edprincess

You can always call the state department of health. They will come in and investigate. If situations are THAT bad they will shut the ER down. No matter what though, I would leave just to protect my license. If you like the hospital system, try transferring to ICU or CCU until the ER's staffing changes. Or you can go per diem and work somewhere else fulltime. The other option is to leave all together. If you do choose to stay, I would write up an incident report for unsafe staffing each shift you work that it's unsafe and if you can manage to get your coworkers to either do the same or co-sign yours, it should help a little bit. Incident reports go to risk management dept which should get the attention of the higher ups (if flooded by these reports). They can't ingnore you. I'm sure your manager is aware but you can try talking to him/her and see where is gets you. Either way, the others are right, you only get ONE license and NO job is worth loosing it over.

Yes, I agree. Although you got there safely...driving while under the influence of nitro and chest pain is NOT a good combo! Glad to here you're doing well.

And now you know why I wanted Ativan and Haldol in blow-darts. No close contact, no injuries . I thought it was a good idea but appartently the higher-ups didn't.

I don't work in OB but I used to be a dispatcher for an ambulance company. One of the girls was pregnant (about 3 mos) and called out stating she felt her uterus stretching.

I usually politely excuse myself saying I have to take care of other pt but assure them I will return as soon as I can. Also, I ask, "While I'm in here and you have me for a few minutes, anything I can do for you and/or get you?". That usually holds people over for a little bit, enough to check on a few more pts w/o feeling like you just left 'em hanging. As for the Press Ganeys, I agree, their BS. SOme people aren't going to be happy no matter what. If they're in/out, we weren't thorough enough. If the tests take a while, we delaying care (How long can just a few blood tests take?). Yeah, I know, no matter what, you're not going to win. Then you have the others that have been in the ER for 27 hours, poked, prodded, and pinched who knows how many times and they're still smiling and saying, "No problem, I understand". Welcome to nursing and life.

I am so sorry to hear this but you will run into "these" type of nurses (and people)everywhere. 1. I wouldn't confront her alone if you do choose to 2. Noone deserves to be treated that way and give you alot of credit for staying quiet so long. 3. Speak with you nurse manager and request another preceptor. Not only will you not have to deal with her day in and day out but you'll learn a lot more if you ahve someone that wants to teach you and help you learn. I love having students and newbies. I think it's great (except when it's a bad day). Tell your nurse manager there is a personality conflict and you feel you would learn better from someone else. Explain (politely) that you don't feel you're taking full advantage of your orientation because of this conflict and would like someone who would be able to explain different procedures to you. Orientation is YOUR time to learn and noone should deprive you of that. You'll always have someone there (even when you're off and on your own) but it's nice to have seen and done things first with an experienced nurse. You need to speak up either way otherwise she's going to drive you to hate you job and leave. Good luck

I would write up an incident report every time you feel unsafe and that your pt's care is compromised by short staffing. Make your nurse manager aware of the short staffing and note that nothing was done to correct the problem. If all the nurses combined efforts instead of battling each other, maybe it'll force your ER to at least hire agency or travelers if no f/t are avail. I am so sorry to hear about your ER loricatus. We got a poster taped to the door in our locker room wishing us a Happy Nurses Week. Yahoo! Big spenders I know. Happy Emergency Nurses Week Everyone:balloons:

The past few years I've dress up on Halloween and X-mas. I just make sure that it's not over the top and I can function in it. Cat outfit with black scrubs and such. I like to have fun and since I work in the ER, you gotta make you're own fun down there plus sometimes it cheers pt up. Some people may take offense as well. It also depends on your nurse manager and what he/she allows. I've always had managers that dress up with us. Last year we did a barn theme and got the docs involved. It was fun.

Tweety, I agree with what you said about handling others. I think though, the reason you haven't gotten "yelled" at is because you're a male. It seems physicians, men and women, have more respect sometimes for the males then the females. I've been yelled at a couple of times and both times I looked the MD in the eyes and said, "Don't speak to me in the tone" or "Don't speak to me like that". One MD started in on me at the patient's bedside. I politely excused myself and when he exited the room....Oh my! I explained that I didn't appreciate his tone or the fact that he did embarrass me in front of my pt. He calmed down and his voice normalized. I guess some MD are "Me doctor, you nurse" and others are just sexist. Either way, the majority of docs I haven't had a problem with but the couple I did, I did stand up for myself and got the desired result.

A guy cam in for the hiccups (which he's had for 7 mos). I asked him what was different tonight and he said "they got worse"!

