stretch thin

Ok, I've got a question. I had this 24yr old female come in last night. She is 5mths pregnant(>20weeks gestation) and she drank carbarator fluid. She has a know history of self mutilation, amphetamine abuse, huffing paint and drinking carbarator fluid in the past. Question is: Isn't this considered child abuse? Especially now she >20wk gestation. It's a viable pregnancy, correct? Any input on this would be great. We had a 2 1/2 mth old infant that we coded last night 2 to child abuse. I would like to prevent that from happening with this situation. Thanks

Need advise. I'm having trouble turning my nights and days around. Translation I work nights. Usually 3 in a row and we work 12 hour shifts. My problem is that I have teenagers and a husband that are day people.(NORMAL PEOPLE) When I get off my third shift, I'm dead. I work in the ER and many times you don't sit down for the whole shift. I want to beable to see my family, but I'm so use to my day sleeping and night working that I can't seem to switch. I can't afford to go to days and don't want to. So whats the answer? Any advise I would appreciate it. Thanks.

My question is, does anyone read the paper or watch the news. Everywhere in the united states the ER is used as a clinic, let alone an emergency room. We see the worst of people. One because their in pain, which would make anyone cranky. They give these surveys to these people on arrival. Common on, that's smart. I mean EMERGENCY doesn't mean FAST CARE. Where people get this idea, I have no clue. It takes time to find out why grandma , who is 90 years old and has extensive medical hx, has been constipated for a month. I have had people scream at me because I haven't gotten them back as soon as they check in. I had this guy scream at me one night because he had been waiting 2 hrs, because he hadn't seen a doctor.(He came in because of back pain, which he had and he was out of his Lortabs) He cursed at me till I had enough. I had given my same routine. Sir we are extremly busy, we are trying to move people has fast as we can. Still wouldn't stop. So I took him to the back to show him exactly what I had to deal with. All rooms full, halls full and 2 ambulance crews waiting in the hallway to place pts. You would think that would be an eye opener. Nope, he still continued to complain. I had a few chosen words for him. Face it, we do the best that we can! Surveys don't mean anything. Please feel free to print this and show this to your manager, because it's this way everywhere. And with so many people out of work, the ER is these people primary care. Wheather it's right or wrong, it is.:)

Acquity? Does the management really look at that? I know at my hospital, it's a body with a degree. They don't care how many they pile on one nurse. I have been argueing with management regarding a aquity scale vs the nurses we have. I know often times we hold ICU pts because the ICU nurse can't have three-somes, but yet we have 4-5-6 pts and sometimes even 7. I know personally, being the charge nurse/transfer coordinator at night, it's often difficult to handle all of that plus take a team. I'm not one of those charge nurses that sit on their butts. I feel so bad because I don't think I give good care and that's why I went into this position. IE. Stretchthin!:uhoh21:

Hi yall, I've been in nursing for 5 years and I live in Tulsa. I'm a die-hard ER nurse. Thought I never would say that, but I am. It's got it's ups and down, but you diffently get a variety of people and situations. I would love to continue my education, but unfortunately, cost is a big factor. Would love to know about any scholorships out there. Thanks

Don't you love her job! Everyone ask why we are the way we are. Well take a good look at what we deal with. Last Saturday night: all 13 beds on the ER side full. All MC beds full. 5 in the hallway-2 of those need monitors, but unable to pull anyone in the hallway, because they need to be on monitors. So as the charge nurse I have the hallway beds and the 1 of the MC room.(we always keep on MC room open, because it has a monitor in it. Usually used for chest pains) Plus with my lovely charge nurse position, I'm also the transfer coordinator. Which I had 10 transfer calls, 8 of them I got to. So yeah I know exactly how you feel. I always say, it's a good thing I color my hair, because I would be gray haired. Hang in there. We love being ER nurses!

