I never thought I'd say this

I am lucky enough to still be blessed by my boyfriends tales of the ER, as he is also an ER nurse. I do not go back until the 2nd week in August. I am looking forward to it considering I just re certified my BLS today (it was awful....here there were 2 floor nurses teaching us) Looking forward to starting compressions again and pushing all the fun drugs. I got a call last week and I was lucky enough to interview for a cath lab position. I am eagerly awaiting the outcome. I will only take the job if I can float to ER. The education gained in a cath lab job would be irreplaceable.

Exciting

I got the Job....back to the ED PRN.

The Recovery Room.

Well....it has been 3 months since leaving my Emergency Room job and I must say I am bored! Tomorrow I interview for a PRN position in a ER. I have learned my PACU (recovery room) and Cath lab recovery trade but I feel like something is missing. I am not learning as much and I miss the rush. I guess I am through and through ER...it's in my blood. Sadly, I have not updated much because I lack fun and interesting stories from the recovery room (PACU). I caught a Stemi 2 months ago and a few other things have happened but I am not using my skills to my max. I beg everyone to do their IV's if one stops infusing or the vein blows.

I do have an issue with nurses in recovery not wearing stethoscopes. Can one tell me how you can accurately chart that breath sounds and clear bilaterally and in all lung fields if you do not listen. I have not seen one nurse place their ears to a chest or back. Why do you not know how to do IV's?? Isn't this a basic nursing skill? I find surgeons hard to work with and often their God complexes get in the way of taking care of the patient properly. It is hard being the new kid on the block in a unit because no matter what others seem to think I am a "new nurse" Sadly, I find myself wishing something would happen so that I can shine. I find recovery easy, fairly laid back and a great job but I need the excitement once again.

Beauty in a new happiness

"The greatest degree of inner tranquility comes from the development of love and compassion. The more we care for the happiness of others, the greater is our own sense of well-being."
- Tenzin Gyatso, 14th Dalai Lamat

Photo by Hearttist. I have decided to post this photo which allows me to go to my happy place. A true beauty.

I feel I have lost compassion, a part of myself and live in fear of losing my nursing license by working in my current Emergency Room position. The fact is...I love emergency nursing and trauma especially and I hold the field close to my heart. The unit is always under staffed and the patients have high acuity. The other night I was expected to take 3 ICU patients, as well as one other high acuity patient, not only is the assignment unsafe for the patients but places my nursing license on the line. I am losing all faith in emergency medicine and the system in general. I was able to address my concerns and took 2 icu patients and 2 other patients, still very unsafe. My ICU patients essentially needed one on one care. This all falls into nursing politics and corporation’s failure to secure enough money for staff. Float pool was not available the other night because the nurses were acting as monitor techs on telemetry floors and patients could not be moved out of the ER to the ICU because the ICU did not have enough nurses. This is ridiculous. I lose faith in nursing...no wonder why hospitals cannot retain nurses. I hear there is a staffing committee and the committee is supposed to have procedures for times when unit staffing is low and I guess in theory this is a great idea. I have not seen this implemented. California has the right idea which mandates proper nurse to patient ratios. One day I hope Texas will jump on board. Its so sad that my nursing career has came to this...to leave the field I love due to staffing. I have even thought of leaving nursing all together.

So this is a new me. I have decided to take a job in the Post Anesthesia care unit. I am extremely excited to take on a new job and look forward to finding the love inside me that once was nursing. PACU will allow me to use my critical care skills but still have the "in and out" patient flow that I enjoy. I took a pay cut but when it comes to happiness, what’s the cost? Unfortunetly, I still have to finish 4 more shifts in the ER. I dread each moment.

