Harley's mom

After many many years as an ER nurse with most of those years as a charge nurse I decided to hang up my running shoes. I took a few months off to figure out where I wanted to go next and ended up doing hospice. I absolutely love the work! I have good days and bad days just like everyone else but that is expected. The problem is my DCS can't stand me. She seems to have a major ego problem and some people have mentioned she appears threatened by me. She tries to micromanage me and then looks stupid when I point out she is incorrect. Nasty email is a daily occurrence and her passive aggressive behavior is obvious. I don't want to leave. I have already called her out on the fact that I feel she wants me gone. My patients and families depend on me so I continue to put up with it without making waves. Any suggestions on how to handle this?

I enjoyed the story immensely. As of today I accepted a position in hospice after many many years in the ED. I have so much to learn about my new area of nursing but am excited and feel honored to be part of families lives during difficult times.

I feel that limiting the use of opioids should be done at the doctor's discretion at EVERY facility. I have found that instead of arguing with the "seeker" they will give them what they want so they can move on to the next patient. To outlaw them completely for patients who truly need them seems cruel. The docs need to get a backbone and stop catering to the seekers. As far as dependence caused from ER visits? Seriously? Maybe the primary care docs shouldn't be handing out scripts for obscene amounts of pain pills with numerous refills.

After many years of working in different sized ERs I finally left due to feeling staffing was unsafe. I have worked a cake job with 1:3 and have had as many as 14 SICK people myself with no tech or transporter. My last job was 1:5 which was tolerable most of the time but there was no regard to acuity. I was night shift charge and although the ER was not huge, management had no regard for staffing, especially at night. If we worked the majority of the shift with 2 nurses to cover triage and the entire ER it was not unusual. Techs went home by 1am so you were on your own. The majority of nurses on nights were inexperienced and some fresh out of school. After being reprimanded by my manager for my staff not getting lunches, (almost always because they felt too obligated to their patients and wouldn't go even when told) my manager's attitude was that if a patient needed to wait 30 minutes for pain meds so be it. WHAT? If that was my family with a kidney stone I wouldn't be too happy. I am done with emergency nursing for good. I worked too hard for my license to lose due to having a tragedy happen on my watch because of understaffing.

I have had up to 12-14! And I'm talking on heparin drips , abdominal pain, DT's and more! So unsafe. It was a travel assignment and after that I left the ER for a while feeling defeated.

I am just curious........What do ER nurses feel is a safe nurse to patient ratio?

I'm pretty much in the same boat. I have been in the ER for over 20 years starting out as a paramedic and then getting my RN 7 years ago. After doing an ER travel assignment where the nurses had up to 14 patients each I decided to take a short (year and a half) try with home health. Well, that didn't work out to well for me because I got too attached to my patients and couldn't put it away at the end of the day. So..........back to the ER I went to the treat em and street em mentality. I had a strong background as a charge nurse and was made charge immediately after coming off orientation at my most recent job. Keep in mind that I had not been there long enough to even learn all departmental policies and there was plenty of flack from the employees. That waned eventually but the STAFFING was ridiculous..During my time there we became a level 3 trauma center and management was fine with 2 nurses from midnight to 7am if there were call ins. One night in particular I had the responsibility of charge, triage, and had 2 critical patients of MY OWN. The burnout and stress became obvious and I finally gave my notice. I am DONE with the ER. I have been not working for the last 5 months and still have no desire to return to that type of nursing. Now what? I have no idea where I belong although I'm ready to go back to work.