OldNurseNewRN

I carry my supplies in my pockets; that's why I wear actual scrub tops and not t-shirts. I keep my stethoscope on me so I don't have to waste time going to get it. My bag has sodas and snacks in it along with tampons, lip balm, lotions, etc.. Basically all personal stuff. There are a couple of drug books but I don't think I've ever used them.

I understood your point being that, regardless of what time the BP was taken or why, the answer from the MD was completely inappropriate. If the MD doesn't want middle of the night phone calls, don't take on call or don't admit patients! It is as simple as that. If he/she is going to admit patients, then he/she needs to be prepared to have his/her phone ring in the middle of the night for concerns re said pt. I have wondered since the day I started nursing school over a decade ago, why MDs are allowed to speak to nurses in a manner in which most people would not address a fellow human being. I don't take it. I will quickly ask them to speak to me in a respectful tone or to call me back when they are able to discuss the issue like a professional in the best interest of the patient. Shocks them into remembering their manners when they are called out on it. Verbal abuse creates a hostile work environment and if my facility wants to fire me for calling a MD out on it, then I don't want to work there anyway.

Lol, I would never use the words I used in the post. I've been in the field too long for that. I would be more likely to explain that I believe I would be able to perform at my most optimal level if I were on day shift. I probably won't say anything, truthfully, and just wait until I can apply for an open day shift position. I actually changed facilities and positions when I obtained my RN. It is a position similar to what I had as a LPN but honestly, it is a new job. New coworkers, new expectations, new shift, new responsibilities...it is all new and I know my expectations on how easily I would transition were incorrect. It has been a lot more difficult than I expected. No other areas of increased stress in my life right now that weren't present before starting the new job. I just feel like if it weren't the night shift thing, I would be falling into the groove of things better by now.

I've been a nurse for over a decade, recently going from LPN to BSN-RN. Very early on, I worked night shift for about a year. I don't remember nights making me stupid then, but I was a very new nurse, so maybe it did and I just didn't realize it?? I've been on nights for about six months now and it is turning me into a blooming idiot! I can't think right at night; I make seriously dumb mistakes. Like putting someone on the monitor but forgetting to turn the cardiac part on, even though I had the leads on. Rookie mistakes that I KNOW better than to make. Or not catching something I would have caught before. So far, I've not caused anyone serious problems but I know it is just a matter of time if my brain stays dead like it is now. Has this happened to anyone else? I don't want to change jobs but I really think I need to be on day shift in order to function! Do I just tell my manager that I've become mentally handicapped because of night shift, lol? I really don't think they'll think that is enough reason to change my shift.

Nothing. Since my original post, I've actually found out it is common practice for EMS to be called to pick up the "just drunks" because the local county facility doesn't want the liability of keeping them safe until they sober up. That night I was told by an officer they wouldn't arrest the pt because technically, the pt was doing nothing illegal before ending up in the ED. They were just drinking at home. It wasn't like the police brought the pt in. And they weren't going to support any efforts to keep the patient in the hospital against their will since they were brought to the ED and held against their will simply for drinking at home. I keep thinking about how I would feel if I had a couple of drinks at home, that effected me strongly for some reason (sluggish liver) and I ended up locked in a concrete room against my will. Doesn't seem right.

Something happened over the holidays that really bothered me. I work in an ER. A very intoxicated pt was brought in by EMS after passing out at home and having family member call 911. The pt was cleared medically. Nothing wrong but being drunk. This patient did not want to be at the ER and had initially refused transport from their home. This patient wasn't doing anything illegal; just drank too much at home. Once at the ED, the pt refused to stay in bed, so pt was placed in our psych room. Windowless room with no equipment in it, just a concrete block with a mattress secured to it so there is nothing a pt can hurt themselves with. When the pt refused to remain in the room and instead was walking around the unit, the mid-level provider seeing the pt ordered the door to the room shut and locked which is considered restraining the patient. So, because this patient was minding their own business at home drinking during the holidays and ended up in the ED where they did not want to be, they basically were restrained. The pt was oriented to name, location, time, and situation and repeatedly voiced a desire to leave. Wouldn't have been driving as there was no car at the hospital. Was this false imprisonment or warranted for the pt's safety? Not my pt but I was nearby and heard everything.

I work in a very, very busy ER for the area I live. We see 85,000+ pts per year. We have 20 high acuity rooms (1,2, and complicated 3s); 24 rooms for level 3s and 4s but if triaged wrong, who knows, we could have level ones in this area. We also have 10 Fast Track rooms. During the day, we have two nurses in triage. One triages and along with a tech gets vital signs and EKGs. The other sorts to the correct rooms. We also have a mid-level provider in triage during the day that enters orders and occasionally treats a clinic-type pt from triage and discharges without them ever coming into the ER. That doesn't happen often. In the higher acuity area, we have two or three rooms per nurse. Lower acuity is three to four rooms per nurse, with occasionally five rooms if the wait time is insane and we're understaffed. Mid-level providers (PAs and NPs) see most of the pts in the lower acuity rooms. If they turn out to be complicated they are turned over to a MD overseeing those providers. We have a charge nurse who handles the radio and sorts incoming EMS pts to rooms. That's pretty much all the charge nurses do. They don't help with codes, they don't help with IV starts or staff conflicts. I've asked for help from a charge nurse with an IV before and got told: Well, you're **** out of luck! The job duties of charge nurses in this facility are completely different from anywhere I've worked. I'm not going to lie: we're in a mess. Day shift has many nurses with 10+ years of experience. On nights, we're working with an average of about 3 years. I was a LPN for over a decade working solely in a smaller ER; RN-BSN now for about 6 months. On night shift, you're pretty much considered experienced if you have a year working in this ED. Our most experienced nurse has been a nurse for 3 years. If it weren't for agency nurses, we'd only have half the staff we need. The turnover is horrible. I really like what I do here and could love this job, but there is a clique that runs the place. If you don't belong to the clique it is hard to get help or get questions answered. The clique nurses all want to be seen as "super nurses" and don't want anyone to challenge their status. I outgrew the need to be a super nurse a long, long time ago, but I would like help doing those things I wasn't able to due as a LPN, like hanging Diprivan or assisting with chest tube insertion. Just someone to stop me if I'm doing something wrong. If you ask a clique member for help, you eventually get it but not until you are ridiculed in front of other team members for not know how to do something. It does no good to talk to management as they are buddies with the clique members. I think about leaving, but I would really like to stay here at least a year to get my experience. But there are days when I really feel like I'm back in high school. I'm over 40 years old and I left high school behind so long ago, it isn't something I want to go through again! I just want to take care of my pts the very best I can and leave at the end of the day feeling like I did a good job. There are lots of other issues too, like the missing communication skills many of the younger nurses lack, because of technology, I assume. We work in teams. I like to tell my pts what is going to happen, but when a team member comes in, grabs an arm, and throws an IV in with no warning, it makes MY communication look bad. When I take time to speak with my pts, I get complained on for being too slow. I don't know...are all bigger ERs like this? Are there always going to be cliques and staffing issues if the ED is large? I love learning the more critical aspects of ED nursing but some of the trade-offs are hard.

Just curious, was that particular pump taken out of service? And if so, was anything found to be wrong with it? If not, if there is any way to identify it, it needs to be removed and checked out!!