Thursday, July 30, 2009

Time to Retire?

What would you consider to be the "shelf life" of a nurse? Especially one who is still working in a very busy urban ED?

I had the misfortune of being the HBIC (Head Bitch in Charge) in Green last night. As I have said a million times, the staff can make or break your night. A horrible night with a great crew is never as bad as it could be. Last night was a not so great night with a really not great crew. People were actually coming to ask who I pissed off to be stuck with 3 of my 4 nurses. Until 11 I had one of the most senior nurses working a zone. When I say senior I don't mean experienced... I just mean old. She has been in the ER for a million years, but hasn't seemed to evolve past what nursing used to be. She had 3 ready beds when I arrived at 7pm. At 1030 she was finally (?!?!??!) calling report on one of them. Nobody was too sick, she just wasn't able to prioritize and stay organized enough to get shit done. I tried to smooze in and snag the charts (to call myself!) but she would have none of that. So essentially that zone, and nurse, were dead weight for the first 4 hours. She actually retired a couple of years ago, but still works part time. Unfortunately she is more of a hindrance than a help.

My dear friend who busted her ass with me last night got stuck with the weirdo of the night. 28 years old with sudden onset of panic attacks which he attributed to the bite from a 5 week old kitten 3 months ago. In short... he thought he had rabies. Funny how the panic attacks subsided with alcohol. Hmmm..... liquor as a cure for rabies??? I'm sure Ol' Yeller would have appreciated that one!

My same dear friend took care of a very large lady who recently had a TAH. Her staples were intact, bt she was bleeding (heavily) from between them. On arrival there was freaking blood everywhere! She busted her ass to get the patient stabilized, OB/Gyn consulted and the patient cleaned up. No easy task considering that the patient was huge and the nurse was not. When the patient's (very large) family came to the bedside they were not happy. Why you may ask??? Because my hard-working nurse did not wash the bottoms of the patient's feet.

Are you fucking kidding me???

The straw for me was the son of an 85 year old lady who fell at 630pm the night before. Her hip was sore, but she didn't call 911 until 24 hours later. On arrival she was neither shortened or rotated so into the hall she went. X-rays revealed a non-displaced femoral neck fracture. Ortho saw her and consulted medicine (isn't that what ortho always does???) with the plan to surgicize in the AM. The son, however was not convinced. Despite multiple films and views which showed a pretty freaking obvious fracture) he thought that we were probably wrong. Why? because he didn't see the huge displaced, my acetabulum is in another zip code fracture. We tried many many times to teach, point out etc and no go. He was mortified that she was NPO and that we had not given her a bath, brushed the teeth etc. UGH!!!!! Can I retire now?


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