Wednesday, April 16, 2014

the ER shit show

One of my co workers once told me that since she had decided she "hated the ER", it has been easier to come to work.  I know you are probably thinking ...hey...why don't you just get another job?  Well, hours, pay, seniority, self scheduling.

Saying this sounds negative and defeatist...but maybe not? What if it says acceptance? I accept that working in the ER is often a shit show.  I'm not going to pretend it is anything else anymore. I'm not going to expect anything else. It is what it is.

You are letting go of your expectations that people will be nice to you.  You know it will be busier than shit. Accept that the ER is not set up for your convenience. Its old and shabby.  However, I chose to keeping working here for whatever reason,

Its the serenity prayer applied to ER:

God grant me the serenity
to accept that the ER is mostly a shit show
and I can't  change it
Courage to change my naive notion that it will change
And the wisdom to face reality. *

the way no offense to AA or Alanon who I think all great organizations.

Tuesday, April 15, 2014

duck duck grey duck


Mental health patients are treated like 2nd class citizens in emergency rooms. These days there is a shortage of psychiatrists and beds.  They ended staying hours in the ER, sometimes overnight.  Either that or they are transferred to other hospitals locally or around the state.  Not a good situation.

There are times we have 7-8 psychs in our ER.  We have 3 rooms set up for mental health.  What this means is there is a cart, with nothing on it or underneath it, just a sheet. There is nothing else in the room except a camera.  When we have more than 3 patients we have to put them in regular rooms, using up rooms that could be used for medical patients.  It gets to be a real problem when there are no beds in psych.

So of the nurses came up with this idea.  Why not put a few of them together in one of the bigger rooms. (GUFFAW) The idea being that it frees up other rooms. Um..

Perhaps we could hold group therapy.   Play board games. Sing a longs. How about a rousing game of duck-duck-greyduck?

So there are 3-4 patients sitting on chairs in the room. The cart have been moved out. There is no TV. (don't even go there with me) The patients are in green scrubs. Everybody dressed alike brings prison to mind.. The patients sit and stare at each other. of the patients is becoming agitated. Another patient is talking to himself.  The other patient is scared shitless. Agitated Alan starts pacing in the little space there is.  Hallucinating Harry starts getting paranoid. The 3rd patient runs from the room.

Its hopeless. Nice try thinking outside the box though. Here's a thought: Why don't we treat the mentally ill in this country the same way we treat the physically ill?  What a concept.

Monday, April 14, 2014

I have a well deserved day off.

This is a typical day off for me doing the grocery shopping. 

Sunday, April 13, 2014

people get ready... there's a change a comin...

Get ready.  The Affordable Care Act is here, "Obamacare".  Its in place and people are signing up for insurance and they will keep doing that. It ain't going anywhere.  Its going to change healthcare.

Why? It is going to force medicine to decrease costs. Its going to expose how ridiculously expensive health care is in this country.  How inefficient. How medicine has basically become a "cover your butt" and "order as many tests as possible" system.

Health care in this day and age is about one thing: money  Making more of it. for hospital corporations and their administrators salaries and bonuses,  doctors in specialties, insurance companies, drug companies, medical supply manufacturers.  Gone are the days (is they ever really existed) of trying to help people and do whats best for them, replaced by greed.

So how will all of this affect nursing?  You can just about guess.  Here's a list:

1) Just because there may be more patients, don't expect more nurses.  You will be expected to do more and more.
2) Layoffs.  They're coming. The corporation I work for has said they need to cut $100 million in the next year. This is code for: get ready for layoffs.
3) Cut in benefits. Most nurses have decent health insurance. Expect to be changed to lesser plans with higher deductibles. Pensions are on the way out.  Raises will be small.
4) Attempt to use paraprofessionals: Do you work with EMTS in ER? Get ready for management proposing they start to do more nursing tasks.
5) Part of your evaluation will talk about whether you have had any complaints. "Patient satisfaction" is the new buzz phrase

Pretty depressing huh? Yeah it is. I feel I have lived in an era that  future.nurses will look back on and wish they could have worked during it. With unions we have had good pay raises, benefits, control of our profession.

That's changing. Young nurses, like young people do, don't realize what went into getting nurses to this point. They don't care. They don't plan on spending 20 or 30 years in one place. Retirement is far off. They are healthy so insurance isn't as important.

I honestly wonder if nursing will survive the huge changes ahead of us.