Thursday, September 03, 2009


When I started in the ER (almost 8 years ago!) as a new grad I was convinced that I was hot shit. The ER had not hired new grads in years.... I was fresh out of nursing school and had been offered every job (all 3) that I had applied for. All I wanted was to play in the trauma room... that's where my love was. 8 years later I sit and wonder what the hell has happened? I have seen more tragedy and gore than more people do in a lifetime. I have literally clawed my way as close to the top of the ED as I am willing to go. I have no aspirations of being a coordinator or management in the department. It seems like as soon as you leave the bedside that all sense of solidarity with the nursing staff is lost.

Case in point.... We are seriously up to our assholes in patients. The acuity is way up. Patients that usually get put in rooms and monitors are in the hallway. There are NO inpatient beds and the traumas just keep coming. Given the situation the charge nurse called the coordinator (its becoming well past unsafe here) and is promptly hung up on. It wasn't until the house administrator came down to investigate the 4,000 trauma pages and saw the zoo that we finally went on diversion "for 2 hours to decompress."

I also noticed that the ED education staff seems to think that this is a democracy. Everyone should be equal and allowed to "do everything." So folks that can't handle a 4 patient zone are being trained for triage, charge and trauma. One refused to check the airway cart because 1) its the dr's job and 2) I don't use any of that stuff. Many don't know how to care for a mechanically ventilated patient (100% fiO2 and pO2 of 430 is not really a good thing!) and ACLS is no longer a requirement.

I am starting to feel like a rat in a sinking ship (again). I want to stay because I know this is what I am good at. I doubt that I will leave the ER completely, but I need something more challenging that makes me think. There is no way in hell that I am going back to neuro. I will kill the troll and they really dislike my use of the f-word. Ugh... don't know where this restless feeling is coming from.

Had to work with one of my least fav doctors the other night. He is the quintessential community doctor who has blessed us with his presence in a level 1 teaching hospital. He is a "white collar worker" who looks down on everyone else. Seriously, he called nurses blue collar workers with no integrity or work ethic. When he starts talking with other "colleagues" you WILL NOT get a word in. I had a patient that was not doing well but could not get his attention to tell either he or the resident about it. He is one of those doctors that will be nice to the patients face and completely bash them as soon as he leaves the room.... no matter what their injury or education level. They are below him. He is also the medical director for our special forces medics.... so when they are around he is all about teaching and being involved. As soon as those guys leave.....he doesn't give a shit. So to my dearest Dr BORED....


love.... one of those blue-collar-nurses!


Anonymous Sean said...

It sounds like you need a bit of a change to get you more "energized" with your job (sorry about the annoying buzz word), But you love where you are and want to stay.

Just a couple ideas that you can totally give or take. Firstly, if your hospital is set up for this type of experience, you could try some cross-training. Take a six month temporary position in the ICU, CCU, PACU etc. and try out some other forms of critical nursing. You'll learn TONNES, be doing something a bit different, and in the end you can return to your position a better, stronger nurse who is...

Energized! (picture me doing jazz hands as I'm saying that).

Another idea: I know my ICU has lots of opportunities to be on committees. We have many of them that look at different aspects of patient care and and work life. It would give you a sense of control over the crappiness that work throw at you.

Any way...just some thoughts.

10:12 AM  
Blogger mojitogirl said...

I second Sean's advice. You're on fast-track for a big blowout....and it's no fun to go to work to just collect a paycheck. You start not to care about your patients, your work, you make mistakes, you cut corners....and before you know it you're OUT.....without options.

Right now you have options. Explore them. You're talented enough to work WHERE you want, HOW you want! Maybe you can't see it, but other people do. Talk to a colleague, someone who you like and admire professionally. Explore the alternatives.

Unfortunately, the economic reality of these times may dictate moving around from home base. I did it AND hauled a family away from home in order to swim, not sink. I know many more who have had to leave home to work. It's like anything accentuate the positive, you open up your circle and meet new people. It's not bad and sometimes it's a matter of survival.

My best wishes to you. Keep your options open. And everyone deserves some JOY in their profession. Hope you can regain yours.

12:33 PM  
Blogger battynurse said...

Seriously? You can work in your ED without ACLS? That's freaking scary. No it shouldn't be an even thing. Only those who are qualified to do the job should be doing it. If other nurses are trying to do so they are risking their license but it also makes it risky to work with them.
I would second the idea to try floating to other areas or moving to other units just to give yourself a change. Good luck. I hope something helps.

9:21 PM  

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