I spent my latest shift in triage. There are two triage positions in the emergency room- one prioritizes the patients arriving by ambulance. The charge nurse usually does this. The second triage position is where patients who walk in are prioritized and sometimes treated. It was a slow day by ED standards, as we had less than 200 patients for the 12 hour shift.
The interesting patients of the day were a guy who ran his hand into a table saw, removing the tips of two fingers, a woman who came here from Canada seeking treatment that she had been unsuccessfully seeking for over a year in her home country, and a fentanyl overdose who came back to us after only being discharged 90 minutes earlier (that particular patient came to us by ambulance). The nurse who wound up treating him and I agreed that this guy obviously didn’t care about his own health and just wanted to get high, and that society would be improved if hospitals simply stopped handing out Narcan to every junkie on a constant basis. Sorry, but this guy has been in our hospital more than a dozen times in the past month. I can’t see how we benefit as a society by indulging in this behavior.
I had to teach one of our new nurses how to splint. She had to do a sugar tong splint on one of her patients for a wrist fracture, but didn’t know how. I went back and had to show her how to do it. Then a second came and asked me if D5W had sodium in it. (D5W literally means 5% dextrose in water. Why would there be sodium in that?) What are these nurses learning in school?
The worst part of the shift was the screensavers on the computers. They show a nurse I work with getting an award for saving a patient back in December. Good for her, except she got the award for what I did. A patient had come in complaining of passing out several times. No one could find anything wrong with him, even after the man had been in the ED for 2 days so they were about to discharge him. I went into the ECG server and reviewed the last 2 days of his heart activity and found that his heart occasionally went into a third degree AV block. He would then spend the next couple of minutes in a ventricular escape rhythm, and his heart rate would drop into the 20’s. There’s your problem, and I can’t believe cardiology missed it. I printed the ECG strips and gave them to his nurse, who forwarded them to cardiology. The man got a pacemaker and was sent home. The nurse got an award. I didn’t do it for accolades, but it still sucks that someone else got credit for my brilliant detective work.
Everything that follows is a “me, me, me” story, so if you aren’t interested, the post can end here.
I got another offer for a job this week, this time for $11 an hour more than I make now. Even though the money isn’t as good as the offer I received a month ago, the benefits are much better. Still, I’m not interested, as that particular hospital is about 45 minutes away from where I live and I don’t feel like driving that far. Still, the jobs are there.
Perhaps the attitude about druggies is the reason why, when I had a conversation with my manager about my coming departure, he didn’t seem to care a whole lot. It went like this, “You know that hospitals around here are aggressively recruiting nurses? Did you also know that this hospital is paying more than $10 an hour less than all of the others in the area?”
He says, “Yeah, I’ve heard.”
Me: “To be honest, I have offers from two other hospitals in the area. Both are for significantly more than I make now. I want to stay here, if possible. My evals are good, above average, in fact. You say you want me to stay and value me as an employee, so what kind of a raise are you willing to give me?”
Manager: “I really can’t have this conversation right now. There are a lot of things going on, and it would be better if you came back in two weeks, and we can talk about it then. My plate is just full, and I really do want to help you, but this just isn’t the time.”
Me: “That’s what you said three weeks ago, and a month before that.”
Him: “I know. Sorry, this just isn’t the time.”
It sounds like they really DON’T value me as an employee. I can’t see any manager who cares about retaining employees saying things like that to one who is making noises like they are looking to go. I do know that they have recently (in the past three months) hired half a dozen new nurses, all fresh out of school. They aren’t hurting for nurses as badly as they were a year ago, even though we are still woefully understaffed, it’s my belief that they WANT to be understaffed. It’s cheaper that way, I guess, even if patient care suffers and nursing ratios stay at 8:1 on the floor, with 30 or 40 ED holds.
So I am going to assume that I have just gotten my answer in the form of a “pocket veto.” If they really respected and wanted me to stay, we would have had the conversation about pay and retention by now. I have done everything but put in my notice, and the manager doesn’t seem to care.
So I have decided that my last day will be in 6 weeks. In three weeks, I will put in my notice.