A last word to the ER patients.
"In the sick room, ten cents' worth of human understanding equals ten dollars' worth of medical science." ~Martin H. Fischer

Hotel vs Hospital

There is a difference between hotel and hospital. Sometimes I want to drag patients into other patients rooms by their hair just to show them what a "sick" patient looks like (of course never possible due to HIPAA). Do not come to the nurses station yelling that you have called for a blanket twice...this is a hospital and when someone is not busy taking care of their patients we will be more than happy to get you a blanket. Last night was my breaking point. I only had one real sick patient all night so I had the pleasure of dealing with bullshit. Everyone was demanding, disrespectful,a good amount left AMA and I was told that I would be sued, or the hospital would be sued by 75% of them. Do not get mad at me because the doctor or NP will not give you pain medicine. I just do not get it! Why is it that the sickest of patients are often the kindnest and treat the medical staff with respect and then the ones who are there for their "free healthcare" shit on us. ER Nurses take a huge amount of abuse. This makes me lose faith in my profession, literally. I am here to help people and do my job well. All I ask of my patients is to give the same respect to me as I give to them. Afterall.....what am I saying. This is a customer service business not healthcare. I am livid.

MI

So I had this seemingly normalish looking patient with chest pain, vitals stable, EKG normal, short of breath and pain 9/10. This was the man that never goes to the doctors and he had pain for about a week now. I got him into the room quick, assessed and placed his line... I awaited further orders. I noticed he was slowly getting more hypertensive and tachycardic and I placed another large bore iv notified the doc. A while later he was on a nitro drip and pain was better. The patient became more short of breath and severely diaphoretic. Troponins were very elevated. This guy was having a non stemi MI. The patient went into flash pulmonary edema and had to be intubated. I was greatly challenged that night and started him on an heparin drip, integrelin, continued nitro drip and with all this he ended up needing neo to keep his pressure up. It was a continued task titrating the diprivan and nitro with effects from heparin etc. I transported this patient to icu with a rolling pole full of pumps with high risk drugs infusing, his bed and respiratory with the portable vent. He left the ER alive. Some patients I want to follow up on, he was one of them but I didn't. Everyday it's a new challenge, new patient in the Er.... That was a scary night.

Cracking the chest

I dont not even know where to start this blog. 2 nights ago a patient bled out in our trauma room because her boyfriend stabbed her 15-20 times in the chest and abdomen....and then I drive home and try to sleep and live my normal day to day life. I have not been the same.



Christmas eve: Night 1: absolutely not how I thought it was going to go. I figured okay everyone will be home with their families boy was I wrong. I ran my ass all night long. I guess there is more freedom on nights. The Emergency room was really busy but I did my job and went home to get some much needed rest...only GOD knew what was coming the next night.

Christmas: I come in...just clocked in and I run into the trauma room because we have a CPR in process and No Nurses in the room, likely because everyone had super sick patients and everyone was trying to save their lives. Patient had been down about an hour and despite many rounds of ACLS the patient died.

Sometimes I think that if I did not work nights and work with a certain doc I would be behind or miss out on seeing amazing talent and willpower to save a life. Nights are just crazy. Of course this night was extremely busy as the night before. I guess our 50plus bed ER is never a patient short but always short on staff. I ran by the trauma room to see my coworkers performing CPR, gowned and scrambling around and here we go. Here we had a 26yr old female who appears to have taken a significant beating and has been stabbed multiple times in the chest and abdomen, on scene she had a pulse....DR. Amazing cracks the chest, clamps the aorta and starts to manually massage the heart while having one of my coworkers take over he inserts a 5f cordis and everyone is on chairs pressure squeezing blood and fluids into the patient. We tried so hard...but despite the efforts the patient did not make it. Merry F'in Christmas. I felt helpless. immediatley after EMS brings in the "boyfriend" altered mental status who is covered in blood.....how do you switch and now take care of this man? I couldnt do it. Needless to say he medically checked out and is in custody. My coworkers and I could not stop talking about this event all night. Our therapy.

December 26-Sunday: hell....end of story.

I am pretty sure I am getting sick..I am not surprised.