9-11 in Trauma 1 ER

[flowerchild]

Yesterday I received a call from my brother, my SIL was at the ER with chest pains, abnormal EKG, with transient tachycardia and hypertension. Fearing an MI, I drove to the Level One Trauma ER ready to make sure my SIL was receiving proper care. My brother told me that her leads, oxcimeter, and O2 was off and nobody came to put it back on after they let her go to the BR. Well, I was ready for a fight b/c they treated my hubby in a similar fashion while he was having a MI - a bad one, and nobody treated him for several hours. By the time they decided I was right and he was having a MI, it was too late, and 50% of the myocardia had died. Since I was told last time not to make a fuss or they'd remove me from the ER (I hadn't even raised my voice at this point and was scared he'd die alone) So I stayed as quiet as possible, all the while asking for help. Soooo, I was ready this time! Then I walk into the ER fully ready to let someone have it but then, couldn't, wouldn't dare cause a ruckus. The place was packed. Atleast 50 patients. They were in the halls double parked and stretcher to stretcher. The cubicles were filled with people with more patients in WC's parked between. It took several minutes just to navigate through the place while I stayed out of everybodies way. It was crazy!

My SIL was in a room off the main ER area with about 8 other patients. (the area holds 4). I hooked up all her leads, O2, assessed her, etc. and calmed her.

A little ol' lady across from us had fallen and had a head injury. She was flat on her back with a collar on and was very scared and alone. All of the sudden I hear her gagging. She had emesis in her mouth and couldn't move to clear it. I yelled for help and no one came. Yelled again and no one was around. Well, I couldn't let this poor lady choke on her own vomit, so I ran over, turned her on her side, and cleared her mouth, then suctioned her till she was clear, she then smiled at me and thanked me for my help, asked me if I was a nurse. I was honest and told her I was an RN but didn't work there. She was very greatful. Still though no one came to help her or me. I thought OMG, I should've never touched that woman, but I also couldn't just leave her either..delema, what should I have done??? I moved her when she could've had a back injury! I only knew that she had fallen out of her WC and hit her head. YIKES!

So then a paramedic tech runs over to me and starts asking me if the supplies he had were what he was supposed to get. I answered and before I could tell him that I didn't work there he was running the other way. He comes back and asks where the roll gauze is located. I knew cause I had worked in that ER before, so I told him and helped him get what he needed out of the supply cart. I did tell him while I rummaged through the cart to get what he asked for, that I DON'T WORK HERE! He still came back asking for my help after that. It was like they were so bombarded that any nurse would do, even if I wasn't an employee.

I finally saw the nurse for the little ol lady and reported what I did for her and why..he thanked me too and smiled. Since I had worked with him before (at another hospital) I gave him a great big hug. My SIL had been waiting for hours to get up to her room and be admitted. I asked him to move her up and within 10 minutes she was in her room. Glad I could help her get settled. I think I wanted out of there myself more than wanting her in her room!

So we get to her room and she's telling me (my SIL) that she wants to be a nurse. I smiled and said we needed her and told her it's not like you think but I'll support you and help anyway I can. I told her to come to allnurses and read for herself. Anyway, she's in PCU on tele. I casually asked the nurse what the ratio was on the floor, she says 7 patient for each nurse! I said that's too many. Now here's what really floored me, I told her 4 patients to 1 was more like it. Her response: OH THEY CAN'T AFFORD THAT, IT WON'T HAPPEN B/C THERE ISN'T ENOUGH MONEY TO PAY ALL THOSE NURSES. This is the same hospital that will pay up to $50.00 an hour to an agency nurse to work the same area! I just about lost it but stayed quiet and smiled. It was as if she was brainwashed into believing such nonsense! This morning my SIL's BP was 70/44 and the nurse tried to give her a BP med, which I had already warned my SIL not to take pills without knowing what and why and to keep track of her BP and advocate for herself. My SIL said, OH IT WASN'T HER FAULT, SHE WAS JUST DOING WHAT SHE WAS TOLD. By then, I'm about ready to blow my top again, but just smiled and told her that it is the nurses job and responsibility to make thier own decisions based on assessment and if the nurses didn't have so many patients the almost error wouldn't have occured b/c the nurse would've had time to check the chart and then she would've known to hold the med. I know it's like this everywhere. I just had to vent. If it's this bad now, I shudder at the thought of the future. BTW, spending time in the ER makes me want to go back but this time on the clock as an employee. I think I'll pick up a few shifts. But, at the same time, I don't want to be one of those nurses who doesn't have time to be a nurse. My regular job, I'll keep, I atleast can be a nurse and not somebody who's just doing what they are told!

[flowerchild]

Oh, BTW, I was wearing blue jeans, a red white and blue shirt with a lab jacket over it b/c I'd just left work and it was cold in the ER. I didn't look "professional" imo, I could have been anyone.

[SmilingBluEyes]

all i can say is WOW...what an eye-opener. How truly frightening for all concerned. How are you holding up,lovie? I am so sorry!

[Burnt Out, ASN, RN]

Verrrrry scary!!!!!

We just recently had an experience with my grandfather and his nephrologist....

My grandfather was in the hospital about 10 wks ago with pneumonia and it was thought he might be trying to develop renal failure (the jury is STILL out on this one).

