TraumaNurseRN

I wasn't having a bad day as it was suggested, I started the thread in the Er nursing area to give koodos to ER nurses. We rock!

omg...too funny....

worth the read ++++++++++++++++++++++++++++++++++++ guest editorial acep news september 2006 by david f. baehren, m.d. for a generation or two, we have lamented the loss of role models in society. as parents and individuals, we naturally seek out others we would like to emulate. sadly, a serious search through the popular culture leaves us empty-handed and empty-hearted. thanks to a long list of legal and moral shenanigans, many entertainers, politicians, and athletes long since abdicated this momentous position of responsibility. we usually look afar for heroes and role models, and in doing so overlook a group of professionals who live and work in our midst: nurses. and not just any kind of nurse: the emergency nurse. there are plenty of people involved in emergency care, and no emergency department could function without all of these people working as a team. but it is the emergency nurse who shoulders the weight of patient care. without these modern-day heroes, individually and collectively we would be in quite a pinch. this unique breed of men and women are the lock stitch in the fabric of our health care safety net. their job is a physical, emotional, and intellectual challenge. who helped the paramedics lift the last 300-pound patient who came in? who took the verbal lashing from the curmudgeon giving admitting orders over the phone? who came to tell you that the guy you ordered the nitro drip for is taking viagra? the emergency nurse has the thankless job of sitting in triage while both the long and the short buses unload at once. with limited information, they usually send the patient in the right direction while having to fend off some narcissistic clown with a zit on his butt. they absorb the penetrating stares from weary lobby dwellers and channel all that negative energy to some secret place they only tell you about when you go to triage school. other kinds of nurses serve key roles in health care and attend to their patients admirably. however, few function under the gun like emergency nurses do. it is the emergency nurse who cares for the critical heart failure patient until the intensive care unit is "ready" to accept the patient. the productivity of the emergency nurse expands gracefully to accommodate the endless flow of patients while the rest of the hospital "can't take report." many of our patients arrive "unwashed." it is the emergency nurse who delivers them "washed and folded." to prepare for admission a patient with a hip fracture who lay in stool for a day requires an immense amount of care--and caring. few nurses outside of the emergency department deal with patients who are as cantankerous, uncooperative, and violent. these nurses must deal with patients who are in their worst physical and emotional state. we all know it is a stressful time for patients and family, and we all know who the wheelbarrow is that the shovel dumps into. for the most part, the nurses expect some of this and carry on in good humor. there are times, however, when the patience of a saint is required. in fact, i believe that when emergency nurses go to heaven, they get in the fast lane, flash their hospital id, and get the thumbs-up at the gate. they earn this privilege after being sworn at, demeaned, spit on, threatened, and sometimes kicked, choked, grabbed, or slugged. after this, they go on to the next patient as if they had just stopped to smell a gardenia for a moment. great strength of character is required for sustained work in our field. the emergency department is a loud, chaotic, and stressful environment. to hold up under these conditions is no small feat. to care for the deathly ill, comfort suffering children, and give solace to those who grieve their dead takes discipline, stamina, and tenderness. to sit with and console the family of a teenager who just died in an accident takes the strength of 10 men. every day emergency nurses do what we are all called to do but find so arduous in practice. that is: to love our neighbors as ourselves. they care for those whom society renders invisible. emergency nurses do what the man who changed the world 2,000 years ago did. they look squarely in the eye and hold the hand of those most couldn't bear to touch. they wash stinky feet, clean excrement, and smell breath that would give most people nightmares. and they do it with grace. so, here's to the emergency nurse. shake the hand of a hero before your next shift. dr. baehren lives in ottawa hills, ohio, and practices emergency medicine. he is the author of "roads to hilton head island." he welcomes your feedback at [email protected].

