Thursday I worked my first day on the floor in forever.
I was really excited and nervous to be back. It turned out very well in the end, mostly becuase we were so well staffed.
We have gone to assigning rooms, which is not really a good thing, but it did help me form being overloaded.
I only had 3 rooms all day long. This is bizarre. In the old ED I usually carried 5-8 patients.
My first patient was actually a really sick guy going to the Medicine ICU. So in my first few minutes back to the Department, I was thrown into serious monitoring, blood transfusions and the like. It was more interesting than I would have preferred. luckily he did get to go upstairs eventually…
Interestingly, the next patient I got was a very cranky man who had been hospitalized recently and had an unusually large amount of bruising on his arms from IV sticks and the like. He kept telling me it was careless nurses who caused the bruising. I did not argue with him, but bruising like that generally comes from taking blood thinners and being poked a lot for lab work. Lucky me got the opportunity to start my first IV on HIM!!!!! I got it in one stick, which thrilled me and the patient. I was very very tempted to tell him I had not started an IV since February, but I held back. It's like bicycle riding, except that some bicycles are harder to ride than others….
After that the rest of the day was pretty easy. The man with the bruising filled out a "customer compliment form" thanking me…which means nothing, but its nicer than the alternative.
I managed to do pretty much everything I needed to do. Unfortunately there is an internal medicine Physician doing an ED rotation who is clueless. He is addicted to Orthostatic Vital signs, which take an incredibly long time to do (BP's laying down, sitting and standing with 2 mins inbetween, and however long the pt dickers about. They are not that incredibly useful…The last straw came form him asking for them on a man who could not stand, so that was a bust.
All in all, having only 3 rooms made life pretty manageable. The only problem is as always, when all 3 get admitted, discharged all at once and suddenly 3 new people arrive and all need assessment and attention at the same time.
In the Old system, you picked up as you went along…this worked well for those people with a work ethic. For those without a work ethic it also worked well, if you know what I mean. Often someone whould have 6 and another person 2…it was clearly unfair. But if you were working with good people, things stayed balanced and everyone helped everyone. I miss that.
My hand pretty much functioned properly all day, though it did eventualy start to really hurt.
The waitin room was still horribly crowded. I hate to say it but it was a relief to see that and know that those weren't my concern…though on another day they will be.
I really had a nice day yesterday, orthostatics aside.
I'm almost looking forward to Sunday. Almost.
Inbetween now and then, I have a few outings with P….which are far more interesting than work…