GOMERNATOR

I've been in the ER for 18 years plus 2 years PACU concurrently. (Went full time PACU but still worked ER prn and as an agency nurse) I think I would like to explore several things. Maybe be a drug / medical equipment rep, look into offshore oil rig nursing, (yes, from what I understand everyone of those rigs has an RN or EMT-P on board), perhaps informatics... i dunno.

I have worked at large and small hospitals and everything in between and while it varies in severity a few constants seems to run through all the facilities. For starters beds being released after an admit order gets put in. Sometimes, it has taken several hours to release a bed. Various excuses from it's not clean, to we have to move a pt out of that room to name a couple have been given. Another issue is, again it varies, is trying to get report called to the floor. I do not have time to remain on terminal hold, and it's been my personal experience having the nurse call me back is dicey at best. Finally, admit orders heavy with "now" orders. Yes, sometimes they are warranted but not in the excess I have experienced. Oh, one final thing. Holding an admit pt in the ER so an admitting doctor can come see them before transporting to the room. Seriously? Walk the extra 100ft to the elevator and go see the pt upstairs.

I know of very few ER nurses who enjoy hold patients. As previous posts have pointed out many times hold pt's orders get missed resulting in late completions or not at all. I know as soon as I walk in and look at the board and see hold status by a pt's name it just darkens my mood. Many times it is not a lack of physical beds but nurses to take care of the pt's being admitted. I could deal with it better if it were the former and not the latter. Bottom line hold pt's are drain on morale and not conducive to good pt care overall.

:dpffffffffffffffffffffffft

I have been a Trauma/ER nurse for 14 years and last November I decided to make a change. I figured I was getting burned out or a bad attitude or was already so crispy I wouldn't know the difference anyway. So, a friend who already punched out (from the ER) to PACU suggested I try it. A night position had just opened up and so hesitantly I took it. The hospital's orientation to PACU took me through the three of the surgical experience. My thoughts are as follows and reflect my own personal tastes, experiences, and observations since last Nov.: 1. PREOP-- Wouldn't have that job even if you threw in complimentary booze and guest pass to the Mustang Ranch all inclusive. HIGH stress getting people ready to be cut open. Paperwork out the ass! Nervous patients, even more nervous family members. People have been NPO since before midnight. They are thirsty, hungry, and anxious. Did I mention the paperwork? Consents for just about everything short of taking a dump. Labs to draw, results to be reported, surgeons and anesthesiologists to find, etc. etc. and all the while that clock is ticking down to go to OR. 2. INTRAOP (OR)-- In a word, BORING. (my opinion OR nurses, not an insult!:)) Put on your hat, booties, gloves, and in this hospital, what I can only describe as a Bio-HAZARD SUIT. Which I guess is exactly what it is. Now, stand there from 1-6 hours depending on the case and sometimes longer. If you're lucky the surgeon's musical taste and yours are somewhere in the same ballpark. Otherwise you are stuck in audio hell. 3. PACU--It's a GRIND. You can recover most run of the mill surgery patients in about hour or so. I mean they are scheduling on just that, the pt. being gone in about an hour. You can hold up the OR if too many patients are in PACU longer than that. OR HELD UP= NEXT SURGERY HAS TO WAIT= THAT MONEY IS NOT BEING MADE. So, You roll one out and they roll one right back in. On a busy day this can go on NON-STOP ALL DAY. And I am serious about that money part. The OR brings the hospital $$$$$ and they don't like that cash cow sitting idle for ****. Bottom line :redlight::banghead:PREOP-- most stressful related to responsibility of paperwork and getting pt to cutting board on time.:barf01: :grn:OR-- you will die of boredom or kill yourself because you have heard this same Inglebert Humperdink song 6 times today. :hpygrp:PACU not much stress but pace is monotonous/repetitious. JUST MY OPINION AND YOU KNOW WHAT THEY SAY ABOUT OPINIONS.... GOMERNATOR

Oh yeah get those a lot. That and the ever present "now" order. reason: "Well if I write it for the floor it won't get done in a timely manner" Seriously? Sure just add to my &@^$&@!!! workload! Sure anything to make it easier on the floor. Christ i already have to start all antibiotics plus fill out a med rec sheet complete and make sure the doc checks of what he wants to keep, modify, and or d/c. All the while hell is breaking loose. Yeah great sparky. Appreciate you. :angryfire GOMERNATOR:smokin:

DEPENDS ON THE SCRIBE. SOME ARE GREAT. SOME, ON THE OTHER HAND, THINK THEY CAN GIVE ME VERBAL ORDERS AND DO NOT LIKE IT NONE TO WELL WHEN I TELL THEM I DO NOT TAKE ORDERS FROM ANY ONE BUT A DOCTOR. ANOTHER PROBLEM THAT I HAVE RUN INTO BUT MUCH LESS FREQUENTLY IS WHEN THEY WRITE AN ORDER WITH AN ERROR IN IT. SOME ARE OBVIOUS AND SOME NOT SO MUCH. I THEN HAVE TO TRACK DOWN THE DOC AND GET CLARIFICATION WHICH WASTES EVERYONE'S TIME.:angryfire GOMERNATOR:smokin: (YES I TYPE IN ALL CAPS. NO I AM NOT YELLING. IT JUST SUITS MY HUNT AND PECK METHOD OF TYPING)

I am an ER/Trauma nurse. Been one for close to 13 years now and am considering a position that has come open in our hospital's PACU. I would be nights and would recover Phase I/Phase II. I have already interviewed and been offered the job. The Unit Manager says I will fit in great, should have no problem transitioning, orientate until we all feel comfortable cutting me loose by myself at night. I would recover the emergency surgeries, appy, ortho, etc. type stuff. No hearts. No major trauma as in my facility they go straight to ICU where a bed is ALWAYS kept open. The "occasional" late case and sometimes care for "holds" when needed. So, you "salty" PACU nurses, cut through the bull for me and give me the straight dope. Does all this sound correct? In your opinion is it a fairly smooth transition for an ER nurse? What should I be wary of? Questions that I need to bring up before strapping in? Thanks for your insight and please for your no holds barred comments. (I'm a seasoned inner city ER nurse. My skin is thicker than you can believe!) Again, thanks! GOMERNATOR

It works well as long as the two departments communicate, ER is not shoving patients to ICU when it is unsafe to take them and ICU has learned to be a bit more conscientious of the needs of ER in moving patients out as soon as possible. so, what's the point of the Intensive Care Unit then?

There are good cops, bad cops, good nurses, bad nurses, good mechanics, bad mechanics, etc. etc. Speaking for myself outside of work I am leery of them. They have far too much power and very little oversight. If a cop is unwarrantedly being excessive physically or verbally what is one's recourse? Pretty much nothing. Absolute power corrupts absolutely.

:hpygrp::hpygrp::hpygrp::hpygrp::hpygrp::hpygrp::hpygrp::hpygrp::hpygrp::hpygrp::hpygrp::hpygrp: scabies!!!!!!!!!

I prefer something in a sensible boxer. (Let's stuff breathe while spending 12 hours in a super-heated trauma room) However, if the big girl panties must be pulled up snugly and worn high and proud, I must. Besides, wouldn't be the first myself or the gang I work have seen a man walk in the ER wearing panties.:rckn: :mnnnrsngrk: