I know this will be an unpopular thread but I am getting more and more frustrated by the day. I cannot understand why nurses who never manage to adapt to the ED pace remain in the department. I am sure we all have at least one person in our department that is unable to physically or mentally keep up the demanding pace that ER medicine requires. I do not understand why there is no self awareness that this is not the place for them.
One RN I work with has been licensed for 6 years now. I think she has been in the ED for 3 of those years. If she has more than 3 patients and even one of them is really "sick" she has a meltdown! The charge nurses have an unwritten rule to keep ill patients out of her section at all costs. If it looked like there was improvement over time I might not be so irritated. Nothing seems to change in either her behavior or the approach to managing her employment in the ED. Why has no one sat her down and talked to her about moving to a less acute area where she won't be overwhelmed every night? More importantly why can't she see that she does not belong here? I am not trying to tell anyone where they can or can't work so don't misunderstand me. If I came in to work every night and felt like I was in crisis each hour of my 12 I would consider a change after a brief period.
Now I understand everyone needs a chance to get their legs under them and some need more time than others. But if you are a person that needs more time to get you're "nursing on" is the ED really the place for you? Some people thrive on the excitement of Emergency nursing and can't get enough of it but that is not enough reason to put a RN in a position that he/she can't handle! More importantly why do these nurses put themselves in this position?
Then there is the physical issue. I won't say I am a track star or a marathon runner by any stretch of the imagination. I will say however I can stand in Trauma for 12 hours doing CPR half the time and still walk home after my shift. I work with nurses who can't stand up for more than 1 hour at a time! Some of them are so out of shape they get chest pain in the middle of the shift and have to be census managed before they wind up being coded. Why do they keep coming back?!!!! If you are physically unable to keep up with the pace of ER medicine then it is time to find something else to do! Go work in a clinic or a school, for gods sake help us all and go teach! Why would you beat yourself up every night? I like being on my feet and I feel reasonably good after 3 12's in a row but some of my coworkers can barely stand up at the end of the 3re day. The management makes accommodations for them by putting them in triage or putting them in ER Obs where the acuity is not that high or you don't have to stand up for more than 30 seconds at a stretch. How is this reasonable? The rest of us carry the workload that these nurses should be shouldering instead of having help from a teammate.
I have made plans to move to a less demanding nursing field when I can no longer keep up in the ED. With all of the opportunities available for nurses these days, why don't others?
I guess I should update my profile...but then again...aren't we all supposed to be learning all the time?!!
Look... I am not saying that any one should be drummed out or benched from the work they love. What I am saying is that if you cant do what the job demands... should you really keep doing it? Is there no room for self assessment in our profession? Just because your pride or ego wants you to stay in the ED does not justify the lack of care your patients might get or the lack of support your team mates might be subjected too.
As for condescending... I am posing a question. If you (whomever you are) are going to take every thing personally and get your feelings hurt I cant understand how you could work in the ED to begin with. Lets also face the facts that just because you have been an RN longer than I have does not mean you know more by default.
Whew...In a few short weeks I will celebrate being 60 years old and an RN for 40 years, all critical care and ED. Of course this does not mean I know more than the OP, but it does mean there are several things I do know. One of them is that I am a better and smarter person than I was was 10, 15, 20 years ago, and have really learned a lot since I was 38. A day without learning something is sad in its way. Some of our nurse residents have requested me to be their preceptor, a very touching honor, so I guess I still have something to offer.
I don't think I could do CPR for 6 hours even when I was 20, and I don't think even our youngest and fittest techs could either..and some of them are also firemen. I work an average of 48 hours/week, and am very productive in my output.
Perhaps the staff the OP is concerned about have strengths to offer the pt besides the physical. Life experience is a wonderful thing to have, even though it may be acquired through adversity. I am old fashioned enough to believe there is still a place for TLC, even inthe ED.
It is extremely unlikely I will be reading these boards when the OP reaches this advanced age, but I sincerely hope they will remember with a light heart the exchanges here.
Age offers more than physical strength. Management is wise to give the older nurses a place to use their skills without becoming exhausted by the end of the day. If you are putting the 50yo in triage then likely the most experienced nurse is assessing patients as they come in the door. If someone with mobility problems works fast track it frees up all the young upstarts to jump in during traumas and learn while they are fresh and eager. Someone that is overwhelmed with 5 patients may make a great 1-1 critical care nurse, or may be the go-to person for SANE cases. I think the OP's department is working to the strength of their employees.
