Saturday, November 24, 2007
I didn't post yesterday and I will tell you why.. Work pretty much sucked. I'm not saying it was the worst day I ever had because I worked with some really good nurses and clinicians and truly that made a HUGE difference. Mostly what sucked about it was the fact that it was the day after a holiday and we were packed! I heard later that we saw the most patients in our ER than we had ever before. So the photo above is a tribute to the poor patients who I know waited a very long time. But it is also frustrating for us, as a team, because really, was the wait THAT long? I mean, come on, our longest wait time between being triaged and being put in an exam room was three hours. On the bigger scheme of things, is that very long to wait in an emergency room? I've waited in my doc's office for an hour and I had an appointment. So three hours when you don't have an appointment isn't so bad. Right? And another thing, at least our department is first come, first serve. The main ER sees people by severity of illness (and of course they are seeing the very sick patients). The patient's that see us do not have EMERGENCY situations! Sure, they may feel terrible, or have a laceration that needs to be sewn but it is not a matter of life or death. And in fairness to everyone we see them in the order that they walk in. Okay, enough ranting. Let me give you a random sample:
An elderly woman came in with her caregiver. Her complaint was thigh pain. She was put in an exam room by another nurse and as I walked by I hear her angrily yelling "Nurse, Nurse!" I walked in the room and asked, "Are you yelling? Do you need help?"
Her (still yelling): I haven't eaten all day and I'm a diabetic! I need to eat something!
Me (calmly): Why are you yelling at me?
Her (still yelling): I'm not yelling! I need some food!
Me: Are you asking me for something? Or are you just barking orders at me?
Her: I'm not barking! I need food! (Let me just say, at this point, that it was 4pm and she had plenty of opportuntity to eat before she got to the ER. And she had a caregiver. Why hadn't the caregiver given her something? And she didn't look to me like she was suffering from low blood sugar. She was just a crotchety old lady who was used to bossing people around.)
Me: Are you asking me to get you some food? (I wanted her to ask me, not yell at me.)
Her: Yes! Get me some food! (Note, she's still not asking, she's telling.)
Me: Let me get you some crackers and juice.
I leave the room and go to the nurses station. I look at her chart to see what she was here for and what her history is. The funny thing I notice is that her last name is "Barker". I brought her some food but check her blood sugar first all the same. It was completely normal. I feel sorry for that caregiver...
Another person that yelled at me yesterday had been waiting for over two hours. She was not actually the patient, she had brought her 18 month old son in who had fallen and had a big goose egg on his head. Us nurses were aware of the situation but because the little boy was active in the waiting room and acting normally for an 18 month old, we weren't stressing on having him be seen right away. All the same, we realized that it must have been hard for her to try to keep him occupied while they waited. We entertained the idea of getting them in before the other patients but didn't want to start a riot in the waiting room. We continued to see other patients in order. By this time we had all been there for almost 12 hours and our part of the ER was supposed to close. We realized that we were not going to be able to see the remaining patients. This woman and her son included. All of us were a little torn up about it. We asked the doctor if she would be willing to see them. She said no. I don't blame her (much) and I understand where she was coming from. If she agreed to see the patient she could be setting herself up for not going home for another hour or so. She already had other patients she was trying to finish up with. And the doctors and PA's work long shifts WITHOUT a break! No lunch or dinner break for a 12 hour shift. Imagine! So I had to understand why she said no. The other RN I was working with volunteered to do the horrible job of going into the waiting room and telling the patients that we were now closed and they would be returned to the main ER and wait to be seen there. The woman with the kid marched up to the nursing station and WENT OFF! Her fury was evident, her son remained a normal toddler. She would not take any of our explanations and continued to scream and cry in frustration. In the middle of her tirade, her son reached up and slapped her face! (Any of you with kids know they do this from time to time.) This did not help our situation any because it made her more pissed. The sad thing about this is that the doctor was present for this whole situation and could have said, "Look, let me do an exam quickly on your son." But she didn't and the woman walked away. I felt horrible for her but realize that at some point we have to stop seeing patients or we would never go home...
A big thank you to all the patients who were kind, understanding, and thankful for the care we gave! We worked our asses off!