Monday, August 09, 2010

Is it December Yet?

Would love to say that July went in like  lion and out like a lamb. Unfortunately, that is not the case. The learning curve appears steep again and the phrase "it is July" seems to drop from my mouth daily. Around here it will be "July" until at least mid to late December. The July bug seems to be catching though and (as my favorite resident has said) "its NOT July for you" has been said to many a resident who has been here more than 30 days. Maybe stupid has finally evolved into an ICD9 code-able disease.

The university, in their infinite wisdom, (and new nursing direction) has decided to make some changes. Not one at a time, but all about a month apart.

June 1: Non-Smoking Campus (I don't smoke, but that has gone over really fucking well) We have a huge campus, so people just go down the street. That hasn't stopped the hospital from hiring security who's job it is to walk the outside of the hospital and prevent people from smoking. I wonder how much that cost?

July 1: INTERNS. I should say 'nuff said, but like I said, the hospital is being fucktarded. Not only do we have to suffer through the interns, but the new ER computer charting which can be compared to pulling fucking teeth. Every attending and resident has to do a computerized note. We have a limited number of computers and and even more limited number of chairs. Can you imagine what the nurses station looks like? Yup, doctor city. Neither a chair, nor computer (or phone) to be had.

July 10: Medics have been shafted. We have a strong group of overtrained, under paid paramedics that work in our department. They are my right hand in traumas, they responded to codes on the floors, they transport ICU patients, they help with IV access, meds (within their list of meds they can give.... which is pretty liberal) and all in all help with the pace and flow of patients through the department. Not to mention they bust their asses and are of more use to me than an intern. Our brilliant nursing leadership has decided to pull their privledges. They are now nothing more than glorified stretcher pushers. They can draw blood, but not flush afterwards (saline is a med you know). They can transport a patient upstairs, but if they code they no longer have intubation and code med access. They are actually no longer to even put a patient on oxygen. These people are more trained than (a lot of) nurses and they are being fucked, hardcore. How are we supposed to claim to be the best and most forward thinking of departments when we are moving backwards? Hospital management is considering forming a committee to decide what to do with the medics now. I am calming myself enough to write a letter to the CNO. I think calling her a stupid yankee bitch with no goddamn clue would be bad. B=Maybe I'm not calm enough yet.

August 1: Uniforms. Yes friends we have sunk to that. We have always been on the forefront of research in cardiac, stroke and trauma emergencies. There are things all over our walls to prove it. Nursing management has decided that success is not enough to portray a "professional nursing image." As of August 1 all nursing has to wear the same color scheme. (we have the choice to wear all blue, all white or a combination) I work in the ER dammit. I get covered in the grossest shit on a regular basis. With the exception of my ICU time, I always wear hospital-issued scrubs. Its cheap and if I get god-knows-what on me, I can go to the machine and change. We tried to explain this to the all-knowing management and their response was something along the lines of "Based on out research ER nurses are no more likely to get soiled than any other nurse. They just need to remember to take the proper PPE precautions." Ok Doctorate and Masters in Nursing dumbasses.... I will ask the drive-up GSW, active labor, GI bleeders and drunks to not get blood, stool, vomit and god knows what else on me until I am ready with my PPE. Seriously?  We no longer require ER nurses to have ACLS because we can't afford to pay for it, and what do we do with it anyway, but God forbid we aren't all dressed alike.

Sometime in August: Tracking systems. Whose brilliant idea this was I don't fucking know. It started with putting tracking devices on our equipment. That way if it needs to be fixed or is just missing from the unit we can track it down. The newest idea... lets put it on the staff so we always know where they are. I do about 10 miles in walking a night (wore a pedometer for about a week), I don't sit a lot. But I don't need to be low-jacked. I don't need big brother to know just how long I take in the bathroom or where I go to find Diet Mt Dew when we are out downstairs. we are told that this is simply a tracking device and will not be used against us. I highly doubt that. I have a feeling that our tracking will start coming up during any discipline or patient relation problems. This way they have someone to pin shit on. I have every intention of hanging my tracker from the computer in the nurses station or tagging a piece of helicopter equipment with it. That should make for some interesting tracking. Fuckers

Any of this sound like a good idea to you? The no-smoking I can get behind. It doesn't stop the random psych pt from harassing us outside (even though I don't smoke), but its a start. Uniforms, tracking? Gestapo Germany anyone? Just checking.