This is my public service announcement. This is directed primarily to non-medicals, floor nurses, ICU nurses, hospital administration and anyone who has an opinion on ED nursing who hasn't done it for at least 1 year. IT'S HARD!!! And, you know all these crazy stories you read? You know? The ones where the pts are attacking us, and ambulating to the nurse's station and popping their own eyeballs out, and the MDs are trying to kill our pts, and the families are bonkers, and the baby mama and the wife of the dead gsw started fighting in the conference room, and bed 24 has scabies head to toe and alzheimers, and the psych pt hung herself from the exam light, and meanwhile the other psych pt stopped masturbating long enough to attach the tech NAKED in the hall like a QB with a football, and nutritional services wants the dinner tray orders at 3 PM (as IF), and bed 3's neighbor is on the phone and wants to know all the medical info on the pt, and new nurse is about to have a panic attack and needs your help NOW, and Dr. Dependent needs you to hold his hand during the suturing of the lac, and evs won't clean the rooms so you have to clean them yourself, and every 500 lb female pt getting lasix refuses a foley, and everyone needs a come to jesus talk before they will let you start their iv, and the drug rep is here for an inservice, and floor killed somebody and is calling a code, and I can't resuscitate the 15 yoa gsw if you won't get off his body, and the tele nurse got attitude when the tech brought the pt up because he needed to pee as soon as he got there (okay??what??), and we are out of clean catches, and none of the rooms have bp cuffs, and the thermometers are all missing, and bed 19 is refusing xrays before pain meds, and security can't count to 1, and no one ran the quality controls on the accucheck machines, and the local no-nursing home is on the phone to give report again on a pt who has probably been dead since yesterday because after all it is friday and nh dump day, and ems is on the wall and tired of holding and bagging the vent dependent pt with a toe sore that won't heal (but that's ok he's bagging himself now to give them a break), and ems is waiting in your room for the pt in svt to be triaged (no it's only ST @ 170...do nhs ever treat fever or hydrate vent dependent pts?), and airmed is waiting on the roof with another burn because a mobile meth lab blew up because they called report to the house sup instead of the ED and she didn't have enough sense to call us and tell us, and a woman came in the front in labor (we don't have OB but she doesn't know that because she received no prenatal care), and bed 8 wants another blanket (geez we are sooo rude), and the dead gsw's wife and baby mama stopped fighting and are now trying to break into the morgue to see his body, and the fire alarm is still going off, and the triage nurse needs help with the high drama pt rolling around on the floor in the front because she is too busy to deal with it, and every stretcher is broken, and the severely demented pt in 11 won't stop screaming and we don't know why, and everything is lining up in a perfectly symbonic pattern just to make our jobs harder/impossible? THIS IS THE NORM!!!! These are every day events. It is more of a rare occassion to have a pt come in , only marginally sick, with great veins, get seen quickly, have an uneventful work up, not have some crazy demands, worse...family with crazy demands, have a full stomach, follow directions, and have manageable pain. Oh, and get a hospital bed quickly. Never, this never happens!! Maybe once a week. Do you people watch Grey's Anatomy or ER? Yeah, they toned it down!! This is what it is like! You think that's bad? Spend four hours in triage!! I dare you, just four! You have no clue. You just have no clue. That's it, no arguing. You can have all the righteous opinions you want, but at the end of the day YOU ARE CLUELESS! You think you know? You did some wimpy 8 hour shadow shift? You passed through on foot one day? You would cry! YOU WOULD CRY!!!! NO I DON'T KNOW WHAT THE STUPID CT SAID! NO I DIDN'T CHECK HIS SUGAR BEFORE LUNCH! NO I DIDN'T ROLL AND CHECK FOR BED SORES! IS THIS A JOKE? ARE YOU PEOPLE KIDDING ME? YOU'D CRY!! CRY!!!!
