ER06

I just signed another 2 year contract at current job which I love. It is breakable at 6 month increments. I also am in school on-line(rn to bsn); I signed a 1 yr contract for tuition re-imbursement for that but so far will only owe 600 bucks back if I leave. I could leave before 6 mths are up but I'm sure I will owe that first installment. I have two great jobs right now and a third (which is volunteer fire dept) All of it is a sweet deal. I don't want to go into details but things at home are not as they should be with hubby and I have two sick parents back home who need me. I am not unhappy at my jobs, for once that is not a problem. But my home situation gets worse by the day at times. And have been struggling to make it work for 2 years. Staying in town is not an option; again details. Of course tried counseling, but there is only so much one can do when the other thinks they don't have a problem. My whole situation is so very sad. It was a fairy tale, it really was. I never would have seen this in a million years. I thought we would grow old together, I could see it. It is heartbreaking. Anyways, because of how things are it is best to just pack up and go. I'm trying to figure out how to give a notice also without anybody knowing. ( I was going to give a two week notice )Co-workers regularly comb through the schedule and if they see your name crossed through you get approached why. I thought of just saying I'm going prn. It's a small community and word gets out. I won't be able to leave if word gets out. I don't want to burn my bridges or break my contract. But I might have too. But if I do leave, I won't be coming back either. There are two positions open right now back home where I'm from and I'm afraid if I wait 6 mths, the position or positions will be gone. Also, do you think they will take my last paycheck?

Oh, yeah thats right duh, orders over the telephone ARE telephone orders. Wow guess my 3.98 GPA wasn't workin' there, huh. See this is typical in the nursing profession, I write in to share the frustration of something and some smart ass has to try to correct you. This is why people are getting out of the profession because of the dog eat dog mentality. Hey thanks for the correction, I really needed it.

Well first off, what do you mean you got "scolded" no one should be talking to you that way. I'm really getting burned out by the unprofessional way some of our fellow nurses treat each other. There is just no excuse, I don't care what is happening; it's a power trip "I'm better than you" Did she be-little you in front of the Dr or Pt? If so shame on her. I've had some pt's where the only place for a b/p cuff is above your ONLY and LAST IV site which in fact might have Levo running through it and the Icu residents are slammed and can't put in a central line for ya. Scary. One b/p above an IV shouldn't make a difference.

Well tonight I took verbal orders over the phone and this not supposed to happen now with our new system, EPIC. AND, the Doc was quite rude. Our hospital gave all the docs I guess these 'palm pilots" so they can enter orders from wherever they are. But I knew this was going to happen, Docs can do anything they want. They don't have to play by the rules like the rest of us. When I heard we were going to this new system I knew they would not be compliant.So, this Doc went on "the list" of offenders. Hopefully our Ceo of nursing will do something about it.

Yeah, that sounds about right. I currently work in two different ERs, both have computer systems but only one computer system has the ability to enter the orders 'online'. The other still uses paper orders. I worked at a level 2 and they could care less what you were in the middle of doing, the world stops turning when a Doc calls for orders. and if you don't get to the phone in time, they will hang up. And then if you have issues/problems with your pt that the ED Doc won't address it since he has already 'transferred' care over to the admitting Doc, then you are just screwed until admitting Doc takes his sweet time calling back. Glad I don't work there anymore. The one Er that I work in now with the "computer entry" orders currently has a list of "offenders', Docs who call in to give verbal orders instead of using their hospital issue palm pilot to enter orders from home or wherever. if they are on campus, they are required to enter the orders themselves. but they manage to find ways to give verbal orders because I swear the other day I had just seen one of the family med docs and he was calling me on his cell phone with orders, it just slows the whole process down.

Wow, that sounds like one of the ER's I used to work in. Every place you work is going to have the same types of people, but with different faces and names; you know the bully nurses, the nice nurses, the ones you can count on in a pinch and those you can't count on, the "cliqs" or whatever, but who cares really? Remember why you are there, for that patient and for your love of ER nursing. Keep your focus.You can do it and make a difference. And experience comes with time. I love the quote "great, someone with less experience complaining about the more experienced nurses?" Sounds like she knows everything there is to know right? Those are the ones who usually DON"T know or have the "experience". And I have seen some "senior" nurses that I have worked with run circles around the younger nurses including me. I stay close by their side, because they have so much wisdom and knowledge that I can learn from.What has helped me also in the ER was obtaining as much education as possible through inservices, certifications and reading/studying. This is in addition to a 6 month critical care internship I did several years ago. Most of the people who reply on this forum are supportive, so don't let some of the comments of others get you down. Hang tough in there kid, you'll make it.

