rzookrn

Just this week this happened to me. I answered a call light in our at the moment extremely busy ER. A female in her 50s, dx with a common cold says "where's my nurse, I need to be discharged. This whatever I have isn't going to get better sitting here." I politely informed her that her nurse was in with a critical patient at the time (new onset seizures, ams, possible brain bleed) and she said, well then you discharge me. I told her I would start the process but because I am triage if there is another pt signing in I will be interrupted. I walked out of the room to pull her meds and met the nurses aide who told me that she had just been in that room and explained the same thing to this pt. The pt told her, I don't care about the other pt, I want to be discharged. Now had this woman been in the ER for hours I might have been more sympathetic. She'd only been there about 45min at this time. I know we all have stories like this but sometimes its all I can do to bite my tongue! One pt even told me, well its not me who's dying so go get the doctor I want to talk to him. Sorry...docs in with the code right now. Have people no common sense???

radiologist interpretation of an abd series... "funny looking cecum" I mean, really??! Maybe it caused him to chuckle...

"When I noticed there was more, I had to get my charge nurse. Now, keep in mind this is a very large older woman who was screaming and yelling the entire time. It took 3 of us to get the rest out ( 2 to hold her down, 1 to dig) We got a p-nut butter and jelly sandwich out of her lady parts.Who knows how long it had been there, but it didnt smell pretty. Can anyone tell me does this happen often with elderly women? I know every case is different...But this scares me! :uhoh21: OMG I will never eat another PB&J sandwhich again:nono:" I have definitely been blessed with an iron stomach. I read this story and thought, mmm, a pb and j sandwich would be really good right now! lol. The only thing that really gets me is GI bleed, like has been bleeding for days/weeks. I once had this little old lady from a nursing home, bil AKA, GI bleed, and very dead. She coded at the nursing home and was not revived enroute or in the ED. I tried to clean her up before taking her to the morgue. Oh my. Every time I would roll her over to put the body bag under her, more horrible smelling GI bleeding diarrhea would come out. Finally after running out of the room gagging (and laughing) about 4 times, I put a towel under her buttocks and zipped her up and took her to the morgue. It was unreal how bad the whole ER smelled for hours after that!!!

these aren't charting bloopers-- but I work in ER, and working triage quite often, I'd like to type just what the patient tells me. Examples: 80-ish yr old woman tells me she saw blood in the toilet but she didn't have a bowel movement so she doesn't know if it came from her rectum or her "majina" "janiva" "whatever its called" hahahah!! she was so cute. "I have fibronalgia and its acting up" "I think my prostrate is enlarged" (hear that all the time) "I was out in the sun yesterday and now my face is swollen and I'm afraid my throats gonna swell shut" now correct me if I'm wrong, but I really can't see that one happening!??? A girl I used to work with was joking around and typed in " I am a sl*t and I like to ***unrepeatable*****" and was showing it to another nurse and accidently hit file! We can "undo" documentation but it still shows up in the chart, just has "undone" after it! Ahhh, watch what you say! I work nights and it can get pretty hairy after working a few in a row. One RN actually started typing about her dreams!! Fortunately she woke up and erased it!! I find myself writing about what people at the desk are talking about when I'm tired. Happens to us all! I'll often call report to the floor and go, oops, I charted that the IV is in the LAC, but really, its in the RAC. (dyslexic maybe?) And my personal pet peeve is one nurse who's first nursing note is the SAME for every patient, no matter what the heck is going on with them. "resting in bed, resps easy nonlabored lungs clear abd soft nontender skin fleshtone dry alert and oriented." Just like that, no punctuation, etc. His assessment then reads "unconscious... or rhonchi heard throughout, etc" HELLO?! Try to defend all that in court.

This could be my story, nearly word for word. I started out on day shift for orientation in the ER...then flip flopped back and forth between days, nights, afternoons and my poor body had nooo clue what it was supposed to be doing. I was miserable. I loved my job, loved ER but I was becoming a miserable person from lack of sleep. I begged for steady night shifts. My boss told me that she required her nurses to have two years experience before being on steady nights. Fortunately for me, my boss doesn't do my schedule. I got my steady nights, I've been on steady nights for a year now. I'm a happy nurse again :) I'm so a night turn person. I even stay up on my nights off. (like right now). My advice-same as the others...hang in there!!! There is something to learn on those chaotic day shifts. If nothing else, you will just be extra happy and content once you're back on nights!!! Good luck

Oh wow, this really strikes a chord with me. I can understand exactly how you feel... I work in ER, so my situation may be a little different, but the same types of people still come through there. For example, the "not so sick" want more and more blankets, seirra mist, sandwhich, more pain meds, etc. Meanwhile in the next room I'm trying to keep a critical patient from crashing on me. I love my job. I love interacting with patients and there families. I see such a lack of common sense and love for humanity in general. If I had sprained my wrist, I could understand why my nurse would be taking care of the guy having an active MI, or is unconscious, or the baby who is dehydrated and needs IV fluids, etc. I have resorted to telling my patients that. "I just want to give you a heads up, I have a very sick patient next door and I'm going to be tied up for a little while, is there anything I can do for you before I leave?" Most times this satisfies them and they are understanding. Our hospital recently started this policy that we have to round every 15 min. In theory this is great. In practicality, Oh my!! I can be stuck in a code room longer then 15 min. I can be initiated 3 iv's and hanging heparin, nitro, integrillin and giving asa and plavix for longer then 15min. I can be trying to calm down a pediatric patient so that I can assist with splinting their fracture for longer then 15min. How do you tell management all of this? I've only been a nurse for a little over a year... I can only imagine what the "politics" will be like in 30 years from now!!

I hear what you're saying. But we also have to protect the patient from themselves, and protect staff and other patients. There's a lot to be said for your attitude in how you approach patients when searching them. I like to make sure that the patient is okay with me going through there things. So far I haven't had any problems, and yes, I have pulled a few knives off of mental health patients.