ode to the med room

What would nurses do without the med room? It is a place of refuge.

If you feel like you are going to lose it, you go to the med room. If you have to blow off steam you take a co worker into the med room and let er rip. You can gossip in the med room. You can make fun of patients in the med room. You can cry if you want to in the med room.

I talk to myself in the med room. I ask myself what I am doing in this God forsaken place? I call the patients idiots. I take a few deep breaths if a doc or coworker pissed me off.

Espescially in an ER, the med room is like the eye of a hurricane. It is a calm and peaceful place in the middle of a whirlwind. No docs, no techs, no management. The only people with reason to be in there are nurses. Its like our own secret clubhouse and it requires a secret code.

I for one, couldn't live without it.

gaming the system

She presents with "back pain". Sitting in the triage chair she says just to check her vitals to see if she is okay. Vitals are of course, normal. She asks if there was something wrong with her heart, the vitals would catch it right? Ponders deeply whether she should be seen.

I can't make that decision, you have to decide. States she will go to the waiting room to think about it. Comes to the desk and asks to use the phone to call for a med cab home. Med cab company calls and is told patient was never actually seen in the ER. They won't come.

Guess what? She wants to be seen. Big surpise huh? She decided this could be her heart, she has had an irregular rate in the past. EKG done in triage = normal. Big shocker that.

You have just witnessed the most expensive cab ride you will ever hear of - about $2,000. All of it will be billed to you - the taxpayer.

waiter there's a fly in my soup

Random thoughts at the end of January...

It seems crack addicts have sensitive palettes. The other day our cuisine just was unacceptable to said addict. Their light lit up immediately upon presentation of the entree. "I don't eat any of this stuff!". Geez, I thought scratching and conniving daily for that high, you would eat just about anything. But no, our friend wanted us to order specific items. Ala carte as it were...but alas, the kitchen was closed. Our poor friend was forced to gag down the entree presented....

When you go with a friend to the ER, why not be seen yourself for that pesky chronic complaint? That sore knee that has been bothering you for six months....hey you got the time right? After all the last doctor you saw was in jail...

Why not come to the ER for a second opinion on your tummy ache? Your own doctor is not telling you what you want to hear, so maybe the ER doc will unravel your complex condition. Also, if you been to 3-4 other ERs and are not happy with their service, come to ours, because we probably have the miracle cure you have been looking for...

We so appreciate it when you tell us when asked if you have a doctor, you say, "no I come here for my care". It makes us feel special that you chose our institution to meet your health care needs.....hey money is money and we'll take it any way we can get it.

When you know that you are going through alcohol withdrawl, grace our doorstep. We would be happy to stave off those shakes with a healthy dose of lorazepam. We will probably even start an IV and given the vitamins you are lacking. We'll make you feel good so you can go out and do it all over again.

Attn: ER staff will now be required to literally kiss the ass of every patient

The message has been heard LOUD and CLEAR by hospitals that REIMBURSEMENT WILL BE BASED ON PATIENT SATISFACTION in regard to medicare and this will drive the future of reimbursement.

All of this is now trickling down to those of us who actually do the work of caring for the patients. Its a WHATEVER THE PATIENTS WANTS WE ARE GOING TO DO, PERIOD, END OF CONVERSATION AND YOU WILL ALL GO ALONG WITH IT OR ELSE.

First thing that happened with this: Changing nurse uniform color so patients will be able to "identify" the nurse better. I don't even want to get into it, but suffice it to say that the hospital had already decided what color they wanted but made a phony attempt at making the nurses believe we had a choice of which color by vote. We now get at least one email daily about things like "don't forget to order your uniforms in a timely manner, so you will be ready". Duh, I really think we can figure this out on our own. Here's the thing: There is another group of employees in the ER who wear the new color and so do xray techs. No doubt all the litle old ladies and crackheads and drunks will be awful confused.

Next "initiative": Every room willl have a greaseboard in which the doc, nurse, EMT, etc will place their name. Ah yeah...I can see the docs doing this...the docs will expect us to do this. Forget it, put your own damn name up there. This has been tried before. Didn't work.

I can't wait for the next "initiative". No doubt there is a committee meeting about it. Maybe it will be required that the ER staff should kiss the ass of everybody who comes in. After all, this stuff is so much more important that the ACTUAL PATIENT CARE.

Dave the drunk and Cathy the crackhead

You know what I get tired of? People bringing Dave the drunk or Cathy the crackhead to the ER. Their life is down the toilet and the family or friend doesn't know what to do with them. They are afraid for the persons safety. Hey I get that. You care about them.

Here's the thing: THERE IS NOTHING WE CAN DO FOR THEM IN THE ER. The doc will run some tests to make sure they are physically OK. THey may give them one of those stupid banana bags. They will give them a number to call about treatment. Thats about it.

Nobody is going to fix them in the ER. The magic treatment fairy is not going to appear and scoop them up. Very few hospitals these days have inpatient chemical dependency treatment. That ended years ago.

I can't tell you how many times I have triaged Dave the drunk and Cathy the crackhead accompanied by worried family. Dave and Cathy just sit there and say little, if anything. Family does all the talking. Tales of how Dave or Cathy are not taking care of themselves, ruining their lives, the lives of those around them. Its sad.

Family is always disappointed when Dave or Cathy are not admitted. They expected us to save them. The thing is ERs are not in the saving drunk or dope addict business. Please don't bring them.