tymomrn

Worked in a state prison for 6 months. Got along better with the inmates than I did with the staff. The inmates treat you with respect for most part. They know that you are not there to judge them. Safety was never an issue. Basically passed meds. Easy, boring.

We are in the middle of a snow storm right now and just got a cabulance(great word!) for an infant that the parents were worried about because it wasn't eating right. He's tired! It's 4am!

We have a total of 33 beds in our ER. We have a peds ER, fast track, even a seperate second trige room with 3 beds that never gets used because it's too far for the docs to walk. We hold more often than not, sometimes we even get hold nurses! Other than that we deal with 1 charge RN(no pts),1 triage RN, and 4 staff RNs after 11p. We lose 2 RNs at 3a. It's not bad, when it's actually staffed like it's supposed to be. But we ususally work short. Oh, and 1 doc after 1a. Winter is the worst, of course. But they try to get hold staff if they can. When it's unsafe, we fill out a specific grievance form with the union. I had one night when we got up to 27 holds(ICU in the hallway!), 2 hold nurses, 3 ER nurses. Of course, they ALL had holds, too. I was in charge, covering triage(we didn't have a seperate triage RN yet), and hadling base calls for the medics in our county. And it was 3rd time in charge! I called my manager, she ASKED if she should come in. I actually said no, because I knew she never worked ER, wouldn't do pt care, only breathe down my neck. Then 2 L&D RNs came down for blood exposure ( not wearing gloves, THEN found out pt was HIV+) and had the nerve to complain the next day about their wait. BTW, that is our record so far for holds.

We had a guy in 3rd degree HB, found on his kitchen floor flat on his face, unable to get up, no palpable pulses, but AAOx3. Was REFUSING to come to the ER. Medics finally talked him into coming, then applied the external pacer and proceeded to pace him sans sedation. The only thing he wanted when he came in was breakfast. We like to call our ER a drivethrough. That's how fast most of our "customers" want their "service".

I married at 22, always made more money than him, so that was never an issue. I worked fulltime while getting all my classes other than nursing done, AND during nursing school. My son was 2 when I stated nursing school. He was a momma's boy, the baby of 5, his mom was 43 when she had him. He tried cleaning once in a while, I wound up cleaning his cleaning. I worked 8 hour shifts before I became a nurse, 12 after. But 4-5 days a week to pay bills. He only worked my days off, 8 hour shifts. I had to make sure to keep at least one day a week off to clean the house. I resolved myself to that, wanted to keep my marriage intact for my son. Then his mom got cancer. Was given 6 months. I thought thing were going well, we were trying to get pregnant, when he tells me that he still loves me, but is no longer "in love" with me. It wasn't sex-I wanted it more than he did. Probably because he was going out with co-workers after his 3-11p shifts, then being too tired for anything when he got home. We always worked opposite days for child care, so those were the only days we had. Anyway...This was in late December, he wanted to stay until his mom died so she wouldn't know about it- being the first divorce in his family and all. His mom had her first chemo tx in early Feb, 3 days later got a serious bowel obsrtuction, came into my ER with a bp of 80, she went to sugery 2 days later and couldn't get off the vent all week until she pulled her own tube on Friday. I was there with her every moring after work and every evening before work. When she went downhill after pulling her tube, I was the one who discussed the morphine gtt with my family. They were great, they didn't want her to suffer any longer. They fully understood what was going to happen. I was the one who also stayed with her the first night when she on comfort care, waiting for her to die. I worked the next night, and left the ER to see her when she did pass. I balled my eyes out for 10 minutes(I loved her, she was a great lady), and went back to work. Through all of this, my ex said I was not supportive enough of HIM. He left, I said good riddance. My son is better off, and I am MUCH happier.

Most new grads need some direction, and I love to teach and tell war stories. But others who may have had some prior experience come out thinking they already know it all. I was an aide for 10 years before graduating and I was still scared of all the respsibility. I was always able to tell the nurse what was going on, and it was out of my hands. Now I AM the nurse, it's all on me. Others, however feel that their prior experience makes them the s***. One nurse I work with in the ER is like this. She was an EMT, a lousy one at that. Now she gives attitude when other nurses try to help her with critical pts(she's been here 1 year, only ER). The other day she took an intubated pt to CT then right to the unit. No CXR for this pt tubed by medics. And SHE got peeved because the ICU nurse gave HER attitude about it! It's just those new grads who already think they know it all that need to be taken down a notch before they kill someone. Sorry for the rant, but this chick REALLY gets on my nerves!

Part of the problem is that so much of society see us as"handmaidens" to this day. They have no idea what it takes to care for them. Some think all we do is fluff pillows! That our job is to smile and bend to their every whim, and that all it takes to be a "good" nurse is to do just that. They don't realize when we notice things like those rales before they're even SOB, EKG changes when they don't have CP, early decubes, abdnormal labs that the doc missed, meds ordered that the pt is allergic to, or is contraindicated due to pt's condition or other meds the pt is already on, BECAUSE WE DON'T TELL THEM. We just do our jobs and go home with the satisfaction that we really did take good and proper care of our pts. And just because we care FOR them, doesn't mean we have to care ABOUT them.

In the ER, I love when they come in and think they are going to get one thing, then they NEED osmething completely different and refuse it.Out comes the AMA form! Until they find out that their insurance might not pay for the visit. If the pt has been a PIA, I make the doc go in to explain the risks and get the signature. As long as they are informed of the risks, they sign that magic form, and you document your tail off, I say let 'em go.

Our ER docs treat us with a lot of respect. They know when a nurse has good judgement. The attendings are a whole other story. As long as you tell them that you will not accept that kind of treatment and can show them that you have a brain, they will give you the respect you deserve.

Wolff-Parkinson-White Syndrome. A type of tachycardia that doesn't respond to convention treatment.

Pulled a foley out of a NH pt one night. The crap that came out was the worst I've ever seen. Thick, yellow/green, and the smell was horrible! THAT made me gag!

It's a bad idea to snort coke when you have WPW. This guy got a 14g IV.

Was given in report that this pt with mental status change never had a pulse ox done, the nurse was unable to get one. Took 30 seconds to try another probe. Then, when it turned out to be 70% and I went to increase the O2, found out the NC the pt was wearing was actully attached to AIR not oxygen. Needless to say, the improved rather quickly.

MOST of our housekeeping staff really do work hard. We treat them as equals. We had a party for one when he graduated college. They see how hard we work, and that we don't call them for little stuff. We even know their names! We try to act as a team. Sounds corny, but it works!:)

I've seen plenty of doctors come in dressed in jeans or sweats/shorts if coming from the gym! One guy I work with wants uniforms like the medics. Um, no thank you. Why? We don't do hands on pt care just take medic calls. Hell, I've come in in t-shirts! Nobody sees us in this box. When I work ER, I wear scrubs, but they are always neat and clean. I hate when tops are short enough so that when someone bends over you can see the tattoo on her back. Most of my tattoos are covered, as well they should be. As long as you are neat, clean, and professional looking, you should be able to wear whatever you like.