We talked about the negative portrayel of nurses one night at work example ER and Greys. I believe one of my fellow nurses had heard that the American Nursing Association had spoken out about these shows and their negative and innaccurate account of nursing/nurses. What a discredit to our profession. It is already hard enough as it is with public expectations and attitudes.

I heard of a pt doing this in our ED. It turned out he had a "superbug" and was also septic, hypoxic. Had pneumonia in three lobes, major consolidation in these areas. He wasn't even diabetic, but his glucose would drop below 50 several times. The 'superbug" or bacteria was "gobbling up" the glucose in his blood stream.

Awsome!

Dear Alkaleidi, Thank-you for your reply. This current ER that I work in has a ratio of 4:1 and they don't give a rats ass what they give you. I could have all 4 sick sick pt's in which I usually do. And I'm talking real sick like head bleeds, cva's, uncontrolled a-fib and septic or just plain septic and needing pressors or a person who keeps flipping in and out of svt with no warning and I could go on. And this isn't even in the trauma bay. I rarely utilize the float RN, because I don't want to be that person that they call "needy" or that they avoid. Now I will call on these resources if it all goes to hell and that night it did but usually that is not the case. And techs in the ED? Whats that? We have TWO in the majors. Two warm bodies for 30 pts in the main ED, which is just one part of the ED. And our techs don't st cath. In addition to everything else, I am bedpanning, walking people to the bathroom, getting food trays if they can eat,etc, etc. Because the tech is usually too busy for her 15 other ED pt's. Depending on who it is, they are busy actually doing work or goofing off. In my last ER that I worked, I was a resource,a reliable member of the team and still have friends and my old nurse manger has said the door is open anytime to come back. But I left to gain other experiences and also it would benefit financially. As far as asking them, 'how can I make it better" to me is an insult. From the get go they( a select group in which the charge is a part of) have been nasty and rude and insulting. I cannot even bring myself to even ask that question when I have been treated so poorly. And I know you don't know me, but I would circle the earth to help you if you needed it that's my nature. I am all about improving my skills and gaining knowledge and experience and I am humble. I know that I am not perfect, but I am good at what I do and you wouldn't believe some of the things I have walked into in that ER; common snese things that a nurse should know let alone an ED nurse. Like a pt who was treated on scene for a blood glucose of 32 and no one re-checked it with an accucheck upon arrival to the ED but instead sent all the blood off to the lab and didn't even do an I-Stat and they had already been there an hour and a half when I had come on duty ( and the lab results were still not back). Of course this was the first pt I go to see and wallah,,, he is diaphoretic!! Accucheck was 52 and an amp of D50 later the world was a better place. I think when it is said and done, I don't like how they run their department. I'm not asking for sympathy or pity, but rather other views which happen to be my own conclusion and is to transfer out; possibly to ICU or perhaps an ED that is similar to my old one. This hospital is a part of several hospitals, lots of choices to choose from. I've had 2 years of ED now in addition to obtaining PALS, TNCC, ACLS and am an EMT. I graduated at the top of my class recommended for Who's Who by my nursing instructor and that's just this college degree. I also went through an intensive critical care internship where I rotated through the ICU's in my previous hospital and I think and hope all of this will serve me well.

well, I talked in passing with my Manager, she was on the way to a meeting and said she would get back to me later, but she didn't have time so she sent another assistant manager and we talked about what happened. She said she would check on it but that she hadn't heard anything about me and neither had my manager. I talked with another nurse and she sid "oh, you got a talk from the charge" so apparently this charge nurse will do this. And the talks can be ugly I guess at times. Our moralle is not very high in this er and the rumor mill is rampant, I'm not used to that. I found out today that another person quit who started a little before me; I don't know for sure what happened and they aren't talkin'about it either. Thanks for listening.