Whew...In a few short weeks I will celebrate being 60 years old and an RN for 40 years, all critical care and ED. Of course this does not mean I know more than the OP, but it does mean there are several things I do know. One of them is that I am a better and smarter person than I was was 10, 15, 20 years ago, and have really learned a lot since I was 38. A day without learning something is sad in its way. Some of our nurse residents have requested me to be their preceptor, a very touching honor, so I guess I still have something to offer.
I don't think I could do CPR for 6 hours even when I was 20, and I don't think even our youngest and fittest techs could either..and some of them are also firemen. I work an average of 48 hours/week, and am very productive in my output.
Perhaps the staff the OP is concerned about have strengths to offer the pt besides the physical. Life experience is a wonderful thing to have, even though it may be acquired through adversity. I am old fashioned enough to believe there is still a place for TLC, even inthe ED.
It is extremely unlikely I will be reading these boards when the OP reaches this advanced age, but I sincerely hope they will remember with a light heart the exchanges here.
Best wishes to all.
THERE'S NOWAY ANY HOSPITAL WOULD DO CPR FOR 6 HOURS...THAT'S JUST STUPID....
I know this will be an unpopular thread but I am getting more and more frustrated by the day. I cannot understand why nurses who never manage to adapt to the ED pace remain in the department. I am sure we all have at least one person in our department that is unable to physically or mentally keep up the demanding pace that ER medicine requires. I do not understand why there is no self awareness that this is not the place for them.
One RN I work with has been licensed for 6 years now. I think she has been in the ED for 3 of those years. If she has more than 3 patients and even one of them is really "sick" she has a meltdown! The charge nurses have an unwritten rule to keep ill patients out of her section at all costs. If it looked like there was improvement over time I might not be so irritated. Nothing seems to change in either her behavior or the approach to managing her employment in the ED. Why has no one sat her down and talked to her about moving to a less acute area where she won't be overwhelmed every night? More importantly why can't she see that she does not belong here? I am not trying to tell anyone where they can or can't work so don't misunderstand me. If I came in to work every night and felt like I was in crisis each hour of my 12 I would consider a change after a brief period.
Now I understand everyone needs a chance to get their legs under them and some need more time than others. But if you are a person that needs more time to get you're "nursing on" is the ED really the place for you? Some people thrive on the excitement of Emergency nursing and can't get enough of it but that is not enough reason to put a RN in a position that he/she can't handle! More importantly why do these nurses put themselves in this position?
Then there is the physical issue. I won't say I am a track star or a marathon runner by any stretch of the imagination. I will say however I can stand in Trauma for 12 hours doing CPR half the time and still walk home after my shift. I work with nurses who can't stand up for more than 1 hour at a time! Some of them are so out of shape they get chest pain in the middle of the shift and have to be census managed before they wind up being coded. Why do they keep coming back?!!!! If you are physically unable to keep up with the pace of ER medicine then it is time to find something else to do! Go work in a clinic or a school, for gods sake help us all and go teach! Why would you beat yourself up every night? I like being on my feet and I feel reasonably good after 3 12's in a row but some of my coworkers can barely stand up at the end of the 3re day. The management makes accommodations for them by putting them in triage or putting them in ER Obs where the acuity is not that high or you don't have to stand up for more than 30 seconds at a stretch. How is this reasonable? The rest of us carry the workload that these nurses should be shouldering instead of having help from a teammate.
I have made plans to move to a less demanding nursing field when I can no longer keep up in the ED. With all of the opportunities available for nurses these days, why don't others?
IF YOU ARE DOING CPR FOR 6 HOURS, YOU ARE BEATING A DEAD HORSE AT THAT POINT.....SHEESH!!!!!
I never took your original post personally, it just smacked of arrogance. I am comfortable with my skills and abilities, and I am sure you are as well. That is my last comment on the subject.
I had all the answers at one time too. The longer I am in this profession, the scarier it becomes, not because I am not learning, but because I AM learning what a critical and high profile job we do. Peoples lives depend on us to be able to deliver fast, accurate and compassionate care. There is no room for egos or urinating contests. We each have different talents and use them in different ways. Sometimes working smarter may look like being lazy. You don't have to be jumping up and down and running around in circles to get your job done, if you are smart about it, and are confident in your abilities.
Dixielee out, not wishing to defend, just making observations.
Dixielee, you make a great point about "working smarter" and not having to run around - sometimes those that run around like a chicken with their head cut off know no other way at all. It appears they are busy, but they are inefficient and burnout... eventually.
TraumaNurseRN
497 Posts
Here's my question. Are you a team player?