ED Doc's message on Craigslist

Normally you'd think that Craigslist would be for selling and buying stuff from local people, but you'll find a place where people will rant about just about anything.

I found this posting via Reddit about an ED doc's advice to narc seekers posted a couple years ago. I like the first point he makes:

The first rule is be nice to the nurses. They are underpaid, overworked, and have a lot more influence over your stay in the ER than you think. When you are tempted to treat them like shit because they are not the ones who write the rx, remember: I might write for you to get a shot of 2mg of dilaudid, but your behavior toward the nurses determines what percent of that dilaudid is squirted onto the floor before you get your shot.

We as nurses make the call on what to give to our patients based on our objective analysis of our patient's situation. I do not give pain meds to patients who are loopy, drifting in and out of conversation, or who yell explicits at me when they don't get what they want. Over time I know what to look for in narc seekers, especially when they keep being admitted to the floor (why I don't know).

It's also hard to be compassionate when I see patients walk up to the post-op surgical floor, demand to be admitted for pain management while completely bypassing the ED, and wanting to talk with their surgeon. I see it over and over again. However, it's like the story of the boy who cried wolf: you never know until it too late sometimes.

Anywho the Craigslist posting great piece. I recommend you read and share during shift report.

[Advice from an ER doctor to drug seekers]

Taking charge

You may have heard of the 61 male who had a heart attack while driving to the ED and had a MVC in the hospital parking lot. Unfortunately he did not make it and some concerns have risen about the hospital's policy about following EMS protocol (waiting for ambulance to arrive) prior to giving care.

Below is the video footage explained with time stamps and identifiers.

One person I want to point out is the charge nurse. Here is the article's account of what that nurse's role:

A Portland Police Officer informed us of a car accident in our garage that we believe occurred at least 20 minutes prior. We advised the officer immediately call 911 because EMS have the mobile equipment to respond to a car accident. Before the officer left our Emergency Department, our charge nurse directed a paramedic to go immediately to the scene. She also dispatched our first responders, who are trained security staff, to go outside to the scene of the accident. When the security staff arrived, the police were already doing CPR. Then the nursing supervisor ran out to the garage. She saw that the ambulance and fire department had arrived and were actively preparing the patient for transport to our emergency room.

That is taking charge, like a boss. The charge nurse could have just continued to follow protocol and wait for EMS to hand off the patient, but knowing the information she immediately took action and prepared the trauma room for this patient.

When in charge, take charge.

[Man Dies at Hospital Waiting for Ambulance Call]

The HRC Verdict is...

I had my meeting with my HRC branch manager last month. I was told the same thing that everyone has been telling me:

Wait.

I was salty. I can't PCS to the places I want to, very limited 66H slots for deployment, the nurse research deployment slot I was told I had was a farce (higher said they were just looking to see who was interested even thought my OIC gave me the ok to go TDY for training this month in FSH), and I have to stay here for possibly another year.

I'm trying really hard to be positive about all of this. It's already a drag that I'm on night shift along with going with this disappointment. Yes I know that when I signed the dotted line and took the oath to protect and defend the Constitution of the United States that my life would be "managed" by the needs of the Army, but don't like where I am: career wise, education wise, and sense of fulfillment wise.

Since I have no choice but to stay at Bragg for the next year I've changed my goals for the year:

• Pass the GRE (they're revamping it in August. I hate doing essays)
• Obtain my Med-Surg Certification (yes it's for the monetary incentive)
• Start IMD/Surgical Ward software project

That's 2011 for me. I know things are subject to change, but I can't live my life waiting for something that may or may not happen; I still need to live.

And yes I'm thinking about the greener grass on the other side. I've even made a reminder just in case: