Here you are: in Charge...with 3 inexperienced, dangerous, slow-as-sh nurses on a shift from he##, every pt you touch is an admit, every "bat phone" call a Trauma, no simple "ear ache" or "finger pain" in sight...
...your 3 inexperienced, dangerous, slow-as-sh nurses (which you've written up MANY MANY times and keep getting told 'upon investigation, their practice is satisfactory', 'your c/o are unfounded', 'you're just picking on them') are unable to start even one IV on their own (too lazy/incompetent), change a soiled pt or do V/S (too lazy), attempt to get pt's to floors (too lazy - want to hold on to pt's so don't have to take new), re-directing ED Techs to perform menial tasks when 3 Stat EKG's are needed, pushing Metoprolol like it's water and wondering why the pt has no pressure, giving additional HTN/cardiac meds to a pt with a HR in 40's, opening Dopamine wide on a pt with a 22ga in their finger (that I found) and not calling either ER MD or Surgeon to start central line, leaving (yes, just up and leaving) as the 3rd Trauma Code gets called and we only have 3 nurses in Dept to start with with an ER full of cardiacs/diff breathers/abd pains who are in the middle of eval or admit or OR (to the point where the Nursing Sup was xporting pts with only Admit orders and no ER notes b/c we, ahem, *I* could not keep up - I had the lot of 'em), trying to give report to me on a pt in "Bed X" while I'm in the middle of the most critical of the 3 traumas...the list goes on - with all problems documented by me and sent to ER Mger, and also placed on House Sup shift report (even she was ready to drop-kick these nurses across the ER after repremanding them a few times herself)...
Welp, *I* get dragged in front of the ER Mger this am about why I "stayed 4 hours to do charting" after the shift seemed "a little excessive."
***WWWHHHAAAATTTT????*****
I busted my hump to keep the ER safe for 12 hrs d/t *HER* incompetent staffing mix and I'm getting nailed?!?! These blatantly unsafe and irresponsible nurses are not placed on some type of remediation (which, BTW, these nurses' have been "re-oriented" 3 times already, and do not hold *any* ER/Critical Care certs or even simple ACLS after approx 8-10 mos in ER)?!?! I am so mad right now, I don't know whether to scream or cry (oh, hell, to tell the truth, I've already done both).
How the he## did I get to be the "bad guy" in this situation?
I am a graduate nurse and have been working for three months in the ER. It's been hard and I have been working my tail off to learn as much as I can. Reading this post is exactly what the old ER nurses TELL me. I have received degrading criticism from these ER nurses. The Director of the ER is aware of the situations and says, "The preceptors don't know how to be preceptors." I am not leaving the ER. This is my dream and despite my "being slow" i will catch on and prove that I am an excellent nurse. I AM an excellent nurse.
good reminder that regulations vary from state to state. in Texas, we've had safe harbor for as long as i can remember.
oh, jslice, kudos for teaching yourself. sorry you haven't had good preceptorship. kinda sucks that your director would say such a thing, given that they are in charge of unit education, etc..
Here you are: in Charge...with 3 inexperienced, dangerous, slow-as-sh nurses on a shift from he##, every pt you touch is an admit, every "bat phone" call a Trauma, no simple "ear ache" or "finger pain" in sight...
Cool...
This is the 1st thread I have enjoyed in awhile. Thanks for the laugh.
They talk about ER burnout but never WHY... never EVER!
This is the reason I started traveling.
Stressed out to no end. Physically ill each and every shift. Not able to sleep.
Absolutely abandoned by administration... I'm in charge why???
I HAD to go. Love the ER, hate the politics and BS.
Listen, continue what you're doing @ your own peril. I hate to say what so many others think and do:
"If your name isn't on the chart then it's not your problem".
Stop trying to carry others. Let them fall.
Tough love! You becha'. Take care of yourself first. There are MANY jobs but only one license. If you cherish yours get out. Pull your shift, treat your patients, help out when you can but stop trying to do their jobs as well. The dirt-bags in your ER will bury you and you'll NEVER change them.
I wish you the very best and hope you stay in emergency medicine. We need you but we need you to be healthy. You can't do it all.
Specializes in Cardiology, ER, Hospice, Pediatrics.
EmergencyNrse
I am going to assume you are still in the ER only as a traveler now. I am an emergency nurse working to get an assignment and begin my travels. i look forward to not being the experienced nurse that the docs come to ALL the dang time. Mind you I do it but I have learned to say "So and so is his nurse and she can handle this just fine. Go talk to her please. I will keep an eye out but you need to have a relationship with Soandso." It is my attempt at being politically correct. I have watched the ED suck the life out of excellent nurses and am determined not to be one of them.
I have also found that by expecting each person to carry their own load and letting them do it incompetence is weeded out pretty quick.
We have a charge nurse who is a bully and unfortunately some of the newer charge nurses are learning from her. I'm not saying that you're a bully and god knows I've worked with some of the kind of nurses that you are describing. I've charged other places I've worked but you couldn't pay me enough to be the charge person where I work now.
When I used to be in charge, I had to remind myself that I was to LEAD the team. That meant that if I had to say something to them bout what they were or were not doing, it was a private conversation. I, with the help of others took newbies who didn't even know that they cared and got them to feel.... we had a DNR one night, I sat and held this lil old lady's hand. The newbie asks what I'm doing, my reply was you wouldn't want to die alone would you?
When they do something well, praise them. Unless they're about to kill someone, say nothing. Help them understand what the proper thing to do is, lead by example. Ask them to help you, that builds trust. Tell them there is no such thing as a stupid question and volunteer as the person to be asked. As another person said, if all you're going to do is tell me how awful I am, even if I am trying, I wouldn't want to work with you either. Note the word with, I didn't say for.
Our bully has run at least 5 experienced nurses off, and others have changed from her shift (nights) to a day time shift even though because of shift diff they won't make as much money.
We've done like you have, reported it all to tha ER nursing director. We've griped and complained. The bully and the ERDON are best buds. Helps to have friends in high places.
I get angry when I walk down our ER halls and see patients that aren't giving the kind of care I give. But are they getting adequate care? By EMTALA standards, yeah they are. At times we've had so many newbies that I considered it a good night if no one died Sounds like that's how you're feeling now. Hang tight, they might just surprise you (in a good way) yet. But.... get some insurance :)
do you have others that can back you up on all of this????
Sounds dangerous and I don't blame you one bit. You sound like you're workin' your tail off doing your own job, along with these other nurses. I would have some others defending you and to speak to the dangerous practice/difficulty keeping up of those other nurses. It's unfortunate that management is siding (or appears to be) with those newer/less experienced/ but more importantly, dangerous and not willing to learn/help themselves/patient safety concerns. I'd document each instance, bring in witnesses, and if management still refuses to hear you out, go to HR. Inform them, see if something changes, and prepare to go further...
OK just realized how old this post is... why is it even still on here? Would be interesting if this OP is still on here and what ever happened.... I like to think the posts on here are up to date and current... though still relevant, but would like OP input on the outcome.
It is very rare that you find 3 "slow-as-sh$# nurses working together in the ER. You might possibly look at what type a leader you are. Their inadequacies may be your fault. They may be trying to make a statement to you "SUPER-NURSE!!! I bet you even have a "S" tatooed on your chest. You go girl, a one-fast-as-sh#$ nurse. With your attitude, I wouldn't be motivated to work with you either!!! Just my opinion. good day.
WHAT??!!?! She gave great examples of how these nurses are unsafe and she's compensating for their workload (or at least having more work because of their inability to manage and frustrated that it continues)..... how can you get all over HER?
***WWWHHHAAAATTTT????***** 
kids
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