ThrowEDNurse, I love you too!!! I'm sure you all have seen my blow ups on here before, but I don't know if ever said it as well as you. And to the RED Xers out there. I always work at least 4 12hour shifts (love the economy!) but lately my ER has put a big no-no on over time, so I have been picking up staffing pool shifts. In the last 2 months I have picked up in ICU, burn ICU, neuro ICU, CCU, PACU, adv. pulm., orth, bone marrow, med/surg, and moblie ICU, and let me tell you they all have no clue!! Even though the pts. in most of these places were really, really, sick, I was BORED TO TEARS!! You can only give so many baths, do so many dressings, pass so many meds, and then your done, especially when you have just 2 pts. And when I got an admit, I took report right away, had the room ready, and fiqured everything else out by myself, and I wasn't on a floor I was familiar with sometimes. I did this while the regular nurses were all either running around like mad, or sitting around doing nothing. And I had 2 codes that I thought I was the only one who knew what the heck to do! I guess that comes from us having to have such a broad knowledge based of EVERYTHING medical. And really, the paperwork wasn't that much, I got that done too! I still can't understand why even this site doesn't considers us "critical care." I actually had one of the ICU nurses I was working with try to help me by gving me a quick run down on levo/propofol gtts. She said "I can't believe you know so much you must pick up here a lot, they usually don't give floats such criticle pts." I told her, no I do every once in a while, but your charge came from ER, and she knows that I can handle anything she throws my way-where do you guys think your pts. come from anyways???" At my level one, you have to be a nurse for two years before you can work in ER or ICU, if you get hired into the ICU you get a 6 week orientation if you think you need that long. If you get hired into the ER, you have a mandatory 6 month orientation that included much classroom and preceptor time. That really says a lot if you ask me.
I thank the nurses who work ED so I do not have to. However, the drama does continue when these pt hit the floor.
For example:
- the ED nurse said you would get me and my family a full tray even though it is 0200 (this from a guy with a massive GI bleed that is recieving blood as fast as it can go in)
- can you trim my toenails and my wife's toenails..***?
- I have 10/10 pain and no on in ED gave me anything, (chart says you maxed out everything that you did not have an allergy to)
- why cann't granny have water. so is so thirsty she is going to die from it now...no sir she is well hydrated with the iv ns, but the heart attak she is having will kill her before the dehyration will
- no I can not treat your entire family, and friends for whatever ails them
I think a lot of nurses can write a post just like that but with rants that deal with their type of nursing. (med surg, ob, icu....etc)
I think that is why nursing is so great. We don't all have to work in the same place and deal with the same bs and when we want to...we an go into a different field.
Just wondering...is this a big city hospital, trauma center?
I think a lot of nurses can write a post just like that but with rants that deal with their type of nursing. (med surg, ob, icu....etc)
I think that is why nursing is so great. We don't all have to work in the same place and deal with the same bs and when we want to...we an go into a different field.
Just wondering...is this a big city hospital, trauma center?
No trauma, but there's no real trauma center in the area, so we do it. It is not a particularly large city, but it is the biggest in the state. We get lots of indigent, thugs, and bangers. We also have the only burn center around.
What an awesome recap of our "normal" workday! I love it!!!
And to the question about do we love it....it really is a love/hate relationship. I can't imagine being anywhere else more than for the occasional float--but when my shift is over (or an hour past "over") you may see smoke rising in my footprints
Especially the other night when I got to open a third fast-track in the EMS hall! We normally only have the one regular area, our back-up CDU had already opened a second one. Lucky me got to create my own zone, Yay! I had 5 chairs and two stretchers (only 2 left in the whole ED) lined up with taped up scraps of paper on the wall with "bed" #'s on them. Two hours before I was supposed to leave.
I think we decided someone posted a neon sign up on the interstate that read "Free drugs at the ER" or something that night!
OHH, and one bed with a mom and child in it ended up having a nice twin set of scabies. So my other pt's in my own little fast track mutinied about the bathroom back there and refused to do anything until housekeeping came and disinfected. Not to mention the fact that now I was down to only one stretcher!!
Yeah, I love my job, again==closet ADHD I think! :hpygrp:
Specializes in Medsurg/ICU, Mental Health, Home Health.
I prefer my pts to die in my room as I don't find calling the coroner and organ donation that arduous of a task. Sometimes, the physical stress of moving the pt upstairs is all it takes for them to follow the light. Sorry you have to fill out an extra piece of paper, but while you are doing that, I am saving your next pt's life down stairs. That said...RED X, RED X, REDX !!!!!
