R!XTER

Because it's mounted and glued to the wall. But this is obviously a larger issue lol he also roams the hallways looking for anything he can ingest.

Kudos to all of you who have so much else going on besides work! Right now I'm working and in school for my masters and a mom and wife, and my energy is depleted by those pursuits! I wish I had more time to volunteer, cook, or spend time with the family. Can't remember the last time I watched a full TV episode or movie. At this point I choose sleep over almost anything. I'm hoping this will all be an investment to give my family a better future, where I can work less and earn more. I just can't see myself being a bedside RN forever, I find it to be beyond draining (mostly due to the people, not the job itself which I do enjoy). Fingers crossed.

Patient came in describing symptoms of TIA but was back to normal by the time he got to the ER. "Any medical problems?" "Nope." (His wife) "tell her about the heart thing!" "Oh yes, I have Afib" "Do you take any blood thinners?" "No way! My Dr. Wanted me to but I vetoed that idea!!!" (Very proud of himself) "Why?!" "Because it's rat poison!! I'm on an all natural blood thinner. " ...yeah... How's that workin out for ya?

A few recent gems from triage: "pt complains of a fingernail stuck in her throat for 6 years; states it's causing fevers" "pt fainted as his fiance cleaned his infected toe" "pt arrives via ambulance for feeling tired and not wanting to take medication today" "I'm allergic to all medications." "All medications?!" "Yes. they don't work." "I have pain on the top of my head and my whole body is burning" "I'm pregnant" Laugh or cry??

Thanks for the support! As of now I'm trying to work through it on my own, but I'm willing to seek therapy if it gets worse. I'm hoping I won't need medication because I don't like taking medications in general. Sending hugs to all who are dealing with this problem!

Can I ask what kind of environment you work in now? I 100% identify with your post. I had a patient the other day who was just so nice and behaved so "normally" that I said to my colleague "isn't it nice when people are just normal?!" then the craziness of that statement hit me and I realized that sadly, I've become so accustomed to people behaving rudely/bizarrely/inappropriately etc. that "normal" is now "abnormal". Thankfully I'm in school, working on my masters, and paving my path out the ED door!! There is a light at the end of the tunnel!! (get through one more day...get through one more day...)

I feel ya. Some days on the way home from work I just burst out crying from all the sadness I've witnessed. It gets overwhelming.

Had an alcoholic patient yesterday, the MD order "constant observation: patient eats hand sanitizer if left alone" Best part of my day!

The ED where I work is very close to a local psych facility where the patients are free to come and go as they please (not lock down) and we are off the wall with it!! In our area they're using K2. They freely admit they are buying it at a bodega nearby, but since it's not officially illegal to sell, law enforcement can't do anything about it. We're seeing 5-10 or more cases a day. It affects each patient differently. Most come in really lethargic, some with stable VS, others with really low HR or BP. These are mostly psych patients so they are "repeat offenders." we keep them for hours to monitor HR/BP, then it wears off and they start waking up and becoming agitated, we discharge them and within hours they're back. SOOO frustrating. The psych facility takes ZERO responsibility for the problem. They just call 911 when they find them passed out on their grounds. EMS and law enforcement are equally fed up.

I'm doing a bit of an unofficial survey - I've been wondering if nurses are disproportionately prone to anxiety. This is something I've been dealing with practically since starting my first job (I do believe there's some genetic component for me as my Mom is pretty high-strung). I have also noticed from discussion/interaction with other nurses that many of my colleagues deal with anxiety too, but are not exactly "advertising" it. Outwardly, you wouldn't guess that I am so anxious because I try hard to appear totally chilled. Also, I feel very safe at work because I know if anything were to happen to me, I'm already in the ER! Anyone I have confessed this to is pretty surprised. An attending MD I used to work with is married to an RN and he told me that he says to his wife "nurses know too much and too little - they know a lot so they worry more than lay people, but they don't know enough to know how to fix the problem, or when the 'problem' is not really something to be concerned about." Personally I agree with this 100%. I work in the ED so I see some very sad/horrible/shocking things, and it definitely affects me. I have been having minor panic attacks for a while now, and I have become somewhat of a hypocondriac with several medical work-ups (endoscopy for stomach pains, MRI for headaches and dizziness, etc.) all which thank God showed nothing. There always seems to be another "symptom" cropping up and I try to tell myself it's nothing and to ignore it, it's just anxiety, etc. but it doesn't always work. I believe our jobs carry an inordinately high level of stress as well as exposure to scary things most people are clueless about, a combination of which is the perfect recipe for anxiety. Just wondering if anyone else is dealing with this too?

