Ahh the holidays…

Over the last few months,  I have noticed an increase of certain complaints in the ER. Overdoses, ETOH and anxiety attacks. One of the charge nurses made a comment that years ago, the only time they had ODs was around the holidays.  One of the patients I received report on the other day not only was a possible OD, she also had multiple weapons and a crack pipe on her. Makes me think how thankful I am that time with my family does not cause me that kind of anxiety. One patient awhile back came in drunk and combative. After he had been there for a few hours, his wife calls. Does she ask if he is ok? Nope. Does she come up there? Nope. She wants to know if he will be released in time to go get the kids.  No wonder he drinks.

Speaking of anxiety, I have a soft spot for people that are having a panic attack. I have heard people make comments at work about them and tend to blow them off sometimes. As someone who has had a panic attack and have also seen someone having an MI, I tend to believe the symptoms feel very much the same. I know when I had my panic attacks, I was thinking that I was going to die.right.now. I have also learned it makes patients feel less “crazy” when they find out that their nurse has experienced them. It helps to let them know that all people have their breaking point and that point is different for everyone. Humans, by nature, place a lot of stress on themselves and therefore, they hit their max at some point. Holidays are stressful, life is stressful. Sometimes, we all need a break.

While I am on the topic of stress, I decided to combine all the stuff into one post. To the person that I deleted their comment, I deleted it because I am using this blog as an outlet. Yes, I am a newbie. I am not up for sainthood. I have my off days and I get stressed and tired. But, I provide the best care I can for my patients. I did not feel that the comment helped any thing. I love my job and I work hard at it. Nuf’ said.

To the chronic pain commenter, thanks for not bashing me about the drug seeker post. I do not place chronic pain and drug seekers in the same group. My mother has many conditions that cause her chronic pain. I understand that. I also believe that if you are someone that lives with that, and you are stuck with no way to get access to your medication, by all means, come to the ER. My mom ran out of her morphine. She did not want to “put anyone out” and went a couple of days with out it. Then, she started vomiting and had diarrhea to the point she could not keep anything down. Finally, my dad rushed her to the emergency room where she proceeded to have a seizure. Before the seizure happened, my dad told the nurses that she had been out of her morphine for a couple of days and that maybe that was the problem. It was not until after the seizure someone listened and helped her. Please…never let it go that long. I would rather you come in, tell me you have X,Y,Z condition and need medication. Drug seekers are the ones that come in, continue to yell at the triage nurse because we are taking back someone with sepsis, acute MI or obvious bleeding before them. Then, get in the room, throw their arm out there with the IV and ask “what do you have for me?”  Very different situations.

In life, you have these moments that make you stop for a minute and really think about how great your life is. I am always thankful for a wonderful family, happy, healthy children, a warm home and food. Some nights, as my feet are hurting and my back aching, I get a little cranky and just want to take it easy. I was having a night that my “butt was handed to me for the last 8 hours”. I was really wanting a chance to sit and actually eat something when I am informed I am getting an ambulance. Just as I sit, they arrive. I get report, key words: nursing home, rectal tube and bag. I go to the room and see this woman, who looks young. I get her paperwork and she is just a couple of years older than me. Long story made short, she was hit by a drunk driver, just got out of the hospital a few days ago. Apparently the tube had come out and the nursing home did not know how to put it back in. After talking with her doctor, he decides that it can stay out, since they did not plan to keep it in long term. She is upset and wants to leave. Her sister is talking to me and she is showing me that the woman had been put to bed in regular clothes and that her skin is so dry. So, we change her, clean her up and get her ready to transport back. I call the nurse taking care of her and tell her that she needs to apply lotion to the patient because her skin is dry and she is itching. The nurse tells me that they need an order. I was floored. For lotion? She proceeds to tell me that this is her first time working nights, and first time with this patient. I am thinking…ok…but in winter, when your skin gets dry, do you put lotion on it? I get the we can not do it without an order, have the doctor write one and we can put it on her. Now, I am mad. So, I go to the ER doctor and ask if we can please write a prescription to apply lotion to the patient’s dry skin. I get this look. I explain the nursing home and the doctor writes a prescription for it. When the transport comes, I ask them to please hand this prescription to the nurse taking care of the woman. I know that places have rules, but most nursing homes have plain lotion around that can be used on patients. They go to get her and my eyes start to sting and water. As I am walking off, I am told I am getting a new patient.  I excuse myself to the bathroom, get it together and go back to work. Yes, this year, I have much to be thankful for.

“You have changed..”

According to my other half and my father, I have changed since I started working. I do not see it, but this is how this statement came about.

Early in the days of nursing school, my family was concerned about me and nursing. They all felt that I would be a great nurse….I am caring, compassionate and have this freakish ability to remember things. Oh, I can not remember things such as…what the real reason I went to the store, or why I went to a particular room in the house, or sometimes my age. But, many times I can remember something told to me that I can repeat it word for word, or I can see something and recall much information about the situation.

So, before I decided to be a nursing major, my SO, L. and I discussed my options for a future career. I think the exact statement was “there has to be a job where your caring ability for other people and your freaky memory will work for you” I think it was supposed to be a compliment.

What was I saying? Oh yeah, the changed thing. The first time it was brought up, was a couple months after I was working. I was told that I “talk” different. Had I picked up an accent? Was I speaking in another language? No, apparently, I say things more matter of fact than before. Not that it was bad…it was, just well, different. I explained that perhaps the change has come from me getting in the habit of telling people information in a way that gets the point across. Not much time to sugar coat it. This is how it is.

Then, my loving family ganged up on me. This is how it went down. It is Halloween and my dad came over and was met by a very cranky Nurse D. See, I had put in for Halloween off 2 months in advance. Apparently, so did most of the shift. I love Halloween. It is only 2nd place because of Christmas. So, I was none too happy at the prospect of working on one of my favorite holidays. I recall dad asking me how work was going. I think I mumbled a few things about drug seekers, drunks and stupid reasons people come to the hospital. Took some pics of the kids and my dad dressed up and stomped off to work.

This is when the ganging up took place. While I was gone, L. and Dad had a sit down and they feel that I have become “hardened” since I started working. *raises one eyebrow* I was not even there to defend myself!! *sigh*

So, this is my theory on my “changing”. I feel that Emergency nursing calls attracts a certain personality type. I know that I was attracted to the ER because of the fast pace. It is a place that you never know what is going to come in the door. I work better when I have to think quick. It is perfect for those of us that have a short attention span. We actually have moments that the person is only in the room for an hour. So, you have to be on your toes, running from room to room. You have to be in a room with one person while thinking about your other patients. You need to be ready to anticipate what will be needed next and how to get everything done. You also have to be ready to change your plans with out notice.

Also, you deal with people and situations that are….unpredictable. You can only be nice for so long when you have a combative drunk that needs to be restrained while the family in the other room is giving you a hard stare because you have not got their family member a drink yet, while the drug seeker is asking for another “shot” of pain meds because it has been 10 minutes since the doctor said they could have another one, while your actually sick patient needs to be transferred to the ICU. Oh, not to forget, while this is going on, people are asking you if you are going to be transferring the other patient soon because they need the room, the doctor is asking you to please give the drug seeker the meds, because he is driving everyone nuts and the other family has started following you because, their family member has not had anything to eat ALL day and they have been here for HOURS now! Also, you have patients in the hall, waiting for a room, giving you the evil eye…because it is all YOUR fault they are not in a room.

Ok…so maybe I have become hardened. Just a little. But, hey, if I was too soft, I would have broke a while ago.