trauma dog

I couldn't help but to reply to this one, as an ER nurse who tries to especially nice to staff of other floors (trying to convince them that they really should come cross-train with us) because of a mass casualty that nurses hospital wide responded to on and off shift and really saved several lives. OK, that said, first, not to bash RNPATL because I don't know the whole story, BUT, why would you not want to contact the physician for new-onset a fib, even if it is only paroxysmal. Wouldn't this patient need to be started on blood thinners and possibly diltiazem. It would be nice to know a big ol' blood clot isn't sitting there in the atria waiting to go on a fatal journey. oh, say to the lungs or brain. Secondly, here is a soap box of mine. I really really really hate when I call report to M/S floor, the nurse accepts report, and when we transport the patient to the floor, guess what, not only is the room not ready, there isn't even a bed in the room for the patient. When I approach the nurse about it I am told, "there may be a bed down the hall in 343b, but you"ll have to move it", now not only are we taking up extra time to do what I feel should have been already done, 2 staff members, a nurse and tech, are tied up doing a floor job when an ER full of patients are waiting and my patient is spending way too much time in a busy hallway often off the monitor. If the nurse had just said, "that room isn't ready just yet, if you'll wait till I call you back when it is, I get right to getting it ready", is that asking too much for my patients?

Our previous manager would always give us the third degree if we called in sick. She made a policy for our unit that if you called in, you called in to her no matter what time a day. She had a bad habit of not calling you back if you paged her because her theory was if she didn't contact you, you couldn't call in. Our manager now doesn't do that, if we have to call in now, we call the house supervisor if she is not in. The problem now is that when we go back there is always somenone who tries to makes you feel guilty. Don't get me wrong, I only call in about once or twice a year, but I shouldn't have to feel guilty about it. When I do call in, I'm usually sick enough that I would rather feel good and be at work. That's pretty darn sick.

How about getting a gsw to chest while your newly tubed/vented pt in room 2 (also your room) decides to now show that lovely s-t elevation and get a syst pressure of 74, oh yeah, he has no contraindications to thrombolytics, and the patient in room 3 (you guessed it, mine too) who's been waiting for a unit bed for 6 hours wants to join in the fun with 8-10 beat runs of v-tach. Who would be the brave individual to walk up to me and say "oh, this is not critical care."