Monday, March 17, 2014

Baseball and Hematomas

Well, it's that time of year again for my kids to start baseball and softball season. This means hours spent at the fields in cold weather watching them run around the bases, drop fly balls and swing endlessly at curve balls.
I was at the parent/ coach meeting outside where we would get all the information and have the kids fit for their uniforms. My son was playing with some other boys running around like escaped lunatics. This one in particular was especially rowdy past the point of being obnoxious. I told my son to stay away from him when he started throwing dirt and rocks at other kids. As the meeting progressed, suddenly we hear a scream, crying and a bevy of children running up to parents to 'tell on' the rowdy kid who threw a large rock at another kid's head. The boy came limping up to his father looking like a horror movie actor - blood all over his face and arms, blowing snot everywhere.
I must say, the father showed more restraint than I would have. He loudly told the kid a thing or two and then attended to his bleeding son. I figured that the dad and another adult had the situation under control, but then by watching them, I decided to walk over there to see if I could help. I got a roll of paper towels someone had grabbed out of the little concession stand at the field and led the boy into the bathroom so I could see the cut.
He didn't require sutures, but had a decent hematoma with no obvious skull deformities palpated. I cleaned him up and helped him blow his nose because snot was dripping off of his chin and it was grossing me out. I told the dad what I thought, that ice needed to be applied to the head and then started to advise him of signs and symptoms to watch for and then he interrupted me, "I know these things, I've coached in the past."
"Oh. Okay. Well, I'm going to tell you anyway and you can ignore what you already know."
I continued on and when I was finished, he said, "Oh, I didn't know about those last two things."
Yeah, well, if you notice any of them then take him to the ER for a head CT.
By the time I returned to the meeting, it was wrapping up and I only missed the boring parent behavioral agreement that they have to review with us.
The kid is fine now. I never saw that derelict kid's parents. I wonder if they were even there.

Wednesday, March 12, 2014

Update

Update to the downward spiral of my ER:

To my knowledge the last of the nurse resignations happened a few weeks ago. We had two mass movements of resignations, so we are extremely short in the nursing department. The admin decided to fill in with agency nurses for the time being. Last week, 2 new nurses were fired for legitimate reasons and our brand new director was also canned. She since has been replaced with a newer director. Also, our hospital chaplain retired because according to him "he saw the writing on the wall" and knew he would be laid off next. Unfortunately, he won't be replaced. He provided an invaluable service to our patients and families during critical times and codes.
I was begged to work the other day because they only had 3 nurses on shift for the whole ER for all of day shift. I agreed to work because I felt bad for my coworkers stuck in the schedule and I knew it would be a horrendous day regardless of how busy it was for them. Well, it was a terrible day. As I triaged patient after patient in the little triage room without a break (I managed to leave once to use the restroom), I became angrier with all the bullshit reasons coming into my triage area. I had to take a little mental break because I wouldn't be able to finish the day without yelling at someone. Everyone felt like they had an emergency or that their problem was the most important of the day. People had to wait, a long, long time and they got angry about that. A patient actually called ahead of time to make an appointment which we told her she couldn't do.
I was able to get quick rooms for the truly emergent patients, thank goodness. Those who had to wait for trivial things such as not wanting to buy tylenol for their kid or decided that today would be the day to take care of a problem they had for over a year sat in the lobby. After hours of hearing the snide remarks, the yelling and the insults - I stopped caring about catering to their whims and complaints. We did not have the nurses to open more rooms, their problems were not emergencies and simply put - they would have to wait.

Wednesday, March 5, 2014

Flying would be fun.

Surprisingly, I had an opportunity proposed to me for a different job. There is a flight nurse position open and I have a contact to get me in the door. This has always been the most difficult part, you have to know someone in order to get your foot into the door. However, there are many drawbacks. The base is 2 1/2 hours away from me. The upside is that they offer 12 hours shifts instead of the usual 24. They do have a base very close to my house, but presently, they are waiting to move it to a neighboring town, so no new positions at the moment. I was told that I could start at the one 2 1/2 hours away and transfer later. The closer base would be massively hiring sometime in the future. The other down side is that the salary is depressingly low. I'm guessing they bank on everyone wanting to have the cool job of being a flight nurse, so they get away with paying lower than normal for a critical care nurse.
Although I want to jump for joy about the possibility of flying, I have to be realistic under the present circumstances. I guess I'll have to wait and see about the hiring at the closer base and make a decision then.