Sounds super unsafe. I would try to avoid being put out in triage with that system (or lack of system). Triage holds tremendous liability for the triage nurse, and it sounds like you are being set up for problems... If your management is receptive to suggestions for improvement, definitely to try to improve the system. Maybe get together a team of nurses who would be interested in helping you improve the process, and write up a realistic plan for safe triage and present it to your managers. Good luck and watch your back!

The only patient I remember yelling for a doctor was an elderly psych patient who was yelling for just about anyone and everyone at top volume. Somehow she got the resident's first name and was screaming "I need Dr. "Joe"! I need Dr. "Joe"!" Over and over Til we all thought we were gonna go crazy, while "dr. Joe" hid behind the partition in the nurses station. The rest all yell "nurse!"

Whatever happened to personal responsibility?

What doesn't kill you makes you stronger...

Why don't they ever yell "doctor!"?

Don't know if this was mentioned yet, but when people say "he's diabetic! He has to eat!" (Especially when they just walked through the ER door. ) Don't know who is educating these people, but most often their sugars are >200 and they're yelling that they must eat now!! Ugh I hate this. I very sweetly told this man whose wife was bugging me the other day about this, that his sugar is actually high right now, so it will be fine if he waits an hour Til dinner arrives. He looked so surprised, like no one had ever told him he doesn't have to eat around the clock. No wonder their sugars are all high...

Ok this is disturbing

Ugh I totally know this feeling, where you are constantly running from one task to the next without any time to process your thoughts so you constantly feel like you're forgetting something. By the end of these shifts I'm always just grateful that none of my patients died. Then when I finally leave, all I can think of while driving home is what did I forget to do, or what important piece of info did I forget to report? These situations feel so unsafe that despite doing my best and all my good intentions, I wind up fearing for my license.

Had a similar situation - really old lady came in for respiratory distress. DNR DNI, so the most we could do was bipap, which she was on. She was admitted to MICU but still in ED because there were no beds. She suddenly went into very rapid A-fib at a rate of 170's and higher and wasn't breaking after several minutes. Her 2 grandsons were at the bedside, one a pediatric ED attending, and one a pediatric cardiologist. I called the the MICU team, they said they were coming down but several minutes passed and they didn't, so I grabbed the ED attending who in the past I've found to be pretty close to useless but what alternative did I have? We tried cardizem with no results, other than making her hypotensive. The attending recommended cardioversion to family - BOTH DOCTORS and they agreed. We pre-medicated with fentanyl and when She was shocked her entire body jumped and she started moaning. I seriously felt like crying. I felt so terrible. Meanwhile the grandson leaned over the rail and says "sorry grandma, but I authorized that and I'm a doctor" I felt like smacking him. She converted back to rapid a-fib within a few minutes and they did it twice more. Ugh I thought I was gonna throw up. The image of that tiny little helpless lady on the bipap and her whole body jerking will prob never leave me.

LOVE IT!! Thanks for that!!

Oh- I also had a girl with brittle bone disease (osteogenesis imperfecta) she had tripped and fell on a concrete sidewalk, which was equivalent to a major trauma in a regular person because of the amount of injuries she sustained. Multiple broken bones and heavy blood loss. The poor girl was in such agony.

I had a patient with Marfan's once. He was extremely tall and lanky and developed several spontaneous pneumothoraxes and bleeds in his life. When I had him he had a spontaneous hematoma the size of a mango on his chest. Luckily everything was ok.

OP you expressed my feelings exactly. I am only working as an RN for 3 years, and I love all the aspects of the job that made me choose this job in the first place, but beaurocratic nonsense won't let me do the work I want to do! I work in a very stressful high volume ER and encounter lots of patients with difficult personalities, but i can deal with all that. What I can't deal with is management and administration making ridiculous and unrealistic demands on us, piling on new responsibilities an policies weekly, and all this from people who haven't taken care of a patient in 10 years. I realized this scenario is not going to improve so I'm exploring other fields within nursing because I do still love being a nurse. Once I have my master's though, I'm so done.

Level 2 trauma ER - 7/8:1