Workin in the desert

Well, it's been another week ...that means 10 more to go before I get to get outta this hospital. How to survive a travel assignment you hate: grin and bear it, make the most of it, just do your job to the best of your ability. It all sounds like good advise doesn't it? Some people would just up and quit..find a different assignment in a different hospital, I've done that as well. Burning your bridges is never a good idea...hospitals can change when the staff changes or they start losing enough nurses they figure out what's wrong. Plus if you like your travel company, you don't want to piss them off either. Yeah, it's a tough spot. If you really feel like your license is in danger I say by all means call your recruiter and tell them and don't put yourself back in that situation. I have done that, when I was in San Pablo CA..it was absolutely awful..I called my recruiter and I got another assignment...never went back. This hospital, it's just irritating stuff.I will refuse to take ER patients when I get sent back to the ER...that's because it is not in my scope of practice...hopefully they will refuse to have me back. Other than that I will continue to communicate my dislike for the units and staff and the assignments I am given in a constructive manner to my agency. Not that it will get me anywhere but it will have it documented. Wish me luck.
Non noc nocere.

Calling all ER Nurses

Hey there all you adrenaline junkies...my hat's off to you! I don't know how you do it but I am glad you do! My question is how do you feel about your ER being invaded by floor nurses, who are clueless as to how your area works (such as myself), when you all are running short?
I got floated to ER "holding" yesterday and it was a friggen nightmare. My first time down there, no here's where your area is and here's who you can ask for help, no here's how we do things in a nutshell...just here's your rooms. I got stuck with a Registry ER nurse who was willing to help when she could, thank God, otherwise I'd have really lost it. The gave me not their floor or PCU holds...but the BHS (behavioral health) holds...all one to ones and a PCU hold..Then they started moving patients on me and not giving me report (apparently I was just supposed to research the pt myself or go find the nurse who sent them over). But, how was I supposed to know any of that? I get a transferred pt from another room, no report, I thought it was someone else's pt since I got no report...guess it was mine..she had a blown iv an was diabetic who hadn't had a blood sugar check since breakfast and hadn't eaten...VERY NICE. Then they kept tossing the BHS pt to me...then they wanted my to take an ER patient...I said, probably for the hundredth time, I am NOT and ER nurse...but they put her in there anyway..bp 75/50...VERY VERY nice. They said "Shawn will help you" well, I never saw "Shawn", the nurse who was doing discharges took one look at this lady and got to work...she ended up being moved out of my room to somewhere else and we looked at her blood work later...let's just say I don't think she made it.
Then they put another patient in that room and the chic who handled the last one says this one is yours, I just gave her that look...it was a 23yr old who took an overdose of somebody elses meds...also not my area of expertise.
I must tell you that at about 12:30 after the incident with the no-report-patient I called staffing and said that they needed to get me outta there...they said we really can't and sent the supervisor to talk to me...I told her I was very uncomfortable and was being given ER type patients not waiting to go to the floor type patients which I was told I would get...and that I wanted to leave. She listened to me blubber for about 10 minutes and said she would try to get someone to come in early...yeah, OK...meanwhile the Registry chic that was helping me had completely disappeared and I was left with Miss Attitude ER nurse who eventually just took all my patients and I got to go home. I guess they realized what I had been telling them all day...I was just in the way.
So, as ER Nurses, how do you feel when we non-ER nurses come to your area? I understand it would be different if you had a bunch of floor holds and I was there to take care of them...I'm just glad I got out without hurting anybody. Absolutely the worst day of my nursing career so far.
First do no harm.

Is it a full moon?

The fountain at the new Palazzo in Las Vegas. Everytime a new casino opens it is more elaborate and more stunning than the last....ya gotta love Vegas.

