What the hell is going on here?
The one on the left has to be a nurse because she is wearing a cap (that looks like a two-gallon Stetson, definitely a -1/10 on the Emergiblog Cap Rating Scale!)…
…and holding a Darth Vader mask in front of her face.
Given the hair, it might be Gene Wilder behind that mask.
(I swear we have “hats” for measuring urine in a commode that look exactly like that cap.)
Looks like something you might don for a “code brown”, lord knows I’ve had patients with what I swear was flammable excrement.
I don’t remember ever having to orient to a welding unit, and metal shop wasn’t a required class in my nursing education. Maybe it’s a graduate course…
I need an attitude adjustment.
Frankly, I think the entire world of emergency medicine needs an attitude adjustment.
But, since I only have the ability to work on my own attitude, I’ll start there.
Work has just sucked lately. Major league suckage.
I’m not sure what phase of the moon or what evolutionary phase humanity is undergoing at the moment, but for some reason we have a new paradigm on the night shift.
It’s called the “0400 Rush Hour”.
Somewhere between 0330 when the “third nurse” leaves the department and 0400, they start pouring in. All ages, all sexes.
And they are sick. Really sick. As in drop-the-blood pressure, rupture-the-viscous, call-the-cath-lab-stat, vag-hemorrhage-from-hell sick.
As in what do you mean there are no beds and we have to keep this patient for four hours? sick.
As in what-the-hell-are-you-thinking-this-patient-is critical and why-don’t-you-give-a-damn? sick.
Yeah, I’m tired.
I snapped at a co-worker this week. It wasn’t the straw that broke the camel’s back, either. Just came out of the blue – BAM! Not exactly the epitome of professionalism.
ER nurses are not supposed to do that. We are supposed to see the whole picture, function efficiently and if we are hungry, have to pee, have a headache or are just plain pissed off we keep it to ourselves and don’t not take it out on each other.
It’s not about me.
But it is about the patients. And I’m finding it harder and harder to give what I consider good nursing care in an emergency department.
We know what needs to be done for our patients. But from the patient’s perspective, it’s the less critical aspects that make all the difference.
And I’m not talking patient satisfaction scores here. I’m talking about making sure our patients are comfortable because we care how they feel, no matter what their chief complaint or how demanding they may be.
Caring. As a nurse I am supposed to be “caring” for the entire patient. That’s hard to do when you work in a department that by definition is a “medical-model”, as the ER is (and should be!). After all people don’t come to the ER to have their chakras realigned. They come in because they believe they have, and often do have a medical emergency.
So what’s my issue?
Well, this week I had someone tell me how to do a fingerstick glucose. A family member of a patient. I responded cordially, agreeing with exactly what they were saying and even adding a little theory as to why we do it the way they described.
In my mind, I was saying “YOU FREAKING SOB, I’VE BEEN DOING THIS GOD-FORSAKEN JOB FOR THIRTY F’ING YEARS AND GOOD GOD I KNOW HOW TO CHECK AN F’ING BLOOD SUGAR!” (Pardon the language.)
You see the disconnect? There’s no harmony between how I feel and what I actually do. I’m acting. I’m acting professional.
The person who felt the need to give me an inservice in finger-stick blood sugars was scared. Didn’t look it, but they were. And the only way they could deal with a frightening situation was to feel as though they had some control over what was happening to their relative.
I know that. And I responded appropriately to them.
Then I went and snapped at my co-worker for absolutely nothing.
And while I’m ventilating, let me state for the record that patients are not stupid, jerks, little-old-ladies, asses, gomers, druggies, “alkies”, twits, hysterical, wimps, whiners or babies.
(Unless you are under 1 year of age and then you are a baby…)
And if I feel something is necessary to report, I am really tired of hearing “I couldn’t care less” or “we aren’t dealing with that now” or “I don’t want to hear it.”
Because it will be mentioned and it will be heard, whether or not action is required. And if I feel it’s germain to the care of the patient, I’ll document that I mentioned it.
They may not know how or why to appropriately access an emergency department. They may or may not have the means to pay for their medical care. They may be talking on a cell phone and listening to their iPods while decrying their inability to pay for the two-hundred dollar antibiotic they just got the prescription for.
Some may knowingly abuse the system.
Most don’t realize they are doing it.
But if we can’t at least try keep a non-judgmental attitude, we are going to eat ourselves up inside with anger, disgust and tension.
It’s happening to me – I’m the only one I can speak for, really.
And I’m going to work on stopping it from going any farther.
Anybody wanna join me?