My charge nurse took me asside after my shift tonight to talk about "what happened' on my shift. I have been in this new er position just one week shy of being able to transfer somewhere else within the organization. I had a horrible night from the get go. Things were left undone which was in part not the previous nurses fault because she I mean we had an ICU pt and Er pt's. However, she became a "float" after she gave report and most of the time when that happens even if things are left undone they take off and go help others and not finish their unfinished work. Well the slaughter continued all night. You can imagine, I had a very sick group of pt's and they either lingered in our er or I just kept getting new ones. We have a float rn who helps out usually and she bailed my ass out all night. Usually I do pretty good or as I thought, apparently I don't. I guess I am disorganized and spending too much time talking to pt's and families. I don't know. All I know is that I got my ass kicked and I think the other nurses complained that I was hogging the float I guess and also I had at one point asked if they could hold off on giving me another pt because I was"overwhelmed" so I could get caught up. "overwhelmed" is not a good word I guess. I have been an RN for 2 years and an LPN previously. My charge said she would check back with me in a week and see how I was doing. I have not been happy at this facility almost from the start, but I signed a contract for a bonus. I love the knowledge portion there are things I've seen that I probably won't see again and I would like to make it work, just for the knowledge portion and educational value. I just feel that in order to make it work, you can't refuse to take on new pt's and don't ever ask for help. I truly beleive that I was getting dumped on in the beginning which has gotten better or maybe it's perhaps I have raised a fuss about the unfair assignments. I have felt like an "outsider" quite often and damn it, I'm a good nurse and really care. My question is, are they giving me a "warning" that if I don't improve then I better get packin'? Other than tonight and maybe a few times over the last six months I thought I was doing well, but she led me to believe that I wasn't. Any thoughts? Thanks for listening

I took a new er job (kept my old er job for just one-two days a week) and I have been at the new job for about 5 mths now. It is more money; I took a sign on bonus and the hours I can live with but the STRESS! It is the second busiest ER in our city and they sure weren't kiddin'. I have come to realize that I love ER nursing but not all of the other things we have to deal with. Every shift there is some kind of issue or problem that arrises. For example, I feel for one I get dumped on. Why that is I don't know for sure. It is very "clicky" and I'm not in it apparently. The same people every shift will be sitting down a lot, talking, enjoying life while the other group which includes me, will be running around short of breath, like a fool because of the unsafe assignment that has been dumped on them. At my other job, I have worked there for 5 years, I know every one and have good working relationships, but the pay just wasn't there. I'm sure this will take time at the new job too, if I can hold out. It has been brought up in meetings by some of the "unpopular kids" in our er of the unfair work assignments. I was busy all night last night while others got to check their e-mails, etc. Now, my biggest concern is a rash I have developed on my arms, abd, part of my legs also. I freaked out about it and have been ruled out for everything. I took a round of steroids, and was also getting weekly steroid shots which I have stopped for fear of diabetes and have spent co-pay after co-pay for dr visits, meds, steroid creams etc. I talked with a friend today and we think it is autoimmune from stress from this new Job! Because it didn't start until after I took it. I really don't want to "quit" or give up I'm not easily "run off". I have made friends and one of them gave me a hug and offered encouragement which helped. Any thoughts?

Dear Fellow New Grad, No this is not how it goes. You should have a preceptor. I did for almost twelve weeks and before that I was in a critical care internship for three months. It sounds like they are trying to "break you in" the hard way hoping you will scramble to learn info on your own of what they should be teaching; leaving you to sink or swim and left floundering out there on your own and that's just wrong. I've been there. I would go to the nurse manager, be professional about it of course and let him/her know whats going on. If you don't get positive feedback, I would almost consider going to a bigger facility or one that has programs set up for new grads like mine did. Most likely, without intervention, next time you work, if you did "ok" with two pts on your own, you will get 3 next time until they "titrate" you up to their expected nurse to pt ratio. I'm sorry that you've had this experience. I loved/love my preceptors. They are a wealth of information. Even though I'm flying solo now, I still will go to them as a resource and it's great to have that. Good luck with everything, keep us updated on the outcome, I will be wishing the best for you.

I did have NSO and do need to pick it up again, thank-you for the reminder!!! At my hospital, the nurse risk manager/attorney told us in orientation that if we have insurance then the pt will go after us too in addition to the hospital. She was siding with the "can't get blood out of a turnip" theory. However, what is stopping them, if god forbid you were found at fault from taking your house, car and future earnings? This nurse/attorney recomended not having it, but I don't agree with her.