Shifts 32, 33, and 34

Shift 32:

Slowest day I have ever seen in the ER since I've been there. By 9pm, with only 6 patients in the entire ER, and 3 night nurses, 1 charge nurse, me and a nurse that leaves at 11pm, the charge nurse decided to let the 11pm nurse and I go home early. At 9pm no less. Not much to report today, obviously.

Shift 33:

A little busier today, at least when I get there. Then it started to even out a little, so I thought it would probably be a decent night. We had a charge nurse and 4 night nurses coming in, plus me there until 2am. I thought for sure I would be cut early tonight, I might have even bet the farm on it. One of the techs "forgot" she was scheduled to work (convenient, especially on a Saturday, especially on St. Patrick's Day). So we had only one tech to help with all the lab draws, specimen collections, transporting of patients to the floors, etc. etc. At shift change, I went to triage and was there the rest of the night. Patients just kept coming in. And coming in in groups, not just one at a time. Nothing exciting or new today, just busy. I felt so bad for the ER doc, who after 11, is there alone. (We have a dr that comes in at 7am to 7pm, a dr that comes in at 10am to 10pm, and a PA or NP that comes in 11a to 11p, and we have a dr that comes in 7p to 7a.) He had patients stacked to see him when I left.

Shift 34:

I come into work and it was a "slower" day. It wasn't dead by any means, but it was slow enough that they never even opened up our fast track area at 11a. So we had three nurses on the floor, plus me and another nurse floating. It was a nice day and I definitely felt like I needed it. Then shift change came around, and it was still a little on the slow side until about 9 or 10. They let the nurse who leaves at 11p go home early, and then it seemed to start picking up. Once all the rooms filled up, they stayed filled. When I went home at 2:45a it was still full. Don't people sleep around here?

Anyway, I had a couple of sad stories today. A patient who came in (wasn't my patient, but I helped with him) who had taken all of the medications he had in his house because he was depressed. I had a patient who came in who had a brief 5 minutes of numbness on one side of his body and trouble speaking, and then he was back to normal. He said this has happened before, but was told he had Bells Palsy. So the ER doc really didn't think it was a stroke, but thought possibly it could be a ministroke. Patient was scheduled to have an MRI the next day, so the doc thought the patient would probably be going home after he had a cat scan. Turns out, patient had a brain tumor. I had another patient who was brought in by their mom. Mom thought the patient had been sexually assaulted. Ugh. That, I hated. I tried hard not to cry when mom was telling the NP why she was there with her child. I have children and I can only imagine how the mom must feel. Another patient came in, again not mine, but was 100 years old complaining of nausea and vomiting. I can't even tell you how many people come in with that complaint. Well it turns out, she was having a heart attack, and not just any old heart attack, but the really really bad kind. The kind where the artery is completely blocked, and in this type of heart attack, treatment entails either emergency surgery to open up the artery, or a medicine is used to help break up the clot. In all of the chest pain patients I have seen come in so far, none of them either even had a heart attack at all, or the few that I've seen that really did have a heart attack to some extent was not the type to be treated like this. I ended up leaving while they were still treating the patient, so I am not sure what happened after I left. Unfortunately, we don't have the capacity to treat the bad heart attacks at my hospital, so the patients get transferred to another hospital that does.

That's all for now. Two more shifts this week, then I have three days off. And a 10 year anniversary to celebrate during those days off. :)