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!!!!
I remember all too well hurricane Jeanne and Fran down here in Florida. I worked a 16 bed ER. We lost all power, including generators, we were BAGGING our patients in shift through the night. I walked around with my disney spray bottle/fan fanning off my patients. At 3am an amublance pulled in with an old couple who were found standing in the middle of their rubble of a home........ it kind of really ticked me off. We were WARNED to get out of mobile homes, obviously... yet they stayed. The ambulance crew just crossed the bridge safely while they watched it collapse in their rearview mirror. A tornado went over our roof while I was hanging out the back door of the ER smoking a cigarette LOL!! I watched it take out all the transformers down the street one after the other. I slept in a radiology file room floor while the doctors who were not even all call slept in any empty patient room and got complimentary cheese and crackers LOL Go FIGURE... ahhhhhhhhhhh memories :)
During our last hurricane our pts brought in kids that were as old as one week with c/o "being fussy." It was the middle of the night and the damage to the city wasn't asseessed. We were supposed to be under curfew, but a crying infant...whoa alert 911. These people literally loaded their entire families in cars and drove in the middle of the night with downed powerlines, trees, etc everywhere. We had no powe, just generators. "Ya'll don't have power?" UM, yeah, how do you think this computer and the lights are operating? "why is the air off?" Yeah our generators are supplying important things like refrigeration, lights, vents, etc. The kicker is we were all sweating buckets, without food and water and our hospital sent around cafeteria workers who were SELLING US BOTTLED WATER AND SANDWICHES!!! That's right, SELLING!
Did they bring their suitcases with them??? for a about 3 days before the hurricanes, little old ladies would drive themselves to hospital with their suitcases and say they were "SOB, weak, chest pain" . It's because they were lugging those suitcases!! lol We had to buy our food during the storms too. But the docs who were staying with us from the "Gold Coast" got private rooms for them and their families, and delivered food to their rooms, no charge. However, they did babysit our pets during the storm. :)
I waffle. I love it sometimes and sometimes I hate it. The days that I hate it though are influenced by factors beyond my control. Other people aren't doing their jobs properly and making my job even harder or other stuff like that. It's hard enough without other people not doing the minimum their job requires. Or days where it's ridiculous. We may be unsafely short staffed and there is no help from hospital administration. I guess I love it more than I hate it though. It's just real easy to burn out.
I'm with ya...I've worked PACU for several years and now OR. You're expected to pull everyone's weight a lot of the time and if you don't you're not a "team player", but in fact you're just hoping everyone else are team players so you can get some HELP!
I've worked the floor, ER, OR, PACU, and ICU. I do get irritated by some of the questions that are asked by floor nurses. Sorry...you have to be able to get a quick report and find out the other info from forms (we don't fill them out just for funnsies) and from family and the patient. It always floored me when I gave (IMO) a very detailed (albeit quick) report (I was giving information that would help a floor nurse to watch his/her patient for s/s of pain or s/s of too much narcotic) and I would get a phone call or a question during the report as to what they ate for lunch that day...or are they having pain (ummmm, yea because she just had some doc's arms up to his elbows in her gut - some Fent and Demerol aren't going to cut it completely). I just wanted to rip my hair out because right at the door is the next patient who's intubated and being bagged...GOTTA RUN! I should have had my patient out five minutes ago, but I was stuck on the phone answering questions about whether I'm REALLY going to send out this patient who's rating her pain at a "5"...well, yea. I'm pretty sure when she gets into a real bed and off of this hard PACU cart, she'll feel better, and with her family...I'm not very entertaining!
It's really about NOT understanding what some of us go through in our specialties. Every single time I would suggest an "8hr shadow" to see what we do, the floor nurse would sarcastically tell me I'd need to do the same because I didn't get it. Oh? Really? I didn't start in this area my dear. I started on the floor...cardiology. New open heart coming down the hall, three need to go home, 300lb guy puking in a waste basket because he doesn't want to get up to his bed to call for help (yea that was gross guys)...another peeing down his leg after Lasix (as was stated earlier) because he didn't want to get up and now he's yelling at me because I made him PEE! I'm sure it's better than being SOB isn't it? Maybe not...I'm sure you've been incompliant for quite some time.
