How is your ER these days?

Does it feel like it's been winter since the end of August? Lots of critical patients and high volumes?

It feels like we are in the throws of winter but it's still only September! Yesterday was the most horrible day that most of remember in a long time.

My personal snapshot of an assignment?

A woman with chest pain and fibromylagia having a panic attack because she has PTSD from hospitals.

Mr. Smith* the dirty, food requesting diabetic, 50 year old COPD exacerbation, on 4L of oxygen at home, who still smokes, is in the hospital all the time, and is frequently intubated.

The guy who wandered from triage before being triaged who had a tonic clonic seizure in middle of the hallway.

And then, my only "normal" patient that day - COPD exacerbation/chest pain. So sweet. Yes she still smokes but thanks for being nice at least.

I was "floating" the first 4 hours and what I saw was far worse believe me. I gave report to the floor on a patient who was assigned to another nurse and I hadn't even gotten report on home (because the nurse was hanging TPA and slightly overwhelmed) and then brought him up to IMC. I was dealing with that patient for an hour before I took him up so I just asked the family and the chart for report.