Major Mistake?

[huggietoes]

I just transferred to the ER after working in Med/Surg and am having major second thoughts. I read posts that talk of adrenaline rushes and autonomy and it seems to me that the only thing that myself and all of the other nursing staff have been doing while I have been on orientation is putting pts in gowns and saying "the doctor will be right with you". I am beginning to wonder why I even bother taking my stethoscope to work anymore, they do not let me use it. The MDs assess apparently not the RN. I enjoy assessments, labs, actually performing procedures instead of holding the patient so the MD can perform them. I am bored, maybe I am just used to the craziness of the floor? Possibly this ER is not quite the right fit for me? It is not a trauma center, however, it is the only ER to serve 7 counties so I had assumed it would be quite busy. It is so frustrating the RNs ask the MDs for orders for everything, I mean everything. I did not think ER nursing was going to entail being the MDs handmaiden. And oh the a## kissing of the MDs by the RNs, enough to make me want to vomit! Rant ended, thanks for listening, now any advice?

[Tink RN]

Huggietoes,

I am curious what type of charting you guys are doing there! Is there no nurse assessment form? Not to mention what DHEC and HIPPA inspecters must think when they do chart audits for your department.

I understand that sometimes people tend to get comfortable with "the way we have always done it" however the roles and responsibilities of nurses have grown significantly over the past several years. You may discover key factors during your assessment that could change the patient's acuity. It is your professional and moral obligation to administer the best care within your scope of practice. Not to mention that patient is YOUR responsibility once placed under your care. If your patient "crashed" in the exam room while waiting on the physician, and you found yourself involved in a lawsuit - I don't think a jury of your peers would understand why you did not assess your patient. All the MD has to say is, "I was not informed" and there you are with a noose around your neck.

You worked hard for your nursing liscense. You may need to utilize management to resolve this issue. Based on the scenario you described, it sounds like unsafe practice to me. Check your policy and procedure manual for your department. Most facilities have an outline for nursing practice - I assure you patient assessment is addressed. Show your co-worker and explain that you do not want to jeapordize your nursing liscense therefore you intend to follow policy.

I am terribly sorry you have had an unpleasant experience - ER nursing can be a rewarding experience. I hope my suggestion helps ... but if not, I would consider changing departments or facilities. Good luck!!!