Monday, January 13, 2014

Burnout

I haven't been blogging a lot recently because I'm legitimately burnt out on the overwhelming number of stupid, mundane complaints we've been seeing in the ER. My current workplace sees an average of 250-280 patients a day, which normally feels like nothing because they've got a top rate first-track and a pretty good system for patient flow. But the onset of flu season means they're seeing around 300, 325 a day and the majority of them are not actual flu patients.

Our numbers have been so high because everyone and their mother is coming in for the common cold. Wait times are up because the fast track area is deluged and can't keep up, so minor patients get overflowed to the core. The core docs then have to see them, and a normal minor complaint visit time of 45 minutes becomes three hours because the doc has to see all those pesky rupturing AAAs and septic pneumonia and chest pain patients first. Then the minor patient gets angry and demands to see a doctor, and then the staff all hates them because they're being a dick on top of being in the ER for the common cold, and then no one is happy. It's a never ending battle, and I am so ready for flu season to be over because right now I hate people and I hate all ER patients and I'm so sick of them that I transition from nice nurse to cynical bastard within the first ten minutes of my shift. All I want is to take care of a real sick patient instead of the BS stuff but we're so understaffed that when I'm in the Cardiac (read: sick) station, I can't keep up because I've got three ICU holds in addition to my other couple of patients.

It's enough to wear anyone down, seriously.

So last night I was working up a near-syncope patient brought in by her daughter. The critical-thinking side of me was doing the usual 'what could this be?' rundown, but the cynical side of me was thinking that it was probably bullshit. And then I looked down at the EKG as it was printing, and noticed big fat elevations in II, III, and aVF. That in addition to the simultaneous dinging of the heart monitor because her HR dropped to 32 woke me right up. I called a doc to come sign up for her, we activated the STEMI team, started some more IVs, gave some meds, did compressions for a hot second when she arrested, and thirty one minutes later deposited her on the cath lab table.

I had the patient for a total of thirty seven minutes. This morning I stopped by her ICU room to see how she was doing. Still sedated after emergency bypass surgery, but alive and expected to make a full recovery.

That, people, is why I am a nurse. It's just enough encouragement to help me wade through the mountains of minor complaints and verbal abuse just a little longer. Hopefully I too will make a full burnout recovery and resume both the compassion and the blogging.

4 comments:

Lisa (aka Mollie's mom) said...

So my son (a paramedic)caught a stemi on his truck. They gave him a plack and a steak dinner. I hope someone does that much for you.

Aesop said...

Nice catch.
We take care of all of them, but it's the actual saves that make the job worth doing.

It also makes me want to sort all the naggy whiner bastards back to the main waiting room with a pitchfork and a meathook.

I compromise, and just tell them tha the wait for non-emergency patients is approximately until 15 minutes after their PMD's Urgent Care opens in the morning.

The little pissed off looks on their faces I get in return are priceless, and warm the depths of my soul on dreary nights sorting through hordes of people too inept to deal with their own snot.

Barb said...

It happens everywhere this time of year. But I still don't understand it... I know personally when I feel crappy/sick the very, very, very LAST thing I would be willing to do is drag my ass to the ER. Sitting in those lovely plastic chairs for who knows how long? No thank you. I'll stay in my warm bed!

Anonymous said...

I just found your blog and will be stopping by again to recharge my ICU batteries with your humor and insights.
I understand what you are saying about bullshit that gets dropped in your lap at times. I work for the local VA hospital and sometimes we get some BS admissions that can be sent to the floor but because the baby docs (we are a teaching hospital) are not "comfortable" sending them to the floor they land in our lap. A GI bleeder with a hemoglobin of 12 and black stools he saw two days ago. Really! You are going to take our last bed for this!
So later that night after they are sleeping and resting well just waiting for GI to come see them in the morning. They wake up complaining that they are starving, want a cigarette and I am being a bitch for following orders. Makes for a long night with a jerk yelling at you! While in the room next door the true GI bleeder is requiring trauma blood and GI is rushing in to do an emergent EGD at the bedside and you are being pulled out of this room to deal with an overindulgent drunk who doesn't need to be in my unit!
Thanks for giving me the venue in which I can vent right along with you! Great job in and out of the hospital!