ERRNJunkie

alrighty then. (crosses FL off travel itinerary:cry:)

I asked what ER (emergency room) ratios were.... I have no idea what area. Maybe Tampa? It varies depending on what part of the state?

have been trying to find ratios for FL as Im considering doing some travel nursing. What are the present ER ratios? Anyone? TIA!

So you're saying that if someone came in waving a gun in your face, you might write a letter in their defense? I mean if they verbally threatened you and you felt they were grief stricken that's one thing. A gun? No thats a little beyond grief stricken.

Whats wrong with people is, people like woody accept this behavior. So these people think they can treat staff poorly. Its unacceptable. And No one should tolerate it.

The last guy who threatened to harm a RN in my Dept was not treated. Meaning, there was reasonable fear for any RN to enter his room. Police were called, and no amount of threatening got him his "pain shot" he demanded. So, If I had been your RN I would have refused to treat you, and so would my MD's. Unless you were on a 5150, proven ALOC or your life was in danger. I find it appalling that you as an RN would ever threaten another RN. You can go ahead and not call the police on threatening patients/families and put yourself and innocent people in danger. Get thrown through a partition, have a gun waved in your face. Based on your comments here, I could care less. I do however care about your patients that you put in harms way. Also, who says that when your life is threatened you have to follow policy's and procedures. I don't believe ANY hospital should tell you (or would tell you) that you cant do as any citizen has a right to do (calling the police). When I call the police, I get 4-8 officers there with in 5 minutes, or less! I have seen and heard of way too many bad incidences that are career ending, let alone some things that happened that were fatal. Im not taking my chances. And if someone lays a hand on me to harm me. I certainly will press charges! As I have in the past. I do not go to work every day to have to fight for my life. I'm there to help save lives. But no job is worth my life/limb or my coworkers being unsafe. I cant believe you would write a letter in defense of some one who came at you with a gun, due to their anguish. I don't care what the circumstances are, there is NO excuse for behaving in this manner. EVER. If I were you, I wouldn't continue threatening nurses/MD's, and please don't come to my hospital. I will have the police there as soon as you make a threat. You're right on one account, you can refuse anything you want. I can also refuse to treat you based on threats. Finally, get spell check. I hope your charting isn't as bad as your post is here.

You know what? You can fire me for calling the police. I could give a crap. I would sue for enabling an unsafe work place. We just had a RN have her finger bit off by a patient. I call the police at least once a week on out of control patients/families.They know if they cant act appropriately they can talk to the police or go to jail. I don't believe its part of my job to have to be placed in an unsafe environment. If it isn't safe, I'm calling the police. I will not lose life or limb, or finger to anyone!

I agree canoehead. The people who will bring their kid in at a ridiculous hours for a bruise is the same for me. Saying they cant afford Tylenol when they have their nails done, a cell phone and cigarettes. There is a high rate of entitlement for some people. Its really annoying. They don't use a PMD because they would have to make an appointment. They tell me, I HAVE INSURANCE! Ok well no thats not real insurance, thats MYSURANCE. I'm paying for you to come to the most expensive place on earth because you, a 20 yr old vomited ONCE. And you took an ambulance to boot. Thanks. My tax dollars wasted. Mean while the person who is SOB and moments away from a tube, or having an MI drives themselves in due to knowing the bill will be too much. I have a friend who's husband is self employed, insurance is too much for them, they have their kids covered but they would have to be dying to come in. Its sad. I have a mother of a friend of mine cut herself on accident and wrap it up, only to have her daughter check it the next day and find she had an ARTERIAL bleed, and she still didn't want to come in! Then I have the young guy who says he moved here a month ago and has been trying not to come to the ER. This was his 3RD visit in a month. Who you kidding? I also had a lady come in for constipation x 5-6 yrs. Due to the medications her MD has her on. She has been to a GI and her PMD she says, and now she wants to come to the ER to see what we can do. Well we can refer you back, seeing as you have no obstruction, and are having BM's.

OK the first few aren't dumb reasons to come to the ER, but shows how amazing people are and the dumb things they do. Once we had a woman come in with 2 guys. Seems they were playing billiards and lost a ball in her corner pocket. I think she thought she was solids, but turns out she was stripes! Had a guy come in with THREE heavy metal rings around his manhood, below the testicles. He waited 5 hrs before coming in to the ER. Actually went to sleep with it erect for 5 hrs. Of course I recognized him. As I had taken care of him before. I came in and asked, "whats up." My bad. He took it in stride. But he didnt like the ring cutter, the MD got through one side of the metal ring only to not be able to pull it apart due to how thick it was. It was nearly as big around as my pinky, and he had 3 of them. They were about to take him to the OR as he couldnt stand the heat of the ring cutter, and we most likely would have went through all the blades we had on hand trying to do so. Instead we called the fire dept who came in and snapped them off with bolt cutters. I must say, If I had an outtie, Id be terrified of bolt cutters. Another guy put a link to a huge thick towing chain around his member. The urologist came in and after over 200 injections with an 18 G needle to remove the edematous fluid in his member finally got the chain off. Had a pretty psychotic patient come in and tell me her heart stopped all night. I had to explain to her what that would mean. Poor thing. Had a guy take an ambulance from out of town C/O SOB. But after he got in the ambulance immediately felt better and asked to go to the train station. Informed the medics he would AMA at the hospital, couldnt they just take him there? I had a guy come in saying he was hit by a car 2 months ago. Was never seen at time of injury. But since the accident he has been on the phone with lawyers who he says suggested he come to the ER by ambulance to make a case against the person who hit him. Patient came in for diarrhea after her GI DR gave her golytely. We have a family that comes in for bruises all the time. Kid fell on his knee during sports, is ambulatory, no limping nothing. And they will wait until 11pm on a school night to be seen. I had a guy who told me he just moved here 1 month ago, and has had this flank, rib, abd pain for "a while." Tells me he has no PMD yet. And he has tried not to come in for this. I look up his record, he has been here 3 times in this one month. Oddly enough, he was given vicodin twice on D/C for previous visits. And strangely enough, he was offered motrin for his Costochondritis, which he refused. And oddly he was mad he didnt get another 20 vicodin. Had a woman come in worried she would get a lady partsl infection due to the fact the homeless dirty guy she had sex with has a really red infected looking member. Makes me wonder why if she thought it looked infected why she chose to have sex. lol Had a CC of a "black arm". So of course Im thinking Im going to see some poor perfusion or necrosis, or something. I go and look at this guy. Of course I recalled seeing him just a couple days before. I look at his arm. He is pointing to his IV site, there is a bruise around it.

