Friday, April 15, 2016

New girl in town

There have been a lot of nurses hired in the last couple of years who have the same first initial.  Frankly, I have found it difficult to keep all the kids straight.  Maura, Mary, Merry, Maisie, Mac, Myra.    But they are a good bunch of ER nurses, smart and young they are.  We dinosaurs are still in the fight, but less prevalent on the off shifts which I prefer to work as the others have gone on to work  day shift.  So it's me and the "kids", 20 somethings to 40.  

Several months ago Susan was hired, with lots of experience.  She is around my age and has a similar haircut and glasses.  Lots of people have been getting us confused.  Which is disheartening since she outweighs me by a good 30 pounds.

One night at least 4 people in one hour, notably all the social workers with the psych patents, approached and started rattling off info about their oh-so-important revolving door suicidals and acting out teenagers.  "Nope", I said.  You want Susan.  I'm Regina".  Off they toddle to find her.  No, I don't know where she is.  With a medical patient most likely and not fixing a meal tray for your entitled douche bag who lacks coping skills.  

Marge is a social worker without any adult social skills, I have no idea how she keeps her job.  She barges in on any conversation and actively seeks out nurses in patient rooms in order to do some sort of emergent phone retrieval, take orders from a psychiatrist, or call report RIGHT NOW to the receiving psych facility.  Doesn't matter if you are in the middle of a code or mixing meds.  
She annoys the shit out of me.

Therefore, when she started to rattle of the latest  ridiculous needs demands for her critically ill attention seeking revolving door suicidal pt, I simply put my hand up in a "stop" gesture.

"Marge", I said. "I am Regina, you want Susan.  She is the other red-headed middle aged fat white woman wearing glasses on the floor tonight".

She spluttered, turned red, and walked away.  

Really it's not that hard. We have ID badges the size of dinner plates at chest level.  


woolywoman said...

So, I'm confused. Are people who are suicidal not supposed to come to the ED? Where are they supposed to go?

EDNurseasauras said...

There are limited resources for the number of patients who require inpatient psychiatric care; few of them are taken "off the street", so the only way in is through the ER. Because there are so few beds, may spend hours/days/a week in the ER. ER's are not set up for this. It is boring and untherapeutic.

In addition, we have many individuals who basically go from one inpatient psych admission to the next, who state they are suicidal and know well how the system works. They can be manipulative. Their lists of demands begins as soon as they hit the door, frequently on the call button and pushing the limits of our already stretched resources. Nicorette gum, lunch trays, extra crackers, crayons, a shower, Ativan, more Ativan, coffee, use the phone, etc, etc. Holding orders are taken over the phone from the psychiatrist. This takes one hour of the nurse's time what with calling their pharmacy to get exact medication information, taking the actual orders and transcribing all of their many meds, which then have to be double checked by another nurse and faxing to the pharmacy. This is in addition to the other 3 medical patients who require IV's, EKG's, vital signs, meds, and charting of same. It is not emergent, possible, or even necessary to fulfill wish lists when other issues take priority. Yet the many demands for various concierge services persists. The social worker does not know or understand my workload so it is unprofessional to demand I drop everything and see to your patient. It is a matter of prioritizing, which I reserve the right to do on my own. It is my license.

So, to answer your question, where are suicidal patients supposed to go? There is no place else. It sucks to be there though, and a lot of time it sucks for the staff. We see 20 depressed/suicidal people a day and several on commitment. Plus heroin OD's and intoxicated patients sleeping it off until their BAL is low enough for them to walk out or commit to an outpatient detox program. Some of these people are dangerous not only to themselves but to the staff. We get to know a lot of them. Our security folks are really good at reading body language. Sometimes they (or we) are assaulted.
We work in a mine field, and it doesn't help when our own people start lobbing grenades at us.

woolywoman said...

Yeah, your social worker sounds like she needs work on her social skills. I always tell people that if they feel neglected in the er, that's an excellent thing, because it means you are not going to die.just close your eyes and nap until they have time to dc you.

Rachedy said...

Do you work in my Er? My name could be Regina or Susan. Our psych nurse thinks I'm the nurse for every single one of these homeless
Attention seeking pseudo sucidal patients. Patients who are there so often it takes me minutes to type them up and put in their meds because they were just there the last time I worked. I keep socks and blankets in the drawer at the nurses station so I don't have to run and fetch them every time one of these leeches on society wants me to wait on them. I wonder who fetches them things on the street corner.

EDNurseasauras said...

Well, well, Ratchedy, where have you been? Nice to see you are around and hopefully still creating nursing mayhem! In fact if we did work together we would probably be fired