RoxCRN

Well as the saying goes, Nurses make horrible patients and I guess I'm no exception but not without cause. I think we hold the nurses that care for us to a higher standard because they know we are watching. I had emergent surgery last year requiring admission to the hospital for 2 days. Normally I wouldn't advertise that I was a nurse but I got sick while I was on shift and didn't have street clothes, just scrubs. Of course the ER staff, my co-workers and docs were awesome with me, they know me personally. The floor nurses didn't know me from Adam. I never was cruel, I never bothered, I never pushed the call light. I also didn't see a nurse, not once for 8 hours. No vital signs, nothing. I wasn't on tele so I could have died in that room ( as unlikely as that is but stranger things have happened ) and no one would have been the wiser. The next morning after my surgery my nurse post op refused to give me pain medication because I had received 1 mg of Morphine already and I had reached my limit. ( Really, my drug seekers in the ED get 2mg of Dilaudid at a time for their headaches while eating McDonalds, but I reached my limit after 1mg Morphine after abdominal surgery!!!) I told her if she didn't call the doctor right then I would and he would be giving her orders, she called and I got 1mg more...it was all I needed. That was the only time I was outwardly cross, but darn it I hurt!! Later she asked how my pain was and I told her OK but since I had been NPO for over 24 hours and just now started clears, I asked for tylenol for the headache I had developed. She says to me "Oh you dont have an order for tylenol" In my head I'm saying listen here miss thing so call the doctor and get a frickin order!!! To the nurse I say "Fine I will be ok" when she leaves I go into my purse and take 2 tylenol. The rest of the stay was pretty much the same. Nurses didn't check on me probably because I could check myself. I changed my surgical dressing, I checked my incisions, I monitored my urine output, I noted when I had my first flatus. When the morning shift came in the second day, I soooooo badly wanted to say"you know that pretty little thing you have around your neck is called a stethoscope, you're supposed to use it to assess your patients!! I had not been assessed once since surgery! Instead, I asked if I could take a shower. "Oh you dont have an..." I didnt let her finish..."let me guess, I dont have an order for a shower...OK" when the doctor rounded 10min later he tells me I could have showered last night. Needless to say I was less than impressed with the nurses but I didn't complain because I didn't want to be "that patient" I went home, all was well, I healed. 2 weeks at home I get a call for follow up and reminder to fill out the "Patient Satisfaction Survey" I told the nurse that called "you really dont want me to do that" she asks "why?" I reply "Well......" and I laid into her everything. Honestly, I didn't think I was gonna be that patient that complains, but after thinking about it I was ******! I'm gonna pay for a hospital stay where I provided my own care! Do I at least get a discount!?!?! What I take away from this is simple, just because your patient is a nurse doesn't mean you give better care, or in my case, leave them to fend for themselves, it means you give them the same excellent care you give all your patients!

Very well said!!

Really!! What is wrong with people! Although I swear nothing should suprise me anymore...I had a 67yo lady come in with an LSD type high, cardiac arrythmias, hallucinations, the whole bit. Her tox screen was negative. Come to find out later that she was smoking bath salts cuz she saw it on the internet....Seriously?!?!

The longest wait time I had in the ER while I was working was over 10 hours. Compared to some other posts, doesnt seem like a lot, but I should mention this was a suburban/rural hospital with only 24 ED beds, and 115 inpatient beds counting ICU. Not tiny but not huge and less resources than the suburban/city hosp I work at now. There was also a lot bad weather and the squad radio went down so for about 2 hours ambulances were just "showing up" before the radio came up. It really sucked, the hospital was at capacity, it was a weekend, staffing was down, the ED was packed, patients were in the hallways. We had paper signs adding bed numbers taped to the walls above the hall beds. I was the charge nurse that night in the ED and I had a load of 6 patients myself trying to run the department. When I left in the morning I had seriously contemplated never going back. I had called administration to request going on bypass because we already had 2 ICU patients holding in the ED because there were no ICU beds open in house and was told that we could not because the policy was that there had to be at least 4 ICU holds before we could even talk about bypass. That and the hospital across county already was on bypass! Lucky for us that night we didn't get a bad trauma...if we had I don't know what we would have done. We had the housekeepers pulling the old monitor out of the basement storage so that we had enough equiptment to monitor these patients. Kudos to my nurses though. Most stayed over passed the end of their shifts to help, otherwise the patient ratio would have been 10:1!! The poor Triage nurse had a waiting room with 30+ patients, most with IV lines and blood work cooking just waiting for a room in the back. Fortunately everyone survived and nothing adverse happened to anyone in the waiting room. I rounded on all the waiting room patients hourly as did the triage nurse when she could...I think thats what kept us going and the patients waiting were more understanding that we didn't just forget about them. That was the worst working night of my life. when I think about that 12hours I sometimes wish I was a dog groomer instead....you know just a little less stress. :)