worth reposting...... ++++++++++++++++++++++++++++++++++++ guest editorial acep news september 2006 by david f. baehren, m.d. for a generation or two, we have lamented the loss of role models in society. as parents and individuals, we naturally seek out others we would like to emulate. sadly, a serious search through the popular culture leaves us empty-handed and empty-hearted. thanks to a long list of legal and moral shenanigans, many entertainers, politicians, and athletes long since abdicated this momentous position of responsibility. we usually look afar for heroes and role models, and in doing so overlook a group of professionals who live and work in our midst: nurses. and not just any kind of nurse: the emergency nurse. there are plenty of people involved in emergency care, and no emergency department could function without all of these people working as a team. but it is the emergency nurse who shoulders the weight of patient care. without these modern-day heroes, individually and collectively we would be in quite a pinch. this unique breed of men and women are the lock stitch in the fabric of our health care safety net. their job is a physical, emotional, and intellectual challenge. who helped the paramedics lift the last 300-pound patient who came in? who took the verbal lashing from the curmudgeon giving admitting orders over the phone? who came to tell you that the guy you ordered the nitro drip for is taking viagra? the emergency nurse has the thankless job of sitting in triage while both the long and the short buses unload at once. with limited information, they usually send the patient in the right direction while having to fend off some narcissistic clown with a zit on his butt. they absorb the penetrating stares from weary lobby dwellers and channel all that negative energy to some secret place they only tell you about when you go to triage school. other kinds of nurses serve key roles in health care and attend to their patients admirably. however, few function under the gun like emergency nurses do. it is the emergency nurse who cares for the critical heart failure patient until the intensive care unit is "ready" to accept the patient. the productivity of the emergency nurse expands gracefully to accommodate the endless flow of patients while the rest of the hospital "can't take report." many of our patients arrive "unwashed." it is the emergency nurse who delivers them "washed and folded." to prepare for admission a patient with a hip fracture who lay in stool for a day requires an immense amount of care--and caring. few nurses outside of the emergency department deal with patients who are as cantankerous, uncooperative, and violent. these nurses must deal with patients who are in their worst physical and emotional state. we all know it is a stressful time for patients and family, and we all know who the wheelbarrow is that the shovel dumps into. for the most part, the nurses expect some of this and carry on in good humor. there are times, however, when the patience of a saint is required. in fact, i believe that when emergency nurses go to heaven, they get in the fast lane, flash their hospital id, and get the thumbs-up at the gate. they earn this privilege after being sworn at, demeaned, spit on, threatened, and sometimes kicked, choked, grabbed, or slugged. after this, they go on to the next patient as if they had just stopped to smell a gardenia for a moment. great strength of character is required for sustained work in our field. the emergency department is a loud, chaotic, and stressful environment. to hold up under these conditions is no small feat. to care for the deathly ill, comfort suffering children, and give solace to those who grieve their dead takes discipline, stamina, and tenderness. to sit with and console the family of a teenager who just died in an accident takes the strength of 10 men. every day emergency nurses do what we are all called to do but find so arduous in practice. that is: to love our neighbors as ourselves. they care for those whom society renders invisible. emergency nurses do what the man who changed the world 2,000 years ago did. they look squarely in the eye and hold the hand of those most couldn't bear to touch. they wash stinky feet, clean excrement, and smell breath that would give most people nightmares. and they do it with grace. so, here's to the emergency nurse. shake the hand of a hero before your next shift. dr. baehren lives in ottawa hills, ohio, and practices emergency medicine. he is the author of "roads to hilton head island." he welcomes your feedback at [email protected].

We are the beasty girls and boys aren't we? We get talked about, yelled to, nasty talk, complained about,kicked, spit on, peed on, pooped, trash talked all through a course of any given day. Even when you are trying to be professional when a nonER nurse gives ya grief because the ICU patient peed enroute to their empty waiting ICU bd with a 2:1 ratio....nice ratio eh?....we take it...until the dam breaks. People need to wear the dirty scrubs we wear everyday/night we work and then say what they need to say....but do it with a respect for what we do. We are the front door of the hospital yet deal with the back door philosophy. No-one wants to know exactly what goes on in any given day in the life of an ER nurse.....only a few can handle what we handle everyday 24/7...365.... So yank up our big girl panties and feel proud that WE work in the trenches, because others can't....and be proud of it.:smokin:

Yeah...I thought it too funny when one of the fellow ER nurses here told an ICU nurse....we wear big girl panties....omg..mad me laugh out loud....

what nursing specialty do you work?

hahahaha....should indeed be interesting....let us know how that goes..... looking forward to it

Yes, I see your point....please see mine. I do not like leaving my 3 ESI/2 patient(s) to transport a now stable patient to ICU, but it's part of our protocol and we do it. It can get quite scarey sometimes....Luckily you speak of only one patient whereas, I have 3 or more.....We all work hard don't we.....my new saying is....come on down to the front door of the hospital.....It's the ER!

