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  1. gemmi999

    Gonna Quit: When Nursing Is Rough...

    I don't think nursing is a calling. I specifically chose nursing, and then specifically chose ER nursing because it is a steady job, with a good paycheck, that has the ability to get overtime on a regular basis compared to med/surg nursing. There is always a minimum staff ratio to the ED because you staff based on what could happen, not what is currently in the ED at that specific moment. I do think a lot of nurses would be better able to handle nursing and the drama/politics/etc that go with nursing if they viewed it as a job and not a calling. The reason that is important to me is because a job is something that you go to, and leave. A calling implies a lot more, and thus you are less likely to leave the drama/politics/bs behind. If the job is not working out, you are free to leave the job. But more importantly you are free to think about what it is about the job that you find unsatisfying. If it is a calling that is not working you, there is a bigger onus of self blame because it's "your calling" and "if it's not working out I must be doing something wrong". So, in conclusion: Nursing is a job. Not all jobs are perfect all the time, but bedside nursing has definite pros. And by thinking of it as a job versus a calling you can remain more detached/leave work drama at work/have a better work/life balance and remain a bedside nurse for (hopefully) longer.
  2. gemmi999

    Investigating Cannabinoid Hyperemesis Syndrome

    I've seen quite a few cases in my ER. The way the doctor explains it best is that the patient is allergic to MJ. Not quite true but pt's understand allergy and to avoid repeated exposure. Haldol works *wonders* on this! More then the typical antiemesis medications at least.
  3. gemmi999

    Nursing Intuition, Part 1: The Visitor is . . . Dying!

    It was a regular day in the ED. I had the back rooms, the "non-critical" patient's that are sick, but not needing to be in our (the nurses) line of sight the entire time. A woman came in complaining about n/v for four days. Through lab work and CT it was determined that she had gall stones, non-obstructed bile duct, but due to her n/v and dehydration she would be admitted to the hospital for 23 hour observation and IV fluids. No other medical hx, not even HTN! A nice, sweet lady. I had just finished writing up her case, calling the floor to let them know she was coming, etc. I stopped by her room to ensure I had dispo vitals before taking her to the floor. She looked paler, a little more lethargic. Her VS were all still "in the normal range" but she was saying she was really nauseous again. I'd given her Zofran only 30 minutes before and it had worked well on her n/v the first time, so I was a little suspicious. I told her I would talk to the ER doctor. Walking up to the ER doc, I asked the tech to do another EKG on her. I knew we had one one only four hours earlier, when she first arrived, but something just felt off. I put in the order and was going to talk to the ER doc when another, emergent pt. came in. He went to that patient's bedside and I decided to wait two minutes to talk to him, instead putting in the EKG order and entering my patient's newest vital signs. Two minutes pass, the tech comes up to me with the completed EKG. It showed definite changes from the previous one four hours ago, but nothing "screamed" STEMI to me. Either way, I took it (and the previous EKG) and went to the doc. He looked at it and listened to my update. He immediately ordered another, right sided EKG and went to assess the patient. Ten minutes later we called for Code 3 transport to another hospital with a STEMI center. She was having a right-sided infarct. I did all appropriate actions within that ten minutes--started a second line, administered aspirin, and gave another dose of Zofran. Total time from her complaint to transfer? Less then twenty minutes. I shudder to think about what would have happened if I had just passed her complaint of feeling nauseous off on her gallstones. Transfers to a STEMI center from the floor can take *much* longer then transfers from the ER. I don't know what happened to that patient but I like to think that she's doing better now.