I agree with loricatus - good points by the way. There is no way the hospital has your best interest at heart. They are going to defend the hospital - "well, our policy states..."and that's it, you're screwed if you didn't follow it to the tee. Heaven forbid you didn't vitalize you tele pt's every 2 hours because something else went wrong that night or whatever the case is. You want someone who is going to defend YOU and you alone. NSO is cheap and good coverage and the first year I think is 1/2 off. Like $50 for the year or something like that.

Ya know, I did mention aerosolized Ativan to my boss a few mos ago. I thought it was a good idea. Obviously I wasn't the only one who thought of that. And I wanted Ativan in blow darts for the fiesty drugs so we don't get hurt. She laughted! Well, I tried.

I thought I worked at the only facility that did that. At my old job we aren't not allowed to say "no break" either unless the charge nurse signs off. When I was charge, I'd write in our log under every staff member that worked no lunch and sign it. If I wasn't, I'd bug the charge nurse to do it but usually they're pretty good about it. We all covered each other. We did what I'd like to call a drive by eating. Send a tech upstairs to the cafeteria and have them buy several plates of finger food - chicken fingers and fries usually. We all take a small plate and leave it at our desk. Then, take a bite and run. Walk by the desk again, take a bite and run. It stunk but at least we got to eat. My father, who was a director of personnel at another hosp would yell at me, why don't you take your break? I'd tell him, noone to cover. Can't leave my ICU pt on 2 different pressers because I wanted a grilled cheese. Yeah, I'm sure the judge would've loved to hear that one. I don't think employers should be able to do that. I know working in the ER means hi stress level, a million and one things that need to be done NOW, and no breaks (usually) but at least admin can pay us for it. THey just don't want to pay and don't want to be held reliable if haeven for bid something happens to a pt because the nurse wasn't able to pee never mind eat. It sucks!

NYer's complain down south because 1. They're used to getting everything NOW! A New York minute IS different from the rest of the world. 2. Sick people in general are miserable and 1 minute feels like an hour when you're sick and noone is helping you. And 3. because they see other people who came in after them be seen before them and that really pisses them off. Even if you try and explain that it's not a deli, it's not first come, first serve, it doesn't matter. They were first and that's all that matters! The other people are not their problem.

I would imagine you're definitely going to need CPR, TNCC, PALS, and ACLS. As for when to take them, as Bullydawg said, probably will have to take them fairly soon, as in 3-6 mos. You're employer will tell you. Also, don't worry about your schedule. If they want you to take these classes (which most ER's mandate) they will either schedule you or give you the time off as long as you give them notice. Since you're new and on orientation, your manager is relying on you as a staff nurse yet so you schedule can be flexible. If the class interferes, either take another one or work a different night with a different preceptor. Sometimes working with someone else can work towards your advantage; seeing how they work and handle things. As for the other certs, in due time. You're going to need experience first. Good luck and welcome to the ER world :welcome:

I agree. There are no "scheduled" breaks in the ED. Some nights you're lucky if you get to pee though I does also depend on if you work days or nights. And if you have a swing shift. In my ED, we have nurses that work 11a-11p so that they can relieve day nurses for breaks and help during the busiest time but nights....HA we're lucky to pee usually. If you get to eat, that's even beter.

Dear Lunah Yes, there are a lot of those moments that are going to happen. Most hospitals will d/c the medics iv site (on the floors never in the ER) nor will they draw blood off of them. Phlebitis and infiltration seems to happen more often for some reason. Also using different drugs, using amiodorone instead if Lido (now that you'll have time to give it). You'll do fine in nursing school and on the boards. You have the drive and knowledge. Good luck.

I agree with Traveler. As ER nurses, we don't get to see the cough, sore throat pts. At least in my ER, they go to Quick Care or Express Care or whatever they want to call it. We get the GI bleeds, MI, pneumonia, A/P going to the OR, etc. 8 sore throats? I wouldn't be complaining. Just this week actually, we were short 2 nurses. I took the medical beds and agreed to take the pts in a room (actually curtain). Rooms 5-14. That's 9 pts. all stable, medical/surg pts. Some admitted and some ER. Anyway, the doc asked me to "just give" the guy in the hall a med. I told him no and that I had anyone in the rooms but no more. I was at my limit. I had 9 pts who "just" needed something or another. I didn't matter what they needed, I wasn't taking any more. My charge nurse was aware and the supervisor actually came down and started IV and gave some pts meds because we couldn't keep up. The doc got mad, probably wrote me up. I tried to explain that I have a license too. I may not have gone to school as long or studied as hard but it's my license and wasn't going to risk it. Now grant it, this doesn't happen all the time but still, admin doesn't care and God forbid if I missed something on those pts, I'm screwed, not admin. Anyway, 1. thanks for listening to me vent. 2. I agree, it's unsafe what they're asking of us. I wish ER nurses would band together like the CCU nurses and get a federal law passed capping us at a certain number of patients (acuity involved of course).

