Thursday, July 10, 2008

You Know It'll Be a Bad Day When...

Every day brings new challenges in the ER. Some more than others. A few weeks ago was one of those days.

You know it is going to be bad when...

* You come on shift to find the board full of nothing but yellow charts
* You are just walking out of triaging the chest pain patient who came in by ambulance, and without a chance to check on your dyspnea patient who just came back from MRI (for possible spinal cyst!?!?), you see the medics roll into your room with a 91 year old.
* You go in the room to deliver critical medications for your chest pain patient only to learn - as your saline flush explodes all over you - that the medic messed up the IV and didn't get it inserted properly... tack on 30 minutes of trying to save the site and eventually starting an IV on the opposite arm. Hope your other patients are all right!
* All three of your patients have admission orders... at the same time.
* One of your patients is getting out of bed to leave AMA, the other is threatening to do so in order to go smoke, and the third is more confused now than when she got there, but you don't have time to check it out.
* The Tech comes up to you and says, "I'm thinking of just putting a big ABD pad on that scalp lac and then wrap a bunch of tape around his head to keep it in place"... and she is serious.
* As you walk in the door to start your shift the 550 pound patient is checking in. You have an open room. Yeah.
* You look up on the tracking board and see more patients in the waiting room than there are in the ER.
* You take just "a minute" to help settle this ambulance patient for another nurse and find out that she has become completely unresponsive. Completely. As in no response from sternal rub or fingernail pressure or baseball bat to the temple. Nothing. How do you spell life flight to a Level 1?
* You are busy complaining about how difficult this day is and look up at the board only to realize that your load is no more difficult than anyone else's.
* Senior Management chose today to do a walk-through and start nit-picking about stupid stuff.
* Really, do they remember what it was like to work on the floor?
* Unit Manager was there, too, and had no choice but to go along with Senior Manager on the stupid stuff.
* Don't fire me.
* You finally get your lunch break - your first break of the day - 7 hours into your shift.

You know that you are in the right career when...

* Your day includes all of that for 10 hours, and as you walk out the door, you think to yourself, "well that was fun."


EDNurseasauras said...

doing my admission coordinator job in the ER yesterday it was...all of the above, plus every inpatient bed filled, post-op floor has 5 patients in PACU and no place to put them, labor and delivery has 3 c-sections and no discharges, there are 3 ICU patients in the ER and the medical CEO thinks it would be a good plan if I could convince pedi to take a 94 year old demented patient with pneumonia. Is it required for all senior management to have absloutely no common sense?

Braden said...

"Is it required for all senior management to have absloutely no common sense?"

I used to work on the Neuro floor... well, okay, it wasn't all Neuro, because somebody brilliant decided that the floor where we send ALOCs and drunks should be shared with pediatrics.

More than once when peds was quiet (all summer) and neuro was busy, I would be caring for a drunk or confused patient who was actually spilled over the peds unit.

So is it a requirement? Who knows; maybe it is just acquired.