Feelin' purty good this morning - survived! Again!
Nine months of Hell to look forward to - yes we are expecting! A brand spanking new ED; ALL the bells and whistles! Nine months of torture to endure. I'd rather have morning sickness...
Fast Track has become a regular 'team' as of Monday because we are remodeling. (Oh Goody! Anyone in healthcare knows that pretty = good care; can't wait for our already incredibly high numbers to skyrocket!) We are now blessed with a tech and a unit secretary (yay for the team!) but this equates to higher acuity! Scared me to death to walk in to a stroke in progress in a cubicle on a gyne table and a portable O2 tank (no wall suction or O2 in our area) and a portable monitor. (I hope the family knows how to read the thing cuz it ain't displayin' on no monitor bank nowhere!) A few level 2 acutes and a transfer to Over There University and I was feeling the pressure. I think I did a pretty good job of managing to accomodate myself, the float nurse, a secretary (and her orientee) a tech, the FT PA, a doc, two consulting docs and their 5 combined students all in my computer station/work space that was built to house 2 chairs/2 bodies/2 computers at an 8 foot counter in a 8x10 wide spot in a hall. Got a bit crowded and I must say that my personal bubble was breached more than once. (I really get the creeps when co-workers insist on rubbing my shoulders while I chart!)
Thank God the charge nurse came over to assess the situation and freaked out about the level 2 patients - apparently NOT what they had in mind for the 'higher acuity' that will go to Fast Track. Yay!
Plan B: job app for the big Ortho group on my desk at home; completed.
Last night was mucho better - a steady stream of level 3's sprinkled with a delightful mix of level 4's. Throw in my fave PA and we had ourselves one great evening! And HELP! WOW! I did not know what to do with the lil' darlin's most of the evening. How did I function without a tech or secretary for over 2 years?! Rooms magically cleaned, telephones answered, orders appeared, pts transported (and OMG! ice water for me!) it was Heaven!
The job app for the Ortho guys is officially on hold...
Wednesday, September 24, 2008
Tuesday, September 16, 2008
Fast track is apparently the bastard child of the ER! Does everyone hate the Fast track patients and the staff there as well? Why does triage try to dumb down chief complaints? Why does FT have to accept higher acuity (no extra staff, no equipment = extreme frustration!) when, conversly, the main department feels no need to take the lower acuity???
Another shift in the FT and I am dragging! Higher acuity AND orienting a new grad PA are sucking the life out of me. Angry patients, angry nurses - somehow it's MY fault that the new PA takes a while to assess. How can people sit and wait for three hours to be seen and then think they are going to get good care by pissing me off the minute we get to the exam room?!
And what's up with retirement age folks? What is it that they do at home that makes a wait for treatment the worst thing that has happened in their day? Bring a book, watch a flat screen TV stuck in every corner of the WR, but for the love of God stop telling triage every 10 minutes that you need to get going...what else do you have to do with your day anyway???!!! Good sized lac and on Plavix and ASA. Yeah, it's bleeding and really needs stitches and a pressure dressing. Sorry you had to wait 2 1/2 hours to be seen. Yeah, I know that there are others who got in before you but they were having heart attacks and/or making a really good effort to stop breathing and some were succeeding. Thanks for trumpeting to the other 20+ folks in the waiting room that you had been there over 2 hours - that helped 1/3 of the waiting room decide to sign out AMA. I really appreciate you interrupting me 15 times to let me know that you were still waiting in your exam cubicle and that you had to get home to your dog. (Feel free to send one of your 5 family members who came with you to go home and take care of Fido) Thanks for standing outside another patients' cubicle while I'm assessing and giving meds to tell me how little time this actually would take at Huge Private Hospital across the river. I know you thought about going there - next time, Please do!!! And BTW, I had no idea how lazy I am until you pointed out that I was just sitting there and could have placed those stitches myself (I do love to quilt and sew - maybe I should have!) instead of charting and calling for consults. I was so glad to have you offer to do something to help "get the job done" please, go right ahead! I request help on a weekly basis and never get some! Transport that guy to CT for me, clean this room where we opened a MRSA abscess, hang a new IV for the migranoid who has sucked up a boatload of meds but won't stop complaining til the Dilaudid is a runnin', grab a couple of ice bags (From the other area of ER since we can't have one in FT - the machines cost too much!) for the work comp ground level fall (aka: I need splints and crutches and a week off of work cuz I fell down in front of co-workers and I need validation that I am REALLY injured not just totally embarrassed!) and get the x-rays ordered. Do this while you finish that chart for the psych admit that plopped into FT an hour ago and "needs to get going to the admit bed, now!"
