I work as an LPN doing Fast Track in our local ED. I just graduated in June and this is my first job as an LPN, I think I'm doing well and catching on fast, I haven't had a problem thus far--I do seek help if I'm not sure about something and my fellow nurses have always been kind and helped me. I get along with everyone there with the exception of last night.
I usually work 5p-1a, however since we're a NP short they've been leaving at 9p and I've been staying and just working with the doc's. Well last night I was leaving at 9p since I had a meeting first thing this am--I had pre-approved this with our Nurse Manager. When I get in last night we had a few pt's and I was informed that our NP was moving really slow. The ED was extremely busy and they started using some of our rooms which left us with 3 rooms--no biggie, it happens. Well the 3 rooms we do have open included one pt that was there before I got there and two that I had just checked in. The two I checked in took forever for her to assess, and they sat there for a good 2 hours, after I discharged two of those pt's I called another two more back. In the meantime the WR was filling up with our pt's. The other pt that was there when I got there was still there--it was a questionable fx--I put in orders for at least 5 x-rays. I called in two more pts one was a repeater that had just been there a couple of weeks before for the same thing. Anyway our NP sat on these three pt's the whole time, she was ordering test after test.
As she was sitting on these pt's the WR had at least 11 of our pt's out there with some waiting 4 hours in the WR. She asked if I could set up a pelvic on the one pt that was just there a couple of weeks ago--at which time she had a pelvic done--when I questioned her about it, she then stated to me "this may sound bad but I'm going to keep these pt's here until I leave" she didn't want to see any new pt's. I didn't know what to think.
I said something to one of the RN's about how long our pts had been there, I made no mention of what the NP had told me as I have always gotten along with her in the past I didn't want to come off as a snitch or something. I was getting really frustrated each time I looked to see the people in the waiting room waiting to be tx and there was nothing I could do about it.
Well lo and behold at around 9p she discharged the two pt's ,one that was there with a questionable break she finally called the ortho resident in and he immediatly said it's not a break. The other repeat pt was given the same meds as she's gotten in the past and sent home and the other pt was still there. I decided to wait until the last pt left before leaving as I didn't want to have to turn her over to someone else--everyone was so busy, I felt bad enough just leaving all of our pt's for them to p-up anyway. So 9:30 rolls around and she hands me orders for the one pt with the discharge papers attached. It's for a strong antibiotic given in two separate IM injections-this is a 5 yo who I had to hold down previously for a lab draw. I asked if there was any alternative and she said no. I told her I would need help holding the pt while giving the IM's and she told me to find someone to help me. It was for 1 gm of Rocephin which hurts going in. I was not very happy but was going to do it. I asked one of the RN's about it and she went in with me to talk to the mom and we determined that putting in an IV and hanging it would be less traumatic than two IM's. During this time the NP comes over the room with yet another order to call lab and order another lab test.
I finally said, I'm doing this now--I was supposed to leave at 9 and here it is almost 10, as I was saying this she said in a snippy way "Can I finish please" and I said yeah, go ahead. So she wanted me to call lab. OK. Why she couldn't do it--I don't know? Why couldn't she help me with the IM's when I help her with procedures? She was leaving, it was her last pt. She got upset when she saw that we were going to infuse the Rocephin insted of giving it IM and huffed as she walked away. She left.
I finally left a little after 10, the dept was still busy and there were a ton of our pt's still waiting to be seen 5 hours after walking through the door--not a very fast--fast track. I felt like crying on the way home. The other two NP's that I work with have never done this--they get them right in and right out--this is what our area is for. I usually feel like I do something good for these pts--except for last night I felt like I did nothing.
Do you think I may get in trouble for being defiant with her at the end of the night--do you think I should say something about what happened? I just don't know what to do. I feel like I don't even want to go back there. I don't know what to do? I'm really discouraged right now.
