zzzzzzz

I'm boring myself at this point. So here's a basic post, because they don't really change these days:

zzzzz....wake up...get to work...oh my god look at all these patients why is it so busy...IV's meds assessments...help I need some help here there's no pulse...chest compressions, meds, shock, ok nsr, write notes....give meds....get yelled at by patients....get yelled at by director of ED "WHY CAN'T WE BRING THOSE PEOPLE IN FROM THE WAITING ROOM I DON'T CARE DOUBLE THEM UP!...no beds upstairs, no ICU beds...more ambulances...stuff some food in mouth...oh great there's some nice vomit on the floor/bed/wall...duck, crazy man on the loose, grab him...more meds more IVs more fluids more orders more assessments more ambulances more problems more patients...go home lather rinse repeat.

Triage Conversation...

Me: So, how long has your son (a healthy 14-year-old boy) had these headaches?
Man: For a long time. Like three months. He keeps getting them.
Me: No vomiting or nausea? No sensitivity to light? (shines light in eyes, pupils are normal)
Man: No.
Me: (to boy) do you have a headache right now?
Boy: Yes.
Me: (to both) Have you given him anything for it? Like Tylenol or Motrin?
Man: No.
Me: He's been having headaches for three months. Have you seen his pediatrician? What did your family doctor say?
Man: We haven't had a chance to go to the pediatrician. Besides, I wanted to bring him here because in the Emergency Room they have all sorts of special equipment and extra tests and things.
Me: Uh huh. (Gives kid a Motrin, makes him a level 5--which means even sniffly noses will be seen before him).

Oh, and another thing.

I know you mean no harm by it, and it's TOTALLY silly, but:

I really hate it when doctors refer to the nurses as "My nurses" or "My nurse."

Just me being touchy, not a big deal, you don't even have to stop it. It just bugs me.

xoxo

GGRN

A word to the docs

Look. I know that we have people in the waiting room who have been waiting six hours to be seen. I know most of them are sick, and may in fact get admitted.

But the ambulances have not stopped. All of our beds are full, and many of our patients are admitted, but don't have beds upstairs yet.

We're working short. Each nurse has 9 to 12 beds in their area. That's 9 to 12 sick patients who all need attention, and multiple meds, and blood draws, and assessments, and vital signs, and extensive charting (not to mention pillows and ice and water and a sandwich and a bedpan and clean sheets after vomiting all over theirs and relatives who ask over and over "When is a doc going to see my mom/dad/sister/babymomma?").

I understand that you guys are working hard too. I understand that you don't like it when people come to the doctors' station and bitch at you about the wait and all the above-mentioned stuff. But you need to understand that you get a fraction of the bitching that the nurses do; we're first in the line of fire and we're the most visible.

I also understand that you're under fire from the administration about patients sitting in the waiting room a long time before being seen, but telling the charge nurse to "double up beds in all the rooms that have admitted patients in them" in order to bring more people back is NOT the way to handle this.

You see, once you've admitted a patient, your job is done. But that patient has no bed to go to upstairs yet, and now I'm responsible not only for all the new people who are coming in, but for an admitted patient--who comes with a whole NEW set of charting and med orders and blood draws and vital signs and a doc who isn't even readily available in the ED if something goes wrong--not to mention a set of angry relatives who are pissed off that their loved one isn't being rushed immediately upstairs to a private room with a hot meal and a TV that works.

I know we need to see more patients. But doubling up the rooms is not the way to handle it.