I am so sorry that this happened to you and sooo happy to here that the itty bitty patient will be ok!!! I'm also extremely greatful that you posted this because this is an error that is sooooo easy to make. I usually trust that my triage nurse is documenting the correct weight and the computer system has its checks and balances when the doctor enters an order for a weight based drug it automatically generates the dosage and once pharmacy gives the green light so to speak (they have to send up all the peds antibiotics because we dont keep those doses in the ED and most all have to go on a syringe pump and have to be mixed by pharmacy anyway) I usually feel comfortable just having another nurse check that the dosing matches the order with me and then I give the drug.....I will now double check that the weight is accurate, even in the computer because there is no automatic check in the system....theres only me eye-balling the baby......oh scary what an easy error that is to make!!! Thank you for sharing this. Maybe we need to implement a time out form for dosing checks on medications like they do time outs for procedures and OR patients....gotta bring that up at the next meeting.

At my facility if an ICU patient or any patient for that matter, tele or med surg, peds etc.. is admitted but must remain in the ER as a boarder patient, it is the responsibility of the ICU intensivist or the admitting physician to write those inpatient orders. There are no Transition order sets anymore because they were so limited and the hold times have become so long. They have even gone so far as that the orders that the ED physician writes in the computer DO NOT cross over once the paitent transitions to INpatient. and that sucks when we have a boatload of boarder patients because its not always easy to get a hold of some of these primary docs at night and they really dont like getting called by the ER nurse for inpatient orders. They don't know us like they do the floor nurses. Sometimes they have order sets that we aren't aware of in the ER and they get mad to be getting a call....my reponse is always "well sir/maam when the ED doc called to tell you that he was planning to admit your patient, you had to agree to admission, you could have gotten on your computer at home and entered those orders. Or you could have asked to speak to the nurse for that patient, me, and I would have been happy to take those orders at that time. You didn't and I dont want this patient to miss out on their treatment because they are here in the ER so could you please give the orders for this patient so we dont cause any further delays in their care?" I never apologize for calling a doctor at home, it's their job and they know when they are on call to expect to be called....why they can be sooo crabby is beyond me, but thats another thread.

To OP, your post had me laughing so hard I just about peed my pants!! It cracks me up when patients come in wanting food when their chief complaint is vomiting and abdominal pain or Severe, god awful 10/10 pain for whatever reason and they want a turkey sandwich and apple juice while they wait to see the doctor!! I think it urks you so bad because when this patient asks you so for food and blankets, you personally have not eaten/ or peed for that matter, since you left your house for work, and you probably have other patients that desperately need your attention while you struggle to hand these not lifesaving interventions for this patient that obviously doesnt belong in the ER!! I know thats a run-on but its soooo true. :)

To OP, IMHO I think each ER will have its own demographic of patient and injury types, and your choice will depend on what you care to see, treat and experience. For example, the first ER that I worked in was a rural hospital, level II trauma center. But I swear this is were I saw some of the best traumas, like the motorcycle MVA's (lots of open road and less cops = high speed accidents with deer) Crush injuries from farmers being wedged by their cows against the barn wall, or blunt chest traumas from the horses kicking or stepping on their riders, GSW with shotguns from hunting expiditions gone bad...even participated in an open thoracotomy in the ER because flight wasn't flying and the level 1 ended up at our hospital for stablization, our surgical team didn't make it there for over an hour due to the weather. AND that patient lived! There were alot of pediatric drownings and boating accidents in the summer because we were smack dab in the middle of a bunch of lakes and rivers. On the flipside I now work at the level 1 trauma center closer to the city and while I still have had some extreme trauma's, and the traumas are more frequent, they are more to the high speed MVC's because the close proximity to the expressway, small caliber GSW's from the gang altercations, oh and a whole lot more intoxicated need to sober up Im gonna pee on you patients than I ever saw at the rural hospital. So I think it just depends.....and remember in the ER you never know what you are going to get, you will learn early not to be suprised when a patient tells you he/she put WHAT? WHERE? :)