your grandma is my typical patient these days

Why does it seem like my job is getting more stressful?  I mean I have been in the ER for a long time, can handle most anything, but I'm feeling overwhelmed these days. What has changed?

Its weird, I don't think we are getting that many more patients. I think what it is, is that patients are sicker. A typical patient I would say is:

1) 70's, female, living in assisted living
2) limited mobillity, overweight
3) Hx: CAD, HTN, arthritis, UTI, TIA etc.
4) now you have another problem

Here's the thing: You will have the $10000 work up. Monitor. CBC, lytes, troponin, UA at the very least. EKG. Chest xray. No doubt CT of some part of you. Start an IV because why not? Its something to do. Give you nausea meds or pain meds.

You require a lot of my time getting you started.  Then your numerous bathroom needs. You are old and you go often and you have to use the commode. Your family arrives and I have to spend time talking to them. Meanwhile I have 3 other patients, the same or worse than you. I could have an out of control psych, someone who is unstable.

After 4 hours you are admitted of course. I wait at least another hour for a bed if not longer if there are no beds.

In other words, I am running my butt off for 12 hours. We don't have enough nurses. With the whole "decreased reimbursement" baloney.

A nurse I work with dropped a pearl of wisdom this past week: "I'm at the point where if they are still breathing, I will eventually get to them".  In other words, stop stressing out and just plod along and it will all get done like it always does.  I like that.