The Nights of My ER.....: We get breaks?

Monday, January 21, 2008

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.

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Oh yeah I almost forgot....

This blog is here for yours and my entertainment..
All identifible characterizations have been changed to protect the not so innocent or smart so they may show their faces in our town.
If you think any of this might be about you or your family you are wrong and should have that paranoia problem addressed..
All HIPPA regs have been noted. Though not always appreciated.
All opinions expressed here are mine and mine alone.. and not shared by any facility,administration, or co-workers I come in contact with., and they are all thankful for that.
All medical information written here is for fun, and in no means should be used to treat,diagnose or otherwise used in an intelligent conversation.
Now that should CMA... On with the show!!

Math Quiz for ED Staff

1. You are assisting a primary nurse with charcoal administration down an orogastric tube. The room measures eight feet by twelve feet. The patient starts to retch before the tube is pulled. Knowing that charcoal can spew out of a tube in a five foot radius (even with a thumb over the opening) and the stretcher is two feet wide, how many feet per second do you have to back up to get less charcoal on you than the primary nurse?
2. Doctor A picks up a chart out of the rack. S/he finds that it is a repeat patient with abdominal pain. Doctor A puts the chart back. Doctor B picks up the chart five minutes later and also returns it to the rack. Doctor A leaves the nurses' station heading south at three miles per hour. Doctor B leaves the nurses station for the doctors' lounge at five miles per hour. How long before the patient is at equal distance from Doctor A and Doctor B?
3. You were assigned two large treatment rooms and the gynecologic room. By the end of the day you have cared for ten patients. Four patients were female over the age of 80, all complaining of weakness. Two patients were male, ages 72 and 50. The last four were female, between the ages of 24 and 40, all complaining of abdominal pain. It is 3:00 p.m. and time to restock the rooms. How many bedpans will you need?
4. You are the primary nurse for an elderly patient with congestive heart failure. The IV stick was exceptionally difficult, but you are able to start an 18 gauge catheter on the second attempt. You leave the room to check on another patient. A relative thinks that the IV has stopped dripping and opens the clamp. How much IV fluid will infuse before you return?
5. You are sent for your morning coffee break. You need to use the restroom but can't find one unoccupied and have to walk down to the lobby. The coffee pot is dry and you have to make more. When you get to the cafeteria, the line extends ten feet into the hallway. You can't remember exactly when your break began. How much time do you have left?
6. You are the primary nurse taking care of a particularly shy female in the gynecology room. Her private physician arrives to see her, but you can see that he is not in a particularly good mood. After much coaxing, the patient agrees to a pelvic exam. How many people will open the door during the exam?
7. An elderly man arrives in the Emergency Department by rescue squad. Twenty minutes later his wife arrives and registers him. She is shown the entrance to the department and slowly shuffles in. How many rooms will she walk into before she finds him?
8. You are assigned to the EENT room. You have a patient to be checked for a peritonsillar abscess. The ENT physician has been paged and expects to arrive in 45 minutes. Three hours later, he arrives and is at the patient's side, asking for a flashlight. Lightly jogging at 22 miles per hour, how many rooms will you have to search before you find one?
9. You have been asked to cover a coworker's rooms during her break. One of her patients is an elderly, confused male with an enlarged prostate. A catheter has been inserted and his physician is coming to see him. Somehow he manages to get off the stretcher. The drainage bag is firmly hooked to the side rail. Knowing that the catheter is 16 inches long and the drainage tubing is three feet long, will he be able to reach the door before pulling out the catheter?
10. A college student named Muffy is brought to the Emergency Department with a sore throat. She has no relatives in the area. Will there be enough chairs in the waiting room for deeply concerned significant others?

Written By Myka Clark

RULES for the EMERGENCY ROOM

Here are some tips to those who may end up in an ER, be it yourself or a family member.

-If it requires the ambulance team and entire truck crew of firefighters to transport you and safely place you on a hospital stretcher, it is time to go on a diet.
-Never start out by saying, "I was searching the Internet . . . "
-When asked how much you weigh, please do not give the "Deer-In-The-Headlights Look", and tell us you "really don't know". It's a simple question with a simple answer.
-Just because you have a phone and know how to call 911, we are not impressed by your arrival on an ambulance stretcher. You had better be sick.
-If you came escorted via EMS for multiple complaints that started more than one week ago and your entire family followed the ambulance to the hospital, you will be labeled a ninnie and treated like one, enjoy the waiting area with your family.
-One complaint/ailment per visit.
-Just because you came in on a ambulance, doesn't mean you're going home on one. You better start making arrangements, now. I am not driving you home, or figuring out how to get you home. Cab vouchers are not an option.
-If you have one of these four, go to your own doctor in the morning: a Migraine; the Flu; a stomach virus; or a stuffy nose.
-Do not ask us how long it will be. We don't know. I don't know what is coming through my door 30 seconds from now,so I sure as hell don't know when you're getting a room.
-We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That is why she goes first.
-If your mother is a patient and we ask her a question, let her answer it.
-If your child has a fever, you had damn well better give him Tylenol® before coming in. DO NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure?
-If you are well enough to complain about the wait, you are well enough to go home.
-Do not utter the words "it is in my chart", I don't have your chart, and I don't have the time to call and get it. Just tell me. It is faster.
-We know how many times you've been to an ER. We can usually tell if you are faking it during the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will have to assume you are lying about everything.
-If you are a female between 16 and 42 and your last period was between 28-35 days ago, please don't waste our time if you are here for Abdominal Pain & Vaginal bleeding. Guess what!!?? You got your period, again.
-Do not bring your entire posse with you. One person at the bedside is all you need.
-Every time I ask you a question, I learn more about what is wrong with you. I don't care if I asked you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless whether you have answered them before.
-If you want something, be nice. I will go out of my way to piss off rude people.
-Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or have been shot. We don't consider a kidney stone, sick. Painful, yes. Sick, no.
-There is a law (similar to Murphy's) in the ER. If you have four patients: one of them will be sick (see above for definition); one of them will be whining constantly; one of them will be homeless; and one of them will a delightful patient. (don't be the whiner).
-If you see someone pushing a big cart down the hall at full speed and you hear bells going off, do not ask for a cup of coffee. Someone is dying, you inconsiderate a*****e. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.
-If you can bi**h about the blood pressure cuff being too tight, or the IV hurting, you are not in that much pain.
-Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonald's®, and you may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, and the lights dimmed, go to the Ramada®.
-If you have any sort of stomach pain and you ask for something to eat, you are not sick.
-Do not talk s**t about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more that I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.
-If you are homeless, don't ask for a bus token or cab voucher to get home. It just confuses the staff.
-Please don't tell us how to do our job. Do we go to your place of business and tell you how to do your job?
-Please don't bring in a "show and tell". If you have to fish it out of the toilet, it's really not necessary to bring it in, we will take your word. If you did fish something out of the toilet, you may not use my pen.
-author unfortunately not me.

The Nights of My ER.....

Monday, January 21, 2008

We get breaks?

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Math Quiz for ED Staff

RULES for the EMERGENCY ROOM