I also want to say I have sereral patients who come in every time their kids have a bruised knee. They can ambulate fine. And these people state they cant go to a PMD due to the fact they are working those hrs. Yet they are in all hours of the day. simple fact is, if they have medi-cal or no insurance and no plans on ever paying, they will abuse they system. And will put one of your ER doctors as their PMD on the sign in. Because really, your ER doc is their PMD.

I have had patients who are asked to pay a 5 collar co-pay and because they cant afford it are not forced to. Of course these patients all have a pack of cigarettes, fake nails and a cell phone, yet cant afford a 5$ co-pay nor Tylenol for their kids fever. Any why should they when they can get an RX for the same. (medical patients of course) I have had patients who C/O rectal bleed, who have a hemorrhoid who bring 5 family members who all insist on being at bedside. Who fight the rule of 1 visitor stating they want a new RN because their RN doesn't want 5 people in their way. I truly believe there was nothing on TV that night. They hate me BTW and I don't care either. I have tried to explain to patients till I'm blue in the face that their URI doesn't constitute they are dying and doesn't come before the 87 yr old with chest pain with a + cardiac history. Instead I get, "How do you know I'm not dying with out an X-ray?" This coming from a 22 yr old with URI symptoms x 3 weeks. I have tried to explain how I'm sure they would be happy if their grandma came in with symptoms of a heart attack and how they would be priority. This doesn't fade them. "well how do you know I'm not dying???" You have stable vitals and are 22 yrs old. Which means you will wait a long time. "feeling like your dying doesn't mean you get straight back." If thats the case the guy with the "scratch" with 10/10 pain trumps you. The back pain or "insert complaint x 6 mo -4 yrs here" is due to the fact we don't make them pay a co-pay. People will continue to abuse the ER until someone finally steps up and refuses to see a non-urgent complaint. We say we will "refer you to your PMD" if you have a non-urgent complaint, but truth be told...we never do. Not really. Sure they may D/C with motrin. But still they see everyone. Because bottom line is they want "numbers" and to keep everyone happy. So I continue to beat my head on the desk, and try no to roll my eyes.

Good luck to all of you! Its pretty exciting and scary at the same time on your first day. But do ask questions, it makes us nervous- new grads who dont ask questions. Have a great day!!

I think daytonight has a lot of great info there. I will say that I had my job 3-4 months before graduating, but also I live in a smaller town where they recruited you while in school. It was easy for the most part. They asked you what positions you wanted, and you interviewed for more than one unit. I wanted ER, but I also had to interview for a cardiac step down unit. I got the choice as both floors wanted to hire me. I was lucky I interviewed well. Its best to start talking to hospitals now, and atleast apply online or call a recruiter and go in and interview. Why wait until you grad and take the NCLEX, you will want to get started and start getting paid, ASAP Im sure. Good luck!

Wow, I'm amazed at some of the stories. Its nice to see some of you coming forward and admitting an addiction and the recovery process. I have never had an addiction to a drug, other than nicotine and caffeine. I have worked with some nurses, and even reported a nurse for taking out the same narcotics she took out 10 min prior. I have heard even more stories. I couldn't ever do it. I would be afraid to even try to do my job under any influence. I know thats the disease, but still. I have heard stories of nurses taking meds out of PCAs and it being tracked back to them. It must be hard to work so hard for something, and then loose it due to an addiction. Hats off to those of you who have beat your addictions.

Jen2 Said it well. ER can be like floor nursing when you have patient holds. I was on "code brown" with a patient who had diarrhea Q 10-15 minutes. Or you have a methadone OD, who is given narcan and they have a huge BM. Or they are vomiting feces. We get the worst of the worst, stabilize them and send them up. The only difference is you usually don't leave and come back the next day to the same patient. Also not as many ER patients use the call light as they are too sick to use it. But not to say it isn't hard work. I sometimes don't get to use the restroom till 430am. I work nights. Sometimes I don't get a lunch, and we also get hallway patients. Also, codes don't care if it is change of shift, in fact most codes happen at 5am, and you get the patient at 0530-0600. Right at change of shift. The floor nurses hate you, because they don't want to get patients at the end of their shift, or even 3-4 hrs before the end of their shift. I really don't understand why they care if they get a patient 30 minutes before the end of their shift, they only have to take vitals and tuck them in. I think all nurses should be required to float down to the ER to see what it is we really have to endure. Don't get me wrong, I love ER nursing, and wouldn't want to be a floor nurse, but some things need to be appreciated.