Verdict is in on Hospital #2: Fuck. This. Couch. And this ER...
I'm over it. The patient load isn't bad, the acuity isn't all that bad, the equipment is pretty nice, the patient ratio is sweet. But the staff? Not okay. For every single nice nurse, there are four who are total giant assholes.
As proof, I present my experience from tonight. I was on the exam side, which has lower acuity higher ratio. I had a full group, half of which were crazy drunk morons. I'm triaging a brand new patient and getting the nine thousand paperwork forms filled out. It's 22:53. All of a sudden, another nurse plunks her stuff down next to me and announces I'm moving over to the cardiac side. News to me, but whatevs. I finish the computer triage and start in on report. I'm not even halfway through report on the first patient when she interrupts me and asks "how come you haven't put in a line yet on this overdose?" Uh, well, it's because she's been here 7 minutes and I'm currently finishing her triage, and oh yeah she's a fake-OD-just-wants-more-ativan type patient. And since I was not aware I would be moving groups, I wasn't too chuffed about it. I finish report on the first patient and move on to report on the overdose. She interrupts me in that report and asks what the deal is on the third patient. I internally sigh and start in on report on this patient. No shit, she interrupts me again to ask for report on the last patient. Bitch please, if you had seventeen more seconds worth of patience in you, you'd have gotten full report on each one of them. I then get asked again why I haven't given the ordered fluid rate of NS 250 ml/hr on the second patient. Since the doc went in to see her while you were getting report from me, it's kinda hard for me to give you report and be in the room medicating at the same time. I haven't quite mastered that metaphysical maneuver yet.
Whatever. Maybe you're having a bad day. I can let that slide. So I sprint on over to cardiacs, where I take an absolute cluster of a group - one patient has been in the room for over an hour with med orders in and still no line. One patient has been up for discharge for 45 minutes. One is being triaged but still needs everything done. I go in and discharge the ready patient, and get report from the offgoing nurse. I then bounce into the first room and throw a line in and medicate the patient, and head into the next room to do a full workup. I'm elbow deep in gowning the patient, blood cultures, IV start, labs, istats, fluid boluses, neb treatments, and po meds (all by myself, mind you, no help from the ED tech) when I hear my name overheaded. It's the charge nurse. I call out that I'm in with the patient, and charge walks into the room. "There's an a-fib patient in the next room, she's been in there for 15 minutes and isn't triaged or on the monitor, with a HR of 160. What gives?!" she says.
I respond that I've just taken report and been in with two patients doing a ton of stuff, and that I wasn't aware of a new patient in my room. Now I'm in trouble because I've missed the five minute cutoff for EKGs. I look over at my computer, and taped to the monitor is a handwritten sign that reads NEW PATIENT IN ROOM 2. NEEDS TRIAGE. PS CARRY YOUR PHONE WITH YOU AND YOU'LL GET REPORT.
Oh no. Oh hell no. You know why I wasn't at the computer? Because I was doing shit. You know why I didn't have the phone on me? Because the nurse I got report from still had it. That is such a dick move, and the only person who actually suffers is the patient. Don't you dare pass that blame onto me. You're the triage nurse who didn't get a cardiac patient undressed, or put them on the monitor, or give report to the primary nurse. At least the charge nurse, who is a decent human being, saw that note and came out to rip you a new one.
And you know what? Karma's a bitch, yo, because you definitely got slapped by a drunk patient not even two hours later. I can't even care.
I'm going to finish my beer and go to bed. Forget this ER. I love this city but I'm over this work environment.