![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
The First Rule of ER Hold is...
Mar. 5th, 2008 11:08 amI got floated to the ER holding area. What this is is a place (and when I say "place" I mean "chaotic configuration of hallways and the odd room for contact patients") in the ER where we monitor (or "hold" - look how nifty the lingo is!) patients that are going to be admitted to various hospital services until a bed is available. Now, let me start by saying that it was absolutely NOT my turn to float, and I'm pretty sure my amenable nature (I usually have no problem with last minute schedule arrangements and/or shift covers in order to fill staffing holes on our floor) was taken advantage of by the assistant manager (the nurse who was supposed to float claimed she was "injured" and couldn't do it [in which case keep your fake ass home, lady!], and the manager claimed there was "pretty much no one else able to float", when there were three other senior nurses scheduled for the night who could have floated). I got to the ER and it was UTTER. MADNESS. I don't think there's any html I can use to get across how fuckin' insane it was down there. There were 110 patients in the ER at one point. ONE. HUNDRED. AND. TEN. IN the actual ER, not waiting to be triaged. We're a frickin' 900 bed facility! Where were all these people supposed to go?!??!
And, no, I didn't have to take care of all 110 patients; for the most of the night I had eight patients. Yeah, not too bad ...until you take into consideration the strain having 110 patients in the ER had on the entire system. It took forever to get orders for patients, because there was only one PA working (a notoriously slow one - it took three hours of paging before he came to see my gentlemen complaining of periodic shortness of breath) and one hospitalist. Forget about getting order clarifications. Ten o'clock meds were given at midnight and one AM, because pharmacy was taxed like a mofo (after the third time I called for a patient's Zoloft the tech whistled and said "man, I hear you guys are swamped", at which point I beat the phone against the desk a couple of times and then replied "yeah, sorta" ). And the thing about hold is that you're doing admissions all night. Because you're just holding onto the patient until a bed becomes available sometimes you just have time to do a basic assessment and begin picking up orders before you get a call that the patient has a bed and needs to be transported up. Meanwhile, as you're doing all these assessments and order pick ups you have to give meds to the patients in your hold area, as well as make sure vitals are monitored, all bloodwork and relevant labwork is drawn on time, etc etc. It was insanity. I had to take care of a telemetry patient on a monitor even though I am not trained in reading EKGs/tele output, nor am I ACLS certified, and this lady kept having chest pain, with a particularly bad bout (you never want to hear a patient describe chest pain as "crushing", believe you me) near end of shift.
Came the morning and I still had all my patients. No one had gotten a room. One gentlemen had been waiting for 40 HOURS. The lady with the chest pain had been waiting for a tele bed for 21 hours. Insanity. In-fuckin'-sanity. Never again. Never again, I say. My manager can go to h-e-double hockey sticks, fo' serious. Being nice and agreeable just leaves one getting constantly shit upon. I'm supposed to work tonight and I only got home at 10:30AM. I have half a mind to call in sick this evening.
In conclusion - screw my floor. Bastids.
And, no, I didn't have to take care of all 110 patients; for the most of the night I had eight patients. Yeah, not too bad ...until you take into consideration the strain having 110 patients in the ER had on the entire system. It took forever to get orders for patients, because there was only one PA working (a notoriously slow one - it took three hours of paging before he came to see my gentlemen complaining of periodic shortness of breath) and one hospitalist. Forget about getting order clarifications. Ten o'clock meds were given at midnight and one AM, because pharmacy was taxed like a mofo (after the third time I called for a patient's Zoloft the tech whistled and said "man, I hear you guys are swamped", at which point I beat the phone against the desk a couple of times and then replied "yeah, sorta" ). And the thing about hold is that you're doing admissions all night. Because you're just holding onto the patient until a bed becomes available sometimes you just have time to do a basic assessment and begin picking up orders before you get a call that the patient has a bed and needs to be transported up. Meanwhile, as you're doing all these assessments and order pick ups you have to give meds to the patients in your hold area, as well as make sure vitals are monitored, all bloodwork and relevant labwork is drawn on time, etc etc. It was insanity. I had to take care of a telemetry patient on a monitor even though I am not trained in reading EKGs/tele output, nor am I ACLS certified, and this lady kept having chest pain, with a particularly bad bout (you never want to hear a patient describe chest pain as "crushing", believe you me) near end of shift.
Came the morning and I still had all my patients. No one had gotten a room. One gentlemen had been waiting for 40 HOURS. The lady with the chest pain had been waiting for a tele bed for 21 hours. Insanity. In-fuckin'-sanity. Never again. Never again, I say. My manager can go to h-e-double hockey sticks, fo' serious. Being nice and agreeable just leaves one getting constantly shit upon. I'm supposed to work tonight and I only got home at 10:30AM. I have half a mind to call in sick this evening.
In conclusion - screw my floor. Bastids.
