Monday, December 15, 2008

Observations from the E.R.

As part of my orientation, I got paid to spend the day (a.k.a. sort of work and observe) in my hospital’s E.R. I had a really good time when I rotated through there during nursing school, and this time was no exception. There were several things that I noticed during that day:

1. As much as I enjoy working with the unconscious or intubated patients who cannot talk to me up in the ICU, I also really enjoy working with the “crazies.” At the county hospital, there is definitely no shortage of those. Take, for example, the old prostitute (so insist the ER nurses) with a walker who demanded to speak with the head of the hospital because we would not prescribe her narcotics. Or, the older African American gentleman who suffered a minor burn to his face after lighting a cigarette while on his oxygen tank. He was there so we could “get this black stuff off of his face.”

He couldn’t even tell us why he needed to be on oxygen in the first place. I must be a bit of a risk taker, because as agitated as he was getting, I still dared to put a catheter in him since he wasn’t able to “go” and we needed to get a urine sample to do a drug screen. He had initially flat out refused to get a catheter put in, but I was able to sweet-talk him into it. For that, I earned the nickname of “Angelina Jolie.”

2. I am getting better at putting in IVs. I was batting 1000 that day. Three for three, baby! I’ll be honest though; every person I stuck had veins fat enough that you’d have to be blind not to get one in. But whatever.

3. The ER nurses are a lot nicer than the SICU nurses. Don’t get me wrong, I do like (most) of the people I work with. However, as talented as they are, there is some serious attitude that gets thrown around, and it’s something I didn’t quite fully realize until I went to the ER. As much as I love my coworkers’ sick sense of humor and can relate to them on many levels, I just hope I don’t get fully sucked into their cult of superiority. I’m telling you, the nurses in my unit have a reputation around the hospital, and now I can see why!

4. Docs are around constantly. I thought we saw them a lot in the ICU, but they are literally there all the time in the ER. That is where they live. And all the hot ones are married.

5. If you are a trauma patient (car accident, fall, shooting, stabbing, etc.), expect a doctor to put his finger in your rear. The trauma hall was very busy that day, and on every admit that I saw, the same doctor was always sticking his finger up the patient’s butt. Yes, yes, there is a totally valid reason for it (to check for bleeding and rectal tone; no tone can mean a spinal cord injury), but the juvenile side of me smiled. I secretly wondered exactly how many butts had this doctor stuck his finger inside of during his tenure in the world of medicine? I was also amused by the male patient who screamed expletives while getting his special exam, as if the doctor was taking his manhood away from him . . .

6. There is nothing like getting to meet a patient up on the helipad. Okay, so I’m sure by the hundredth or even tenth time you get to do it, it would get old, but I was absolutely giddy inside when I learned that I would get to watch the CareFlite helicopter land and help wheel the patient on a gurney all the way back to the trauma hall. The warm wind, the setting sun, and the Dallas skyline in the background made for a perfectly surreal experience. You couldn’t pay me enough to be a flight nurse, but I’d love to take over once the copter lands! In a word: awesome.


sBs said...

Although I don't miss my former LOW paying job at a hospital (RDs make shit for pay even with master's degrees!), sometimes the things in the hospital make for interesting stories, for sure. One of my old roommates was a hospitalist. There were so many crazy people. It seems like a lot of ppl know the secret to admission (chest pain) to try to beg for iv narcotics.

Kim said...

And now you understand why I interviewed and practically begged for a position down in the ER.

The first pt. I had down there during clinicals urinated in the middle of the hall as the nurse and I ambulated her.

Then there was the time I got to use my psych nursing skills to calm down a schizophrenic in the corner who was seeing spiders on the bed.

I can't wait to start!

Anonymous said...

i am a jca who occasionally checks your blog- i am also a surgery resident who has done my time in the er/ trauma bay and when i was an intern, iwas that dr doing all the rectals! now i am the big wig and i just tell someone else to do it! (sortof)i thought your take on that was pretty funny!!