No, really - what is your EMERGENCY?

This used to be the journal of a nursing student at a prestigious 4 year university that will still remain unnamed. This is now the journal of a Registered Nurse working in an Emergency Department in a major US city. All names have been changed to protect the stupid and the mean. There is no educational value in this journal, sometimes it will be downright mean and catty - this is where I come to vent!

Thursday, November 22, 2007

Gobble, gobble

Happy Thanksgiving! I did not have to work, but I do have to work all of this weekend, so no shopping for me. Oh well, I don't have any money anyway!

Monday, November 12, 2007

Good Day

I worked yesterday. It was a good day in the ED. Not super busy, but not totally slow either. We had a whole lot of kids - it is croup season - fun. I did start an IV on a 4 month old. My first time and I got it on the first try. Probably beginners luck, but I was pretty happy.

I also had, for the first time, one of our frequent fliers. This patient is actually very ill and so is one of the ones that you don't mind coming in repeatedly. So my preceptor is giving me the background info, yet leaves out one important piece of info: this patient is deaf. I didn't know that and I go in there talking to this patient and I get a look that equates to "you are really, really not very smart." But hey, I was also armed with Dilaudid and Phenergan - so I'm pretty sure I was forgiven!


I apologize for my tardiness on both of these occassions:

Happy 232nd Birthday to the US Marine Corps! 10 Nov 2007

Thank you to all of our Veterans - 11 Nov 2007

Thursday, November 08, 2007

Final Exam Tomorrow

Tomorrow is the final exam for my critical care class. There are not too many things that I have been less motivated to do. I did, however, get paid to study for 4 hours today. So, one of the girls that started with me has been fired from the ED. She did not pass the midterm or the makeup midterm which was a stated requirement for staying in the ED. True to form, the management handled the whole thing in the most inappropriate manner possible. I wouldn't have even fought to stay in the ED (she did) if they had treated me that way. It will be tough for me to ever respect these people again. I will not make waves over this because there are enough personnel issues in the ED right now, I think it would be counterproductive on everyone's part to make a stink. However, if things don't change for the better, I doubt I will stay where I am longer than a year or two. The main reason for staying that long is that I would lose my signing bonus if I left before a year. But also, I feel like I need to stay at least that long in one place in order to really solidify my skills before moving on. Besides, like I said in my last post - I really like the people I work with and honestly, I'm new and can avoid the management fairly well.

So, my ED has some serious personnel issues. We actually have more travel nurses than staff nurses. This means that the bulk of our workforce does not actually work for my hospital and they only stay 13 weeks at a time. Good things - they are experienced and bring in new perspectives. Bad things - they complain all the time, they come and go quickly. Well, this staff shortage came to a head the other night. I was on a 7a-7p shift with my preceptor and it was a good thing there were two of us. Somewhere along the way, we ended up with 3 ICU admits (no room in the ICU, they stay with us), a ruptured ectopic pregnancy (very sad, been trying to get pregnant for years), and another vag bleed. This is a lot to have in the ICU. And the waiting room was starting to really back up. Everyone was swamped with no kidding actually sick people. Not the usual overload of not really sick enough for the ED people that we normally get. We had like 2 or 3 rule out strokes, chest pains, amputated fingers, broken bones, guy who ended up with a ventriculostomy (drainage tube in the brain). Needless to say it was crazy and we were getting overwhelmed. Shift change comes around and the nurse educator (I'll blog about this idiot later - she gets her own entry) decides she needs to get into the patient assignment business (wrong answer, this is the charge nurse's job) and pisses everyone off. Pisses them off to the point that no one will take my last patient. I ended up staying late because no one would take my patient. I really didn't mind staying, but the thing that pissed me off was that they were trying to make a point but they would never stay late in the morning when we come in. So, selfishness wins in the end and it was a good lesson for me.

I do really like my job. I do enjoy going to work and I really am not bitter yet. Or at least not any more bitter than I was before I took up this career. My issues are basic management and leadership problems and really don't have anything to do with nursing.

On a positive note - there are days when I actually think I know a little bit of what I'm doing. I put an NG tube in a woman that had a self-proclaimed strong gag reflex (it probably helped that she was fairly comatose), I haven't killed anyone yet (to my knowledge), and my preceptor doesn't think I'm a total idiot (most of the time).

Happy Nursing!