As a charge nurse myself, I do know the struggles that the charge nurse takes. There are times when I snap, but I always apoligize to the other person. Everyone in the ER is backed against the wall already, they don't need a charge nurse that is a b----!. I think you need to talk with her and tell her your stand. For one thing, she's not the boss, even though she thinks she is. She is a fellow co-worker. At least that's how I feel. I always tell my my co-workers if they have a problems with thing I do or the way I act, please don't hesitate to come talk to me. I don't want anyone to feel uncomfortable. We are a team and if someone has conflict with me or another staff member, then we're not working as a team. I hope that helps.

We all have good triage stories but jay levan has a point. I know I get very frustrated when the encoder goes off or I see all the people in my town check in. People need to be treated granted, I think what everyone is saying the system is abused. I also agree that our government is not doing anything to change that situation. Look at how well their dealing with the nursing shortage. On the other hand it's the PCP's that aren't doing their job. Example, we had a pt that did the right thing, he went to the after hours clinic for his c/o. They did some lab(which by the way shocked the heck out of me). The labs came back and they were totally screwed up. It read that his hemoglobin was 2. Now if this doctor had looked at the lab closely he would have realized that it was a contaminate specimen. No he sent him to the ER. We finally sent the man home after a 5 hr wait. I ask pt why they didn't they see their doctor for their complaint. Some people say "I didn't think about it" or "they told me to come here". People need to be educated! That's the big problem, because it's not happening. Just my thoughts.

I work at 557bed hospital and we have to call in our CT person and the results are faxed to Austrilia. So yes it does take along time. Granted someone should have explained to your husband what exactly was going on, but I know sometimes we do get caught up with other pt. Please don't think the ER staff doesn't care. We're just like everyone-short staff:rolleyes:

Ok, hears the answer. From a person looking on the outside, sure 40,000k per year sounds great, but many of us have families which takes a big chunk. Then if you took a student loan to go to school, there goes the other chunk. Next you have to look at the job as a whole. Under the discripition of nurse: maid, housekeeper, nutrionist/dietary, intrerpretor, social worker, and sometimes a security guard. Now what do all those people make a year? It doesn't add up, does it.

I love the ones that say; I take this pill for my b/p, I don't know the name of it but it's a little yellow pill, you know what it's called. I feel like saying, oh yeah I know which one it is, but isn't that for being stupid.

Oh I think I've got the best FF's. It's a husband and wife that between the too of them weigh about 7001bs and both of them are in wheelchairs. One wheelchair is powered which the man drives and the other is manually which she is in. She holds on to his wheelchair while traveling down the road or in the halls of my ER. And by they way, he has a foley in. Please don't ask him how that works in their relationship. I'm kinda of scare to know. We simple cringe when they come in, because I don't think they have water or soap at their home. We see them very quickly, give them Lortab and send them out the door. I have another one. This guy always come in by ambulance, of course. They pick him up at Media shops or @ the strip clubs. Same complaint: Chest pain and dysuria. Always wants a female to put a cath in. I'm not touching that one.

Where I work is in the bad part of town and to top it off we also have a behavioral hospital across the street from us. So you can only imagine what we get. Our security guards are limited to what they can do and for PD, oh that's a joke. Their the ones bringing them in. Anyway in cases where the patient is extremly verbally abuse, that's when you give them the 10 & 2. DEFINITION you ask 10mg of Haldol and 2 of Ativan. There wonderful drugs, unless the pt has been taking PCP. Nothing pulls those pts down. I had one doctor get so angry at a patient that was being verbally abuse, he intubated him and then he said TAKE THAT! We all busted up laughing. I know not nice, but it was funny

Oh yes, does it ever. And to top it off, those pt's asking, or let me rephrase that, demanding food are the ones that come with abd pain or n/v. You want to ask them, where's your sign. (Stupid sign that is)

Thanks. I hope things will change. The hospital I work at has been sold:) and I hope this new company will elimante several of the administration. I could only pray. Please don't get me wrong, I would hate to see anyone lose their job, but I do want people to DO their job. Thanks again for all the advise. It helps:balloons: