Friday, March 22, 2013

It is beyond my control

The past few days have been quite challenging. They scheduled only one doctor who is notorious for being the slowest patient moving doc in the ER. The situation was also exacerbated by the fact that all rooms in the hospital were full. So, while we still had to find places for new ER patients, we had to hold the ones waiting to go up. Everyone was cranky: the patients because they all had to wait for a very, very long time - no matter what situation they were in; the doctor because he was asked to work a little faster; the NP because he couldn't move his patients faster without the final stamp of approval from the doctor (remember..slow?); the nurses because we were getting grief from all sides.

While trying to appease patients with whatever I could to make their wait easier, most still snapped and snarked. After a while, I felt like John Malkovich in the break up scene from Dangerous Liaisons with Michelle Pfeiffer.

"blah, blah, is beyond my control."
"I understand you want to get your room, but there are none available right now. I will let you know when you have a room assignment. In the meantime, I'll try to make your stay in the ER as comfortable as I can."

"How long is it going to be? I don't want to stay down here."

"Blah, blah, is beyond my control."
It is beyond my control.
It is beyond my control.

Friday, March 1, 2013

Shifts like this...

It is a shift like this (and they're occurring more frequently) that I seriously question if it's actually worth the time and money to pursue my education in nursing. I have a diverse educational and career background, perhaps I should research other avenues to direct my attention.
The job is not going to change, attitudes are not going to change, patient's unrealistic demands and lack of personal responsibility are not going to I have to be the one to change or get out.

I had my full load of patients and helped another nurse who was getting slammed with new patients all at the same time. I helped her with 2 of them. As time passed, I noticed that she wasn't taking care of the two that I  admitted to the ER and was asking for help with her two other patients. One of the adopted patients was stable, the other borderline critical. I was irked that she would not go into that room. If I didn't take care of him, he was basically on his own. Now, my patients were all stable and one was borderline BS. I popped in to that room minimally because the others (mine and the other adopted ones) needed more care. Obviously, the borderline critical patient kept crossing the line into critical. Critical patients are time suckers when you still have to take care of a full load of patients and are expected to treat them all as though you have all the availability in the world.

Can anyone guess who lodged a complaint against me?

That patient received her pain medications promptly except for the last order which was to be given before discharge. She had to wait 30 minutes for it. I didn't know there was a pain medication order with her chart, when I peered over to the pending orders rack - I saw D/C paperwork. So, I did what all of us do in the ER, prioritized. She was about to go home - she can wait, she's not going to die. I had to turn my attention to the one who was trying very hard to circle the drain.

This discharge patient didn't like that she had to wait 30 minutes for her medication. I understand that, if I had a headache I wouldn't either. Although, she did receive some nice strong IV medication not too long ago. I apologized and explained that I was with a critical patient who needed my attention.

"I know how the ER works."
"Well, then you understand my situation."
"I'm not happy with my service."

I offered the opportunity to speak to my charge nurse.
"Do I need to?" was the reply with a smug look on her face.
"I'm trying to help address your complaint."

I informed my charge of the situation which she replied, "Well, why did she have to wait for the medication? I'm busy, maybe I'll talk to her."
"Okay, consider yourself notified of the problem." back up from my charge nurse, my critical adopted patient starting to crash now, AWOL unorganized nurse (discovered she was leaving for smoke breaks because the stress was getting to her) - I was on my own. I documented everything to cover my ass.

I seriously doubt this is what I want to continue pursuing. Call me crazy.....