I too agree, between losing your autonomy and multi-tasking several pts are going to be your biggest things. You'll learn - as you have as a medic - that some docs are more leanient than others and will / won't let you do your own thing. Most ER docs trust the ER nurses and trust their judgement. Of course there are a few.... Your other obstacle is that you'll have continuing care. Esp those annoying pts...no more just dumbing and going. They're YOUR pt now. Oh the drunks and the fiesty elderly. Oh what fun. And Hospitalstaph is right, no bedbaths in the ER. Foley's and bedpans yes but you get used to it. It's no big deal. You'll adjust just fine. Good luck!

Ok, I have to ask a dumb question...what is scripting? From what it sounds like, it's a stupid questionaire. If it is, I had to do that at my last job, Press Ganeys they were called. I gotta say, on a slow night, we would read them and laugh. Unfortunately that's all they were good for. Admin did nothing to improve that situations or the complaints. And Dixielee, I am so sorry to hear about your hospital! I remember taking out the surgilube from the rooms when JAHCO came around. Oh and the NS in the liter bottles because someone might drink them! As for your tubes...that's ridiculous.:angryfire Here's what I do, though it's a pain. At the beginning of my shift, I make up IV start kits. I put everything I need to start and IV in a biohazard bag. And I make several of them. Try that and hide your extras in a drawn near your desk. Just remember to remove them at the end of your shift. They're great if a code comes in, no fumbling. Wow! I thought where I worked was bad. I am so sorry guys!

Nurses as a whole eat their young. I don't know why but we do. That's part of the reason for the shortage. We tell people horror stories and scare them off. Nursing students and newbies get a miserable burnt out nurse as a preceptor and they get a rash of crap because they don't know the answer. And of course the idle gossip. That's everywhere. I agree with Mjl, stay neutral and don't get involved. I love nursing but also get frustrated with it. Don't let your instructor discourage you. Also, it depends on where you work. I work with a great group of nurses but sometimes people just dont "play nice". It's what you make of it. Good luck and don't worry, it's not THAT bad and if it is, as Mjl said, move on to somewhere else.

I believe it stands for Bayonne, Edison, Newark, New York. All the "northerners" that come down to the shore from Memorial Day to Labor Day. That's the "Benny" season.

We're now there because it's so damn warm! As for the wait...yeah, pt's wait 3 hours just to see an MD, never mind the nurse taking care of them! Especially if the c/c is stupid...it's gonna be a while. I used to work at the Jersey Shore. In the summertime, the New Yorkers would come down (we would call them bennys). Anyway, our evals would go up because they would be seen in an hour vs a few in the city. That's so weird that they complain to you. Sorry

At my first job, I had to take telephone orders and hated it. The docs always seem to call at the worst time, get mad when you don't jump to the phone and say, "yes doctor, ok doctor, not a problem doctor". It stunk! And then to call them back because whichever med is non formulary at the pharmacy...YUCK. The ER I currenty work in has house physicians who come and see the pt's in the ER and then follow their care upstairs. It alleviates cellphone cut outs and taking up your precious time. The down fall is 1. It's not computerize so you still have to interpret his/her handwriting 2. waiting for the physician to come down and see the pt. Since the house MD's stay in the hospital it's great except when they're busy on the floor with a nurse/patient and you're waiting for orders. The patient has a bed and it's clean, just need orders. In this case, most ER attendings will write "interum orders". The floors nurses hate it but it covers our butts and helps decompress the ER. If only we were allowed to make the rules...this is the computer age and I still have to decipher a doc's handwriting. UGH!

I know what you mean about the drive by nursing. It's horrible. Teaching? What teaching? You drawn blood, give a few drugs, chart and move on. Hopefully in a couple of hours you can get back to reassess. That I don't mind that as much as the holding of pts in the ED. An ER is supposed to stablize and move on. Get 'em in, get 'em out. But when you have to do FS q1h and CE on 3 tele pts and ER pts, that's when it gets interesting. 4:1 That's so awesome. I need to find that! TamrRN07 is right, 8:1 is about average in NYC. but the ratio changes come holding season (what I call Nov to Feb). Hospital admins think the ER has limitless beds. The floors are full so keep them down in the ER and somehow we have to make room. Then go on divert or bypass because we're too full. Never ceases to amaze me.