Shift 43, 44, and 45

Shift 43:

Not much to say about today. At the 7pm shift change we had a charge nurse AND 4 nurses come in (usually its a charge nurse and 3 nurses). We got slow, and the charge nurse closed our fast track area at 9 or 9:30pm and sent that nurse home. At 12am, we were still slow and I had thought for sure they'd send me home early by now, but nothing was mentioned, so I asked the charge nurse if I could go. She said yes and I was out of there by 12:15am. Nice. It doesn't happen often, so I will take it when I can get it.

Shift 44:

Paid for going home early the other day today! It was a busy day!! It was actually ok when I first walked in the door, but soon went downhill fast. I can't even remember how many fire rescues came in, there were so many! I had a pretty sick patient come in about two hours before I was supposed to go home. She had a hysterectomy about 3 weeks before and about 45 minutes before she came in, she started bleeding badly. While en route via fire rescue, the paramedics told me her blood pressure kept going lower and lower. When she arrived, her systolic blood pressure was in the 80's which is not good. She was still talking and conscious, but she was very weak and very pale. We gave her fluids, ran some labs, and I put her bed in a position to keep the blood flowing to her brain since her blood pressure was so low. We also gave her a unit of blood. Unfortunately, she had to be transferred to a hospital that treats OB/GYN since she had a GYN surgery and that was what was causing the bleeding. I didn't get out until nearly 4am (I get out at 2am!!), and we stayed busy the whole night. Even when I left at 4am, I think all the rooms were still filled. Thats not a normal thing for the night shift, and when I left, there was only the charge nurse and 2 nurses on the floor, so the 2 nurses that were left had to split the whole ER. Yikes! (Although I had 2 patients when I left, and the charge nurse actually took those 2 patients, so the other 2 nurses split what was left).

Shift 45:

Better day, but busy for a while. Then it slowed down a bit until about shift change and then it picked up again. At shift change, I got to go to triage, which was nice. After I triaged the 5 or 6 patients that were waiting when I first got out there, I caught up and it stayed slow (at least out in the waiting room). At times, a couple of patients would come in a at a time, but no more than 2 or 3. Most of the time, only one patient would come in at a time, and there would be times where no one came in for a while. That was a nice break for me.

It still amazes me, I don't know why, the things people come into the ER for. I mean, I get the whole not having insurance thing- I didn't have insurance for 9 years. But people just come in for things that are not emergencies. For instance- in triage the other night I had a patient come in for his knee that has been hurting him- FOR TWO YEARS!! And he wanted to find out what was going on with it. On top of that, he had come in earlier in the day, signed in, waited to be triaged and then left before he could be taken back. So, it apparently wasn't that much of an emergency if he left. Believe me, I know I may sound harsh here, but when my patients are sick, I am caring. Even if they aren't sick, like this guy for instance, I am still caring- outwardly. Inwardly, I may shake my head a little :), but I never let them know. I'm always nice, I always smile, but sometimes I do have to wonder about these people.

I'm back on Thursday and I have a tough schedule ahead of me. I work Thursday, Friday, Saturday, off Sunday and then back Monday. And on top of that, Saturday night we will be very short staffed, so I am praying for a very slow night Saturday. Stay tuned.....