our charge nurses and managers really need a pat on the back. We have an RN staffed from 12-12 and the first thing she does when she comes on is start subbing for nurses to take lunch breaks. On the rare day that we don't have someone coming in at 12, the charge nurse goes from nurse to nurse letting each of us have 30 minutes.

[LaNorteBellaRN]

My questions for you would be: ARE you the only one that takes a break? If you are then that could be why you get the rolled eyes look. Another thing, do you help your coworkers when you aren't busy and they are or is this when you take your break? One more thing, are you taking your breaks during a time that you have patients and are busy? And, do you expect your coworkers to cover your patient load so you can take "your 40 minute break?" ER nurses are a whole different breed and with the exception of one, the nurses where I work never leave the department for meal breaks for any length of time, let alone for 40 minutes. The charge nurses are good about letting us go to the gift shop or letting the smokers go out for a few, but ONLY if there is NOTHING going on, patients in holding patterns waiting for test results, doctors, etc. Are others in your department getting or even taking breaks? Look around, if the pattern is that your coworkers stay in the department and eat and take only scant pee breaks or whatever, then I would suggest that you amend your behavior to match theirs, or you will be the object of resentment among your coworkers. As I said, ER nurses are a whole different breed, we learn to inhale food or go with none for 12 hours, as well as hold our bladders for 12 hours, and we learn to take care of patients non-stop for 12 hours without a break to "regroup." There are times when we have down time, but there are times when we are full for 8 to 12 hours straight, taking care of multiple patients one right after the other, and NO ONE even thinks of taking a break, let alone asking for a break. Does it exhaust us, yeah, but the occasional patient that gives you the adrenaline rush makes up for the exhaustion. ......."

I worked ER for many years in the States. And the above post pretty much describes a typical day..... unbelievably busy (and unsafe) no breaks, no time away from the department and certainly never any sit down meals.

I hear it's still like that where I used to work. They haven't added any staff, the daily census and acuity have skyrocketed........ but thank goodness because of those nurses who never eat, never pee and continue to do so.... the hospital hasn't had the need to hire extra staff.

Why do hospitals expect us to continue to work in such a manner........... because they can.......because we do! If we really cared about our patient's safety, we'd insist that our body's and most importantly our MINDS had regular breaks during a gruelling, chaotic 12 hour shift.

If you're working in an environment where no one ever gets the 'luxury' of eating a meal or relieving their bladder...... then someone is not doing their job, and it's more than likely the person who is never present in the department to begin with.

To the original poster....... let your co-workers roll their eyes, I'd rather a nurse with a rested and nourished mind take care of me any day.

Good Luck.......and hang in there. Hopefully your colleagues will catch on to the foreign concept of breaks and begin insisting on the same.

[Lawdo2]

We have been fortunate in California! I work in a busy ER that has 2 docs, 9 RNS, 3 Techs and 2 PAs. We get 2 15 minutes and 30 minutes for lunch, sometimes you may skip a 15 minute break but youdo get to eat otherwise ther would be a lot of people passing out.

[SarasotaRN2b]

For the OP, I understand where you are coming from. Don't stop fighting for you right to have a break, especially when you are working a 12+ hour shift.

I think that instead of complaining that someone is having a much needed break, that all the nurses work together to work out a plan so everyone can get at least a 30-min meal break. Set up a buddy system. As long as you let things go status quo, you'll never get a 30 minute break. If you have a busy trauma center, it is not going to change...As someone mentioned earlier, your charge nurse should be fighting for you.

[TinyNurse, RN]

I'm a travel nurse, and let me tell you that when I got to california I was STUNNED to the point of.............. almost not even being able to take my break......haha

cali has these staffing laws that make sure that I get 2 15 min breaks, and a 30 min lunch. there is one nurse that is there JUST to give breaks and lunches!!!!!

I can remember going 11-12 hours without even getting able to pee in some states........... wow!!!

[Pitbullgirl]

My husband works at a Level One ED here in KY and IMHO it has become an unsafe and dangerous situation, not to mention unhealthy for him. I work in the same ED as a tech until I, too, finish with my BSN in December.

I am furious with management at our hospital and ED for allowing this situation to continue. Not only are we horribly understaffed with nurses, but they have been fairly indiscriminate in the nurses they do hire, with some extremely spoiled and lazy ones. It leaves the few good nurses like my husband working even harder without breaks.

To top it all off, some of our more experienced nurses have left (gee I wonder why), leaving our department with more new/inexperienced nurses, especially on night shift.

At one point, I thought I'd definitely interview to work in the ED. Not now. I'm interviewing for Neuro ICU and PACU. I'm also encouraging my husband to transfer to a different department. It's not worth it. After I get some experience, we can move to a different part of the country where the ED is better managed. THERE MUST BE SOME OUT THERE!!

Thanks for letting me vent.