2 nights of triage hell

Specialties Emergency

Published

Phew - am relaxing for a few minutes before my 3rd 12 in a row - in triage. My city decided to take a bit of a dump on us the last two nights, never seen it so insane. So this is just a vent, to prepare my poor self for tonite.

For two nights now, we've had every bed full in the back and a WR full of pts when we came on. Friday night even had a guy in triage with his finger on the counter in a cup! Ahh that bodes well for your shift, doesn't it?

Last night had a guy come in for a "risen" on his thigh. Oozy, icky, nothing dire. VS great. On listing his meds, I see coumadin 6.5mg a DAY. Ok, check off CBC, CMP, PT/PTT on the labs. Busy insane doc (alone on duty!) has a fit, why'd I order a PT/PTT... well duh. Revitalize the guy (and the other 20 in the WR), all's ok. Then the labs come back. Creat 15.6, PT/PTT over the moon, H&H and PLT in the toilet (mind you the guy gave no hx for ANY of this, he's like 35yo, and zippo sx). Now, the doc has a fit that this guy wasn't brought back right away (before labs came back). Erm... when does the psychic part kick in please?? Off to ICU for him.

Bright spot...got to deliver my first baby in a hallway. Pinked up, screamed her little precip head off and off we finished driving her to OB. I love my job.

One more night....

(thanks for letting me go on and on)

Specializes in Emergency.

Is this craziness going on all over the country? 24/7 in our ER we have no beds available with 15 to 20 waiting in the WR for tx. sometimes 6 hours! And the administrators don't want to re-route "because we need that extra money that a squad could bring in". No kidding, that's what we were told in a town hall meeting!!! The triage nurse gets the brunt,of course. Families and patients (usually the ones who could have seen their GP) or the ones who had a Dr.'s appointment "but I couldn't wait any longer" (the appointment was 30-60 minutes from ER arrival and they've been waiting long enough to have had 4 appointments) get down right surely at the desk!

We have protocols to start if you have time; but, you are usually so deep in getting them all triaged that drawing blood and ordering x-rays gets put on the back burner!:uhoh21:

Specializes in 6 years of ER fun, med/surg, blah, blah.

I walked into work Monday morning with 20 boarder patients being held in the ED since the night before. We have 36 beds total in the whole department & as per usual, the Monday crowd coming to Triage started early. At least I wasn't in Triage that day, thankfully but did my best to clear out the regular patients. I understand it's the same all over with the overcrowding, patients in hallways being treated & having the keep the admitted patients in the ED because there are no beds on the units. And it's not even winter yet.:trout:

Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

When I was growing up and a teen (ok I'm not young anymore), we pretty much knew about yeast infections and OTC monistat (and when it was only prescription), we knew about UTIs, and vagisil and other basic stuff. Maybe not clinically but we knew where to find the OTC remedies for most of the generic stuff we got. Don't remember HOW we knew, we just sorta did. How come the younguns these days have no clue? Did the mama's and grandma's stop teaching the younger girls? :blushkiss What's up?

Can't tell you how much of this I see (and it's always an emergency at 3am, no less.

Thoughts?

They were raised by moms who took them to the ER for every 101 temp, cough, sniffle, runny nose, episode of vomiting, or runny BM. :D

What a night?

There is no way I would let them schedule me to triage for 3 shifts in a row??? That is deadly. I find 12 hr. at triage too much.

We usually will work one shift triage, one trauma, one obs/ex. You get the variety and your not continually in a stressed area.

How are you assigned?

Curious,

Sarah

They were raised by moms who took them to the ER for every 101 temp, cough, sniffle, runny nose, episode of vomiting, or runny BM. :D

I used to think this was the case...not sure now...

i went to the ER only ONE time growing up...Now my sister runs her kids every time they have a fever or cough at 0200...she certainly didn't learn it at home...

who knows...sometimes i think these people...nah, nevermind

Specializes in ED.

Congrats on the delivery! Boy or Girl? 10 year ED vet here & I feel your pain!!!

Specializes in ED.
It's the McDonald's drive-through, next-gen video game, instant gratification mentality. I think it's only going to get worse...

I agree! And each generation is less accountable and less respectful - they know their "customer" satisfaction survey is on it's way & the customer is always right!

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