I was invited to check out the responses to "ED admissions" by nrsang97 who recently visited the ER nursing site and voiced her opinion about a new policy her hospital instituted..... (having the ICU nurses come to get their patient from the ED). I must say, I thought there would have been much more discussion on this issue on this CCN site other than 2 responses before me. nrsang97 made it sound like there was actual debate and conversation going on. Frankly, she was rude and insulting on the ER thread. I got the impression she needed the ole 3 vacation days with a mimosa in hand somewhere on the shoreline. I see now....there really isn't a debate..... I think we all work hard, and in general overworked....I think it's a managment issue myself and feel it wrong that there now seems to be a ERRN vs ICURN issue here. I know from my own experience.....I'm never afforded the luxury of an empty room less that 3 minutes, the amount of time it takes for me to wipe the bed down, and prepare for my waiting EMS stroke/MI/MVC/Resp Fail/Full Arrest....etc.....let alone the bogus drug seeker, the drunk the police brought in, the hang nail from triage....constipated for 2 weeks (ick...manual dissempaction in my future) lady partsl bleed, omg and the list goes on. ...sometimes not even 3 minutes. She was actually quite rude and insulting.... We all work hard......we all deserve a break....and as I said in the ER nursing forum....It shouldn't be ER vs ICU RN....it's managment who doesn't care. If she is forced to be in charge, take a load, and pick up patients for admission or other transport.....it's not the ERs fault....it's the hospitals management.

I think a criminal is a criminal, and the police have learned through experience what works and what doesn't and the philosophy of safety to self first applies to them just as it does to the drug seeker in the ER angry and abusive towards staff when narcs are refused. I wouldn't begin to try and judge a police officer for their decisions to use force. If force is needed, it's needed. Koodos to the officers in our city. If yiou need cuffs and are not immediately doing what they say to do....force should be used. No brainer, if a cop tells you to lay down hands where they can see them and you do not comply....use force. :yeah:whoohoo to the fine police officers!

It can be a dirty, exhausting job but ya know, I wouldn't go anywhere else. We complain and whine but my co-workers love what we do....and do it well I might add....we have an awesome crew.....even the newbies... Has anyone mentioned the digital dissempaction task yet......ick?

lol.....I get hotflashes and t-shirts under my scrubs would be miserable. I do wear a sports bra though.

I think it depends on what has occured. In general, I have never seen excessive force used but rather force used to handle the current situation. Just the other day I had a patient who was verbally agressive towards me, when the doctor came in he became physically aggressive as well. It took 3 security men the doc myself and another nurse to handle and then medicate. First line....Is to protect yourself.

Is this post for real?

According to my husband who sold nitriles, among other gloves (Safeskin) before they were bought out by KimberlyClark. There is not only latex allergies to gloves but the powder and proteins in the gloves can cause reaction. I am not trying to tell you what to do.....but a barrier over and above a glove and ice should have been used.....sorry to hear of your problem.

was there any other barrier used besides the glove?

I read the posts you are referring to.....2 people responded....And yes there will be no understanding at this point, and that's something we can agree on. I thought you were done with this ER nursing thread?

apparently you too haven't worn the ER clog

What?...now you know I have never had crippling pain? hmmmmm....

Plese don't try to tell me how to be a good ER nurse. My question was a question which is asked every minute of every day in very ER around the world if the nurse is worth her skills. Plain and simple....don't insult my intelligence. BTW: I have refused to medicate a known drug seeker and yes the doctor has then canceled the order. You really have alot to learn about the specialty called ER nursing.

Pain is a subjective thing so suggesting that someone isn't having a migraine because they can work through it, is ridiculous. I still think migraines are non-emergent.....and sitting in triage for 7 hours could have been spent at home in bed with meds prescribed to treat the migraine. And drug seekers/fakers do come in complaining of a migraines. I think this venting ER thread is interesting for sure and you can tell who's worked in the ED, who hasn't and who isn't even in the medical field. Unless you've walked in an ER nurses shoes....as the saying goes

:yeah::yeah::yeah:you go girl! tell it like it is!...lovin it!

I just asked you a question about whether you had contacted your primary about your 3 day migraine. Protesting a simple question or becoming angry because it is asked, puts up a red flag in the assessment process for me.

There's no explaining the ER nurse perspective at this point. Unless you have worked ER it's understandable you wouldn't know exactly we do. We aren't able to hold beds, period. Many times the squad is waiting outide the room of the admitted patient and we are treating them right there. Where do you think your patients are coming from? We stabilize them an ship them out, it's our job. We do not have the luxury of holding any bed. They just keep rolling in.