I did find an ad for an interesting new job...does anyone else think that an RN/BS qualifies for a vet's office assistant?
Another shift in the FT and I am dragging! Higher acuity AND orienting a new grad PA are sucking the life out of me. Angry patients, angry nurses - somehow it's MY fault that the new PA takes a while to assess. How can people sit and wait for three hours to be seen and then think they are going to get good care by pissing me off the minute we get to the exam room?!
And what's up with retirement age folks? What is it that they do at home that makes a wait for treatment the worst thing that has happened in their day? Bring a book, watch a flat screen TV stuck in every corner of the WR, but for the love of God stop telling triage every 10 minutes that you need to get going...what else do you have to do with your day anyway???!!! Good sized lac and on Plavix and ASA. Yeah, it's bleeding and really needs stitches and a pressure dressing. Sorry you had to wait 2 1/2 hours to be seen. Yeah, I know that there are others who got in before you but they were having heart attacks and/or making a really good effort to stop breathing and some were succeeding. Thanks for trumpeting to the other 20+ folks in the waiting room that you had been there over 2 hours - that helped 1/3 of the waiting room decide to sign out AMA. I really appreciate you interrupting me 15 times to let me know that you were still waiting in your exam cubicle and that you had to get home to your dog. (Feel free to send one of your 5 family members who came with you to go home and take care of Fido) Thanks for standing outside another patients' cubicle while I'm assessing and giving meds to tell me how little time this actually would take at Huge Private Hospital across the river. I know you thought about going there - next time, Please do!!! And BTW, I had no idea how lazy I am until you pointed out that I was just sitting there and could have placed those stitches myself (I do love to quilt and sew - maybe I should have!) instead of charting and calling for consults. I was so glad to have you offer to do something to help "get the job done" please, go right ahead! I request help on a weekly basis and never get some! Transport that guy to CT for me, clean this room where we opened a MRSA abscess, hang a new IV for the migranoid who has sucked up a boatload of meds but won't stop complaining til the Dilaudid is a runnin', grab a couple of ice bags (From the other area of ER since we can't have one in FT - the machines cost too much!) for the work comp ground level fall (aka: I need splints and crutches and a week off of work cuz I fell down in front of co-workers and I need validation that I am REALLY injured not just totally embarrassed!) and get the x-rays ordered. Do this while you finish that chart for the psych admit that plopped into FT an hour ago and "needs to get going to the admit bed, now!"
I did find an ad for an interesting new job...does anyone else think that an RN/BS qualifies for a vet's office assistant?
Friday, September 12, 2008
Survival of the Fastest
I have decided to jump in feet first to the blogosphere!
As an older, seasoned ER nurse (read antique) in Big Religious Hospital, I find my interest waning and frustrations growing in a world of lightening fast changes. Do others hate doing more with less? Do you have an employer who changes process and procedure more often than our drug seekers change their stories? How many days have you arrived for shift to find that one more step has already been added to your back (and knee) breaking load?
Please come journey with me as I evolve. Do I remain in the ER? Nursing? Or do I follow the many before me and find a path the leads out the doors of BRH into the wide scary world!
As an older, seasoned ER nurse (read antique) in Big Religious Hospital, I find my interest waning and frustrations growing in a world of lightening fast changes. Do others hate doing more with less? Do you have an employer who changes process and procedure more often than our drug seekers change their stories? How many days have you arrived for shift to find that one more step has already been added to your back (and knee) breaking load?
Please come journey with me as I evolve. Do I remain in the ER? Nursing? Or do I follow the many before me and find a path the leads out the doors of BRH into the wide scary world!
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