Dear Moms and Dads that visit my ER,

I am beginning to think that you lack all common sense. It seems that all of grandma's home remedies and experience has been forgotten or thrown to the wayside. The days of chicken soup, ginger ale, and vicks rub all but forgotten instead the treatment of choice is hauling your children to the ER in the dead of winter at 2 am demanding instant fixes and ABO(antibiotics). So I have decided to do a little education teaching and hopefully save a kiddo or two from my rectal thermometer..

Ok I am going to start with my biggest pet peeve. Medicate your child's fever. Don't bring them into me and when I ask whether you gave tylenol or motrin look at me like I am insane. When you have a fever you treat it.. pass on the courtesy. Also remember kids have little bodies and they get hot faster and hotter than you and me. They are able to tolerate these fevers, don't bring in your child with a 100 temp freaking out. You won't get my attention until maybe 103 .You will get my attention and a tongue lashing for bundling up these children practically suffocation them in the 5 layers of coats and blankets. When you have a fever would you want all that on you... NO so why do you think your child does... think parents.

Next kids vomit.. those buggers do it alot. And amazingly they don't need to be rushed to the ER EVERY TIME! If junior has been vomiting for more than 24 hours and not peeing, and hard to arouse I want to see him. I don't want to see him 20 minutes after the very first episode, nor do I want you to bring in juniors vomit for me to see. Now if it is pure blood, and not spaghetti sauce ok I might tolerate seeing it but DON"T shove it into my face the minute you walk into triage.

Suzie and Sam are going to get colds many times in their childhood. So you better learn to deal with it and come up with some coping plans.. because there is NOTHING I can do about it. No we aren't going to prescribe ABO to make YOU feel better like they use to do.... that is the reason why we have so many bugs that are resistent to almost all ABO. What I will do is give little one tylenol/motrin if needed for that fever that you have chosen not to treat just to prove to us that Sam and Suzie are sick and then a popsicle. And that Mom and Dad just cost you $400+
So in the future why don't you try to push fluids, give tylenol/motrin for fever and if needed a vaporizer and let junior veg on the couch for a day. That way we can avoid that pissed off call to our billing depart yelling "All they did was give motrin and a popsicle, I could have done that !"
Exactly.. and if you had you would saved yourself that $400+.

Now on to my favorites.. you know who you are.. Stand up proud parents... You who bring in your beautiful sleeping babes at 3am because they are NOT crying. You kill me. You should be thanking whatever GOD you believe in that you don't have a colic child. That you aren't awake at 3am crying yourself and begging your baby to please finally go to sleep after being awake for days on end. New parents cherish the silence, because it does not last.. soon you will be yelling for them to keep it down because you can't hear the TV or the phone.

Now that I have covered all the things that with a little common sense or call to grandmother could fix and keep little one out of the ER ....lets talk to the parents of children that are really sick... Thank you for realizing that Sally is sicker than chicken soup can fix and need to be seen by a Dr now and treated and can't wait for the clinic to open in the morning. Now you have made it that far why stop with great thinking... Why now that you are here are you refusing to let us do the tests necessary. I know as a mother myself that it is hard to see Sam cry as we stick an IV in him but we need to run test on his blood, give him fluids and medicine through it. I know that the idea of us placing a catheter into Sally is something you don't want to see dad, but I need sterile urine to see if she is lethargic because of a severe UTI. I need to do that LP(lumbar puncture) on your 36 hour newborn with a 103 temp to rule out menigitis. I know that all of these tests are going to cause discomfort to baby, but please know I do them as gently as I can, and as a last resort when there is no other way to get the information I need. Your parental instincts were right to walk thru those doors with your dear sick child.. now please trust me and my team to care for your child so that you don't walk out of them empty handed.

I think I covered the issues that bug me the most.. there are more that I know I will cover in future postings but I gotta run.. I think I just heard my Sally sneeze!

We get breaks?

What a weekend from hell. I ran non stop.

It was another weekend of shifts where lunch breaks are what you can cram down while pulling your meds out of the pyxis, and legs bags should have been handed out when you clocked in. Nurses are truly the worse when it comes to taking care of ourselves, but we are the first to preach to our "care-taker" relatives of our patients about putting themselves first..yada yada... Why do we put our needs last? Why do we promise ourselves that bathroom break or bite to eat after we get that one patient's IV started, or triaged or painfree, and yet when accomplished there is always something else we view as more important than our own 1200ml bladder or 60s bloodsugar? I think after years of this it contributes to the burn out of us... or at least I am seeing it in me..

I have always prided myself on my work ethic.. Come in 20 minutes before my shift to get a feel for the night and get an idea of what is happening on the other floors so I know where my beds are available, always willing to stay over in the morning to help the dayshift get started, and make sure that my transfers and admissions are completed or at least the report is given. Consider true "leave the floor lunch" breaks as a luxury. And viewed the nurses that religiously took their breaks and left on the dot every morning as having poor work ethic and lazy.. But you know I think I am the one that needs a perception adjustment.. maybe I am a masochist.

This year I am really going to push myself to take my breaks or at least walk off the floor for a few minutes and take a breather... Go look at the moon, grab a soda or if nothing else go stand in the bay and watch our patients go from full functioning adults into complete debilitated crying/hyperventilating drama in the 30-50 yards it takes them to walk across the parking lot into view of admitting and the triage nurse. You gotta love those.

Ok so that is my plan as i sit here in bed typing this.. let's see what happens in reality.

Why Blog?

Welcome to my blog... After 11 years of nursing and about 4 of them in the ED I find that I need a place to "detox". There are some mornings as I walk to my car that I wonder why the hell do I keep doing this job, not just working in the ER but nursing as well.

I got into this job with all the good intentions, and thoughts of being the next Nightingale, when in actually I find myself night after night wrestling with my patients, watching them get tazed and then placed in 4 points. Most times I win the fight, but there have been times I have had my ass handed to me...

I find myself with each day becoming more and more cynical. Are they truly sick or just looking for drugs? I find myself feeling more like my patients drug dealer and not their health advocate. Now a days we prescribe/handout narcs more than ever before just to "shut them up and get them out" and because so many Drs fear getting sued for not providing adequate trx.

Come in for a fx(fracture) get 20 percs, stabbed 20 percs, assaulted 20 percs, migraine 20 percs, dp(dental Pain) 20 percs, nothing better to do at 0300 then come hang out in the ER 20 percs!

So I guess this is where I am going to come to detox and vent and hopefully meet others that are going thru the same, but not quite ready to throw up our hands and say enough.. on the other hand it might get us 20 percs!