Where are all the ED PCA/PCT . . .etc

loricatus · Sep 9, 2007

I so wish that you could work with me.

Where I work now you cannot get them to help. I do get help from one PCA, but he spends his time talking to the patients like he was their doctor, giving out medical advise and such. The rest huddle around in corners avoiding work and when asked to do something, I usually get something like: "You'll have to ask XXXX, I'm not assigned to you" "I'm doing EKGs now, can't help you" "I'm on a break" "You're not expecting me to do it myself, are you?" The PCAs where I work are union and the nursing staff is not. I get more help from housekeepers than I do from PCAs.

Now that I had my vent, I did have good relations with the PCAs from the prior ED I worked for-that's probably why I find it so frustrating in the place I am now.

I was pretty new to my prior ED when a brand new batch of PCAs started. What I did was assist them in various tasks, explaining why each thing was important, what were the norms and what needs to be reported. I wanted them eventually to be an extension of my eyes and ears, to form a team for patient care. Being nervous and insecure was expected, it showed there was an understanding of the importance of the position. Nurses start out that same way, too. What I felt was most important was to make rounds with the PCAs: explaining what the patient was there for, what needed to be done and why, answer questions, introduce the patients to the PCA, explain what to look for and why it was important. Each PCA kept a report sheet so they could keep track of the basics of the patient, the diet orders if any, tests or blood draws scheduled, times for vitals, I&O, etc. As for knowing the norms: BP 120/80, T 98.6 F/37C, P 70's, R12-18. What's more important is to watch for the important deviations from the norms: eg, pt on digoxin-HR in 40s (if you got report on that patient you would be told about the digoxin and to watch for and report HR less than 60).

So, to try and answer your question better on what would gain my trust is: honesty on what you know, don't know, want to know. If time permitted, I would always be willing to walk a PCA through something if they were up front about things. The ones that I didn't trust were the ones that became complacent on patient care or too proud to admit they didn't know something.

You brought back some wonderful memories of the relationships I had with the PCAs at my former employer. I really miss them-just them, not the other nurses, nor the management. I hope the nurses you are now working with will come to value you as much as I did with the ones I used to work with. You seem to be very much like them and will probably become a valuable asset to the nursing staff.

widi96 · Sep 9, 2007

I worked as a tech in the ER for two and a half years before becoming a nurse - my suggestion is, if they ask you to do something and you aren't in the middle of something else, do it. If it is something you aren't sure how to do - the best way to handle it is "I'm not sure how to do that, but I'll be glad to assist so I will know how to do it in the future." You don't have to know everything - you never will, but a willingness to learn and help will get you on most nurse's good side.

UNCgirl · Sep 9, 2007

I have been working in the ED for over a month now as an ED Tech (I guess the same as PCT/NA/etc.) and am also doing a preceptorship there with an RN for my last semester of nursing school. I also get very nervous under pressure, similar to suddenly forgetting normal lab values, etc. I have never worked as an NA before this so I am coming into it with only experience from clinicals. One of my biggest fears has been venipuncture since I have no experience whatsoever with this and it seems that normally our manager does not hire techs without any experience and expects that you can draw blood. I have been practicing this past week and am starting to feel more confident. So I think I understand where you are coming from.

Regarding expectations, I agree with the above posters. I always ask my nurses if they need help whenever I have down time (no labs to run, no blood to draw, etc.) Also if they look busy I will also stop what I am doing to help. When I see them cleaning stretchers or something like that, I ask if they would like for me to do that and if they have something else they need to do or need help with. Often, they don't seem to mind doing it if they are not busy. Occasionally, a nurse will go across the department to find a tech to ask them to do something like a glucose check...even though it seems so silly since they could have done it in the amount of time it took them to find me, I do it. I think it's just a matter of prioritizing- this aspect of nursing school has helped me immensely here. Just thinking to myself if it's more important that I get the EKG on the new patient with C/O chest pain, or if I get the hourly vitals on the rest of the patients, or if I help the nurse with the Accucheck. Once I figured this out, I started to feel less stressed out and am enjoying my job a lot more.

Morecowbell · Sep 15, 2007

Thanks everybody. I really appretiate the good advice. It has really helped me to chill out a little. I must say, I just got done with my second week and I feel a little better.

I helped with my first LP (with both overbearing granny's in the room asking questios EVERY step of the way) and handled it very well. Doc's were pleased! So again, thanks!

longjourneydream · Sep 19, 2007

okay so i'm new to the ed experience. coming from a ltc background. needless to say, its only been a week and my head is swimming . i literally came home with headaches trying to access all of my book fed "p&p" . . . however i love it! the atmosphere, the patients and the fact that i'm taking the steps needed to be a great nurse makes me so excited to come to work . . . but (and there's always a "but") . . . i know i have knowledge and training to do things but when i find myself in the room with patients and family looking on i get nervous. god, don't let them ask me a question either! i completely freaked out and feel like i'm stuttering to find the words . - ummm, now what is the normal range for bp, temp, pulse? aaargh! - i think its because i want to do so good sooo bad that its driving me nuts when i can't get it. that and all my experience thus far has been with dummy's that don't ask "why?!". i get so focused on sticking that heal/finger just right that i can't even answer any questions/comments . . .it takes me a while to get back from where ever my brain has traveled.
anyway, i'm here to find out from others (espicially ed pca's) just what to expect from my first weeks on the job.
1. how did you blend in with an already establishe ed family?
2. is there any unspoken "rules" to working in the ed?(my first lesson: if you are just standing there doing nothing and a nurse ask you to do something don't tell them to ask someone else! - i saw somebody get ripped for doing that!)
and #3 is for all the nurses out there. . . tell me what do you expect from a newbie pca? how do i gain that trust that you will ask me to perform a procedure and not just wait for another pca that has been there. i hate when that happens because how is anyone to learn?
any stories (good or bad) that i can learn from would be nice.

alright here i go!

i was a pca before becoming an er tech.

forced to change dept., due to closings, i was given a choice between er and cardiac care.

after i took the er i loved it...

it was not an easy road in at start.

we had 3 orientees at the time and guess who was short changed?

i was expected to know everything on the fly.

did not know how to do blood draws, and went with a phlebo tech for 1.5 hours and did one draw, was expected to know what to do.

because i was in my 1st year of nursing school, i did not have time to think about how difficult it was to be an outsider to the dept(well i felt it but had no time to think about it, due to the diversion of nursing school).

i did for as many nurses as i could, when i could do it. so my skills became better and at the same time, i developed relationships.

yes, i did take abuse, but it made me assertive when i could take not more. ex: doing one thing for one nurse another nurse tries to pull you away (tell them after you get done helping so and so) or you are busy at this time (with explaination) as long as you have a reasonable explaination most will understand.

i now am a nurse. because i have a history there, i get help when i need it. i also know how to treat people (never take them for granted, and tell them if they are doing a great job!!!

yes it pays to work hard, and respect your co-workers.

good luck in the ed.