I started a PRN job recently at a freestanding ER and clinic.
When I went on the job interview, the ER director told me that it would be a slower pace than what I'm probably accustomed to and less acute patients. "Actually, more like clinic patients. Sometimes we get a patient to transfer to the hospital ER, but not very often." The interview was more like a "you're hired already - this is what it's like, do YOU want to work here?"
During my first training day, we saw a bunch of patients and transferred 3 out. The nurses and doctor were amazed at how busy they were. I was surprised because compared to my usual ER shift, this was the slowest day in comparison.
Every ER is different, but I have always found that there is a good working relationship between the doctors and nurses. This place is odd. There was really no talking between the two. Everything is computer based - documentation, orders, etc. So, the doctor would walk out of the patient's room, not even say 'boo' to the nurse sitting right in front of him, go to his computer and type in the orders. The nurse would wait until something popped up on the screen and then would know what the orders would be. I don't know, I find it strange. No speaking, no heads up, nada.
I placed a patient in the room and he had a laceration that needed sutures. I then placed all of the items in the room so the PA could walk in, assess and suture. He walked in as I was finishing up.
"What are you doing?"
"I got all of your things together for a lac repair."
"Oh wow, thanks!" He appeared bewildered.
Very, very odd. The nurse training me said, "well, they like to get their own stuff. We don't get it for them"
All righty then.
One of the nurses said he was going to go on a Starbucks run. He collected our orders and I noticed that the doctor and PA weren't on the list. My God, they sit 10 feet away from us! I turned my head and asked them if they were ordering. They declined, but the nurses were surprised by my asking.
The nurses told me about how certain doctors like certain things. For instance, this one doctor does not want the paper lining for the exam table UNDER the band, he wants it OVER the band. I was in disbelief - who the hell cares about something like that?!! Seriously?? This isn't the OR!
As we were going through shift change, this one night shift doctor walked out of a patient's room after performing a lac repair and literally threw all of the items to be autoclaved (they were wrapped in a towel) onto the counter next to me. It landed with a big crash. I looked down at the mess and then up at him with no expression, back down at the pile and then back to the other nurses. He looked at me and then walked on. OH HELL NO! I hope I don't have to work with this guy a lot because I'm not playing that game. How unprofessional and juvenile.
Like I said, strange place. I guess I'll see how it goes this weekend when I work again. This will be my first time on my own - I sure hope I remember how to place that paper liner! <sarcasm> ;-)