No need to yell.
I understand the need to vent, I just don't understand the need to bad mouth other kinds of nursing. I wrote what I wrote to see what your response would be. I realize that you're stressed, and I understand that I have no concept of what you go through. My hat is off to you, I'm being serious. I just don't like high and mighty attitudes, even if it's just the way it seems because of a vent (I hope.)
16 beds, 8 staff, various docs and family members rotating in and out, 2 working bathrooms, and 15 of the patients are (still) waiting for a bed on the floors.
14 people in the waiting room, and 2 ambulances 10 minutes out. 3 patients coming in from docs offices via private vehicle.
Oh, and we're under construction, so no cheating with hallway beds. We don't actually have hallways, just a plywooded tunnel attached to the rest of the hospital. We do have 3 hallway chairs, right by the ambulance entrance (freezing cold, and snowing outside).
Administration comes down Q2H to survey the damage, and offer helpful suggestions.
I thought the charge nurse was going to implode. I still have no idea how she shuffled beds so fast.
I understand the need to vent, I just don't understand the need to bad mouth other kinds of nursing. I wrote what I wrote to see what your response would be. I realize that you're stressed, and I understand that I have no concept of what you go through. My hat is off to you, I'm being serious. I just don't like high and mighty attitudes, even if it's just the way it seems because of a vent (I hope.)
I'm sorry, where did I bad mouth other kinds of nursing? Nor do I feel I exhibited a high and mighty attitude. The message isn't that I do everything perfectly right all day. It is just that I do get through the day! Yeah me! I didn't cry, I didn't quit, I didn't abandon the pts. I stayed calm and fought through it, sometimes making mistakes, sometimes not, but always considering the best interest of the pt despite the circumstance. If your response is a reaction to "the floor killed a pt" I always say that, everyone I work with does. "I killed bed 8" or "John killed somebody else again," or "well, you almost killed her." It's not like murder kind of kill, just that the pt died and you were the caregiver, so I call it kill. It's just supposed to be funny. It's called humor. It's just a twisted way, instead of an overly sensitive way, of conveying the same message. It kind of takes the edge off a tense situation and opens up room for humor (even if it is inappropriate.) After all, ER nursing is nothing if not full of inappropriate humor at inappropriate times. (ie: something funny always happens in a code.)
I_LOVE_TRAUMA, RN
185 Posts
ThrowEDNurse, I love you too!!! I'm sure you all have seen my blow ups on here before, but I don't know if ever said it as well as you. And to the RED Xers out there. I always work at least 4 12hour shifts (love the economy!) but lately my ER has put a big no-no on over time, so I have been picking up staffing pool shifts. In the last 2 months I have picked up in ICU, burn ICU, neuro ICU, CCU, PACU, adv. pulm., orth, bone marrow, med/surg, and moblie ICU, and let me tell you they all have no clue!! Even though the pts. in most of these places were really, really, sick, I was BORED TO TEARS!! You can only give so many baths, do so many dressings, pass so many meds, and then your done, especially when you have just 2 pts. And when I got an admit, I took report right away, had the room ready, and fiqured everything else out by myself, and I wasn't on a floor I was familiar with sometimes. I did this while the regular nurses were all either running around like mad, or sitting around doing nothing. And I had 2 codes that I thought I was the only one who knew what the heck to do! I guess that comes from us having to have such a broad knowledge based of EVERYTHING medical. And really, the paperwork wasn't that much, I got that done too! I still can't understand why even this site doesn't considers us "critical care." I actually had one of the ICU nurses I was working with try to help me by gving me a quick run down on levo/propofol gtts. She said "I can't believe you know so much you must pick up here a lot, they usually don't give floats such criticle pts." I told her, no I do every once in a while, but your charge came from ER, and she knows that I can handle anything she throws my way-where do you guys think your pts. come from anyways???" At my level one, you have to be a nurse for two years before you can work in ER or ICU, if you get hired into the ICU you get a 6 week orientation if you think you need that long. If you get hired into the ER, you have a mandatory 6 month orientation that included much classroom and preceptor time. That really says a lot if you ask me.