Anyway, about 3-4 weeks ago, my mom calls me and tells me Papaw is in the ICU because he is having GI bleeding. Then she proceeds to tell me that 3 days before Papaw is admitted, the nephrologist's "nurse" called (who knows what she really is-sometimes there ain't any LICENSED people in these MDs offices) and told my grandparents that Papaw's potassium was 6.7!! And then tells him that he should go to the ER if he starts to have nausea, vomits, or has chest pain!!!!

I told my mother that he should have been ADMITTED IMMEDIATELY-that Papaw could have died instantly from an arrythmia!!! She then tells me that they called another MD and asked him if there was a medicine they could give Papaw to lower his K++- he said "NO" Hellllooo, I know 2-sps or Kaexylate!!!!!

Needless to say, I'm still a little pi**ed off!!!!!

I have been wanting to go talk to the nephrologist, but my mother told me that "it would upset your grandparents to no end." I keep telling her the doc fell beyond the standard of care and though my grandfather has not suffered visible long term effects, he needs to know what happened SHOULD NOT HAPPEN!!

I just want to ask him if he knows what a normal K++ level is and does he know the consequences of hyperkalemia!!!

I also want to know if he enjoys practicing in the state he is currently and ask him where he went to med school-McDonalds?!

I know from looking online that he graduated in 1984 from med school-you'd think he'd know better!

Any advice???

P.s. I think I'm going to need someone to hold my purse!!!

I love that line!!!:chuckle

[notyetanurse]

I am in Nursing school. This is an assignment for me to be involved in a discussion. I'm glad to be on here and hearing your stories. These things are really frightening. It seems I'm learning more and more of what not to do than what to do. Thanks for sharing and allowing me to be aware of what really goes on. I'm afraid sometimes, though I wouldn't be able to respond as quickly, or properly to some of the situations you've discussed. I guess that comes with time and experience.

[P_RN, ADN, RN]

What would a "good samaritan" law cover in the first instance? I have done the same sort of things and not thought twice about them until this moment!

Sheesh if she had aspirated....what would a prudent observer do......are we held to a higher standard inside a facility than outside? I don't know.

[teeituptom, BSN, RN]

howdy yall

from deep in the heat of texas

Well. flowerchild, sorry youe experience in that ER was so difficult. Not all are that crazy, and most work better than that which you describe. I wouldnt trade ER nursing for any kind of floor nursing. I would sooner retire than be a floor nurse. Ive been thru some attrocious nights in the ER, and some boring ones too. Though attrocious outweighs boring 4 to 1.

Dont know where this place is, and I wont pass judgement on them without more information. Maybe it was just a bad night all around for them there.

doo wah ditty

[colleen10]

Wow Flower Child! You are amazing and a true nurse.

[flowerchild]

Thank you for the kind replies. It really helps to know that somebody gives a hoot. I figure I was covered by the good samaritin laws when I helped that lady but it didn't matter, would've done it anyway. I know that this ER is not always that busy. They never go on diversion, so this is the result. I just wish they'd bring in more nurses when they are this busy. The ratios I mentioned were for tele/PCU and not in the ER. I have no idea what the ratios were that day in the ER. I wouldn't ask since they were so busy. The nurses probably didn't have time to even think about how many patients they had that day.

I really do appreciate the comments, special thanks to colleen10--what a nice thing to say---thanks again!:kiss

[flowerchild]

Oh, and SmilingBluEyes, thanks you so much for your concern, I am holding up pretty good. Thanks for asking! :kiss

[NurseLKY]

I had a bad experence at a hospital after my sister had sinus surgery. She got up to her room about 11:00 am. Her nurse came in assessed her and took her vital signs. Then we saw no one for 3 hours. I know at my hospital any pre-op gets vitals taken q1 x4. The only reason the nurse cam in is to hang a IV antibiotic. Well after about 30 min the bag was still full. She forgot to open the clamp. I know how you can get stressed and forgetful but I was being nosy and walked down the hall and saw the board with the pts. names on it and there were only 15 patients on the floor with 4 nurses. Ok so the new nurse comes on at 3 and she seems a little better than day shift nurse. Well by 4 my sister is trying to pee with no luck. She says it hurts and you can tell she is distended. We call in the nurse she says she will call the dr. Two hours later still no word. I have to leave to run some erronds etc. I get back around 10 and still no word from the nurse or dr. I confront the nurse saying my sister has not used the bathroom and she is in pain. Well next thing you know the night shift nurse comes in at 11:30 and we tell her baout my sister not going to the bathroom, the other nurse did not even tell her about her problem. Here it is 12 hours and she has not yet peed. She calls the dr and he calls back right away. The other nurse never even called him. They straight cathed my sis and got 1000cc right away. Come on people get with it. By the way this was the same hospital that my uncle was in when he had a stroke and they lest in in the ER for hours without being seen. Then they took him to his room, didn't take his clothes off and my aunt found him in the morning, still in his clothes and soiled in urine.

Neadless to say my family does not go to this hospital any more.

[amylynn]

You know what I find really disturbing? That lots of us (nurses) have these experiences. So, don't you wonder about all the others who aren't nurses having these same experiences--only they have no idea!!! I don't get it?! Do you sometimes think you were the only one listening in school or in orientation?? Just a thought...