Code Green

I am reading an interesting book titled Code Green Money driven hospitals and the dismantling of nursing. The writer did this study as her PhD after being a patient in a hospital and noting the frustration and stress of the nurses. It is very interesting to go back thru my 30 year career as a front line nurse and revisit all the things that occurred. It was also a little sad to realize that out of my 30 years I have only felt valued for 8 of them and the battles we fought for even those 8 years. So here I am in yet another down economy watching hours and hard fought staff increases disappearing. My facility going for magnet status which is truly a joke in my mind while the familiar refrain of more with less comes from on high. I don't in any way disagree with cost cutting and working to keep your business functioning in tough times but if you are "all about the patients" there are other things to cut like 2 cases of coffee a week or sending people to conferences. As a professional I expect to see to my own continuing education. So we work with less and then if things quiet down for 30 minutes I am expected to send even more people home resulting in more rushing around. An ED cannot cut to bare bones as we cannot turn away patients. This differs from inpatient units as when all the beds are filled they are done. I am glad this is ending.

Meds in my pants

Had a 72 yr old woman come in with back and leg pain. She is unable to get around and her husband felt he could not take care of her any more. She had been seen in the ER a couple of times over the past few months for the same and given pain meds. She was slurring her words when she came in. Her nurse was changing her diaper and found 2 bottles of vicodin hidden there. She was extra medicating herself for pain relief because she felt she wasn't getting enough medication. She blamed her family and they blamed her, it was funny but sad too. I had to give her points for creativity as in 30 years I have never found meds secreted in a diaper.

Ghost Town

Our closest competitor opened up and our ER is becoming a ghost town. Losing anywhere from 20-30 pts a day which for a small ER is significant. We are sending people home early and starting to slash hours in an effort to keep them from cutting actual people. I don't know if it will be enough. Some of this hysteria is annoying as the hospital is still making money just not as much and we just hired 2 more contingent staff. I think we should just freeze hiring and see how it goes. I've had to revise the next schedule twice now to keep cutting. Oh well may be heading to Florida earlier than I expected.

ER tip of the day

If you come to the ER because your legs got sunburned on your trip to Mexico and there are no blisters only red skin we WILL make fun of you

Feels like spring

It's noon 60 degrees and the sun is shining, I turned the heat off and opened the windows, it feels wonderful. I know there is more winter ahead but I will enjoy this day!