Do ER Nurses have PTSD?

Here's a great blog post written by Edwin Leap MD, a doc who has been around the BLOGOSPHERE for years. He writes a blog at the Huffington Post: http://www.huffingtonpost.com/edwin-leap-md/


Here's the post about PTSD:  http://www.huffingtonpost.com/edwin-leap-md/suffering-and-burnout-in-_b_8448704.html

Wasting away in frequent flyerville

When you work in an ER for any length of time, you realize that there are a substantial group of people who you see on a regular basis. A few hundred actually. These we refer to as the dreaded "frequent flier".

Yes, these are the people who appear at the triage desk and you don't have to ask their names because you already know them. They are there so often that if you don't see for a couple of weeks you wonder if they died.  You ask you co-worker if they have seen so and so lately.q

Yes, they sometimes come in weekly, even daily, sometime even 2 or 3 times in a day. There are some who come in only on weekends. They are the drunks, the migraineurs,  the chronic painers, the depressed, the obsessive constipationists, etc etc etc.

Some of them, when you see their name on the triage screen, you want to run for the hills.  Others, you think whatever... They are not the kind of people who get the concept of primary care.  We are part of their life, the ER for them, is like you and I going to the grocery store. It's just routine.

We will keep seeing them, that won't change. The only thing that will stop them from coming is if they move away or die.

Step away from the tylenol!

There have been a lot of advances, shall we say, in my ER since the dark ages when I started. We have a lab in the ER now. The techs draw the blood an do some of the blood tests. That's cool.

We now have a pharmacist. With the pharmacist comes the practice that EVERY med has to be approved by them before we can get it out of the million dollar drug dispensing machine. There are exception of course, many actually.  Anything we would need right away, narcotics even. We can override the machine.  Here'the thing: something like Tylenol can't be òverridden.  Bacitracin (yes it's now in the machine - IT IS a drug you know) can't be overriden.  So let me get this straight - I can take out ten pounds of dilaudid but I can't get a tylenol?  OKAY THAT MAKES SENSE.....

Help wanted: blank fillers

My days in nursing are numbered. There is light at the end of the tunnel.

I have to say I am glad to be getting out because medicine is losing its human side.  The focus of hospital administration's these days is money, staying in business.  In order to stay in business all attention is focused on meeting criteria.  JCAHO pretty much controls hospitals . They decide how things should be and threaten loss of accreditation and therefore, loss of government money which would  close most hospitals.  Administrators live in fear of their visits.

Then there are the certifications. All hospitals are in competition with each other so there is a rush to rush to be a certified chest pain center, stroke center, trauma center, magnet status, etc, etc, etc. Banners are hung proclaiming the hospitals achievements but no one talks about the millions spent to be able to put up those banners.

Hospitals are paid based on patient satisfaction. Companies are hired to measure that satisfaction and improve it. Millions are spent.

As we know only too well, shit flows downhill. At the bottom of the hill sit the nurses. More time is spent scrutinizing whether or not we are filling in all the blanks than anything else. We are called to task if not enough, or, the right blanks aren't filled in. We get email after email about JCAHO current focus,  the chest pain certifiers possible questions.

In between all of this, we squeeze in patient care.  

Damn them