Was it a full moon yesterday? Wow, my day started out ok. I went to a different floor at the new hospital I am working at , it was the surgical floor. Not a big deal, I can do surgical. It started off kinda crappy because I couldn't punch in, there was no paper to tell me the punch code for the unit, so, I had to walk over to their sister unit and punch in there, only a minute late not too bad. Then I came back and get report, doesn't sound too awful. They came from Interventional Radiology and swept my patient away while I was in another room...didn't get to see him. Then I have the guy who's wife is a nurse (great), someone else going to surgery, somebody with back pain and a copd pt. The morning was ok, trying to find my way around the floor and learning the flow...my other guy goes to surgery, and I get to eat lunch. When I come back, my first guy comes back from IR with a stent in his leg and has to lay flat for 5 hours, my other guy comes back from surgery in pain, my pca has to be changed, my copd pt thinks she has a blood clot in her leg and calls her family who calls me then....

My back pain guy calls me and says he's in a lot of pain in his face...I went to his room and he is squirming around in the bed, his jaw is all clenched he feels like he can hardly breathe, he is majorly freaking out...and secretly so am I ...no idea what is up with this guy. He says he feels like his head is all distorted and he can't close his eyes.or open or close his mouth all the way and he really sounds like he's having trouble breathing. So, I use my calm voice and hold his hand and tell him to breathe through his nose. The cool thing about this hospital is that the hospitalists are on the floor from like 8 in the morning to like 6 at night..literally they see everyone on the unit and they have a little office they sit and chart in. So, I go and get the doc...we give him Ativan and it helps a little...the doc asks what meds he is on and one of them is IV Reglan...you can see the light bulb go on above his head he says give him Benedryl and Cogentin..IV. I have never given cogentin IV before but, it worked! The guy was having an acute dystonic reaction to the Reglan. Never seen it before in my life...I have given Reglan hundreds or maybe even thousands of times...and this guy had been getting it for at least 24hrs...weird. He was very nice and grateful for us being there and helping him so quickly. I told him he taught me something and he thanked me again for being there and being calm.

It's weird how that happens...in that emergency kind of situation...I can keep cool and not look freaked out even though inside I'm going "Oh my God, Oh my God, Oh my God...somebody help me!!!!" I don't like the feeling and that's why I don't do ICU...stuff like that happens so fast and it happens all day long...my little heart couldn't take it.

So, after all that you'd think I'd get a break or something, like in football after a really big play the wide receiver gets to sit out a down or two to catch is breath..nope I'm right back in the game. Giving my pain meds, checking pulses, giving insulin, printing out education materials...constantly moving constantly checking my patients...you'd think I'd weigh about 100Lbs with all the walking I do,huh. Fate.

Non noc nocere.

Vegas

Hi all,took a few days off for my wedding vow renewal. Here we are after the ceremony in the conservatory at Bellagio. Behind us is a miniature of the Bellagio and a miniature Bellagio fountain...only in America. We did a drive up wedding, it was as expected. I would probably pick a different place next time we went to A Special Memory Wedding Chapel on a Sunday afternoon. It looked pretty deserted, we picked from the "drive up menu" but we were told some of the items they no longer offered like the commemorative photo. I was not really happy about that one...our only option for pictures was a package of 6 which would cost $70...no thanks. We did our vow renewal ($25) and had to pay the "minister" her gratuity (no less than $40) for our 5 minute ceremony. It's was an experience. I found that people are really nice to you if you are wearing a veil..they'll even take your picture and not steal your camera!!
This week I started at my new assignment, 8 miles in the opposite direction of the other hospital. I find that a new building and "healing" surroundings doesn't actually change how it operates. It's the same stuff in a prettier package. Same amount of patients going and coming and no team work. The charge nurses are still just a voice on the vocera or a piece of paper on your desk with another patient's name on it. No thought to how many patients you have already admitted or even ask if you've had a break, she was nice enough to take report for me so that I had absolutely no warning that my patient was coming and then poof she was just there in the room. Yeah, it's like that.
I do miss my friends at the other assignment.. I was hoping to go back there prn but, I don't know if that will be possible either. Computer glitches might prevent it.
Sometimes I do wonder why I continue in this field, then I get the paycheck and the reasons are a little clearer...sometimes I even get a thank you and then I know why. Non noc nocere my friends.