I've been at this new hospital for a little over a month now, and there are some SIGNIFICANT differences from the one I just left. Some are good and some are not so good.
The new place is a medical center and is significantly larger than the old place. The ED is a level 2, same as the old place, but only has 20 more beds. But there are a zillion more nurses down here.
The standard assignment is six beds: three two-bedded rooms. Each room has a monitor. At the old place, the standard assignment was at least 8 beds, if not 10, and then you could be doubled up in an instant. Here you might put a stable, admitted patient in the hallway as they wait to go up to their room. Maybe. (One difference is that I've noticed that it takes much longer for patients to get beds and go upstairs.)
Despite this, the nurses in the new place have no idea how good they have it. There is a LOT of bitching about who got a patient and who has a sick patient and blah blah blah...also, as I am finding out, there is a lot of interpersonal politics. I guess when you have a lot of time on your hands, you can look around and find fault with your colleagues and then gab with your buddies about it. Whatever. I'm just glad I have time to actually be a nurse, instead of a medication waitress and procedure monkey like at the old place. Oh, and here I have a whole nurse tech to myself!! No sharing!! They do things without me begging! It's AMAZING! These nurses have NO idea how great they have it. Some talk about how this place is going to hell in a handbasket, and how they're looking for new jobs. Well, let me tell you, the grass is NOT greener on the other side.
There are big differences in the patient population here too. Before, I saw a zillion nursing home patients. Here, I think I've seen maybe one. A lot less bedsores. A LOT more junkies and bad alcoholics. This is due to the neighborhood. The population is a lot younger (packed with drunk college kids on the weekend). However, due to the junkie/alcoholic/homeless population, I've gone from being the best at getting tough IVs to being only fair at it. These people have NO veins whatsoever. At the old place, we'd get a lot of methadonians. Here, we have full-blown junkies etc looking for rehab, which we provide.
Here, the nurses can order labs and chest and limb x rays. This really speeds things up. However, I've been warned to look out for the super-old-school attendings who hate it when the RNs order anything. They tend to quiz you on your reasons for anything, so I make sure I have rationales for anything I order when working with them.
The residents seem ok, but the jury is still out on them. At the old place it was so crazy busy that a lot of face-to-face communication between the MDs and RNs was necessary. This created a bond between us, a sort of we're-all-in-this-together siege mentality. Here, the residents and PAs just order what they want and really don't communicate well, as far as I've seen. If I'm not constantly looking at the computer, I won't know anything's been ordered.
Another thing is that there's a separate psych ER for medically stable psych patients. They just go straight there. This is great from a work standpoint but not so great from an amusing-stories standpoint.
All in all, I think I'm going to like it here. I'm a little lonely because I have no buddies yet, and the commute and hours are killing me (we're staying with my in-laws in another city because our house is still being renovated--more on that later; and I'm working 7a-7p while on orientation, instead of my usual 12p-12a), but I'll fit in eventually.
All in all, I'm a little bored, actually. Oh well.