Our pain as nurses is subjective I guess. But a little understanding goes along way. My patients aren't parked in their room for my entire shift. The idea is the keep the revolving door moving...turnover! And that's what floor nurses don't get. Your patient is there (unless coming in the door as an admit, then they are stayin' put or being discharged). Our patients come in and go...and the faster the better. That's the way it is...assess, treat, release. A little like fishing I guess.
I LOVE the original thread starter, that sums up most of my days. I have read several times that a complaint is pts having to pee; well here is my rule on that, if I am going to give you lasix, you are getting a foley-period. Chances are, you are too big to ambulate to the bathroom safely by yourself or too big to use a bedpan / urinal (can't see your winky to aim it--after the first time a "fluffy" fellow urinated all over the place--I said NEVER again). I need to monitor how much fluid I pull off anyway--I've got at least 3 other patients to worry about--let's just save some time and drop a foley.
I had a floor nurse call me the other night (there is one floor that I take patients to that WILL call back 10 minutes after I deliver the patient EVERY time). This nurse informed me that the pt was c/o pain, and wanted to know what I had given them and at what time. I asked her "I don't remember, what does my nursing note say I did?" "Where is your nursing note, what does it look like, we don't have time to shuffle through those." So then I politely asked if she had EVER read an ER triage sheet--she said NO-we don't have time to. I replied that until you find the time to read MY note, I don't have time to talk to you--and I hung up--I guess she found the time to look at the triage sheet.
I took another patient, I got a call about 45 minutes later--"that pt you just brought me had a FSBS of 50!" I said "Wow, well what did you do about it?" The nurse quipped "I gave her some OJ, and now it is 90". I commended her for her quick thinking and hung up. The pt was not admitted with anything blood sugar related--admitting md orders were fsbs at ac&hs, this was at like 3 in the morning that I took her up.
We have this thing at our facility--home med list; we have to fill them out on each admit. I had a patient the other night that denied taking home medications, so I didn't see the need to fill one out as the admitting doc covered in his admission order what medications he wanted the patient to be taking. Well, I got a phone call from the floor saying that they needed me to fill out a home med list on this pt. I ran through the story with the nurse, and she told me that I still need too fill one out and write on it "PATIENT DENIES HOME MEDS"!
I will use your rant to best use..I am a lowly peeon floor nurse who has much respect for er nurses. my sister on the other hand is a paramedic and oh i do hear the nurse jokes..point the needle away from you is the nicest one.
I get along with my er nurses but we do have a standing joke of what alert and oriented x4 is..cause er a/o is very different than floor a/o. i have learned which er nurses consider grandma screaming "help me help me dont take my baby" is a/o. seriously we do get along..when i ever i have needed them they have helped i have tried to do the same..
My husband was an ER patient this past weekend...way too busy for me, and he got very good care from the doc and nurse. Amen! He didn't have to be admitted, or he might have been admitted to my floor, lol!
shuu girrl let it outtt... but you know on the good days you love what you do...or you would have long moved on...and you know that even though you might not hear it from patients much as they watch you sweat, grunt, tear up, and curse under your breath...that they are sitting there thinking wow this lady has way to much on the plate to eat at once and needs to sit down and take a 5 minute breather or at least eat so 12 hours dont go by without a short break or no food in the belly...and when they do thank you it makes you feel good because although you didnt have the pt +1 day you will remember them and they will remember you..hopefully as doing the best you absolutely could as a human being and ensuring 1st their safety beyond the other minor things that if lapsed in a 6 hour time period, won't kill the person. It sounds like you work very hard but know that your not perfect or superwomen...keep chugging!
who has much respect for er nurses. my sister on the other hand is a paramedic and oh i do hear the nurse jokes..point the needle away from you is the nicest one. 
ashleyjean3
74 Posts
amen!