Saturday, April 14, 2012

The ER Beast

I usually write an inspiration to nurses on my blog and who knows maybe that is what this will end up being, but I feel the need to write about my experience yesterday and the decision that is solidified for me.  I work in the ER, in case you hadn’t gathered that from my blog already, and have done so for the last 11 years.  The ER can be a roaring beast that devours all in its path…or at times can be a gentle beast that lets those working there stay alive to come back another day. 
Yesterday was one of those days that just makes you want to find a corner to cry in…we had 2 nurses call out~ so we were short staffed from 7am -7pm and the patients just kept coming…our supervisory staff were all off to conferences so there was no physical help available from them…the rest of the hospital was dealing with their own issues and had no nurses to spare….(which makes me think of the Seinfeld episode where Elaine is in the public bathroom and asks the women next to her if she could spare a square….and sure enough the women says NO!) any way…
Our amazing team that worked yesterday pulled together and we got the job done and we did it very well!!!!  BUT for 12 hours we didn’t get a break…we ate sandwiches, sent to us from our cafeteria, on the run… we had full rooms and a full waiting room all day long so there was no break  to be had when a patient was discharged…just another patient put in the bed…we had a serious trauma come in, in the midst of the day…so that takes 2 nurses, a tech and a doc out of the mix for an hour… and again the nursing team, techs, docs and secretary all did an amazing job keeping up with all the patients, the orders and the chaos!! 
I have stayed in the ER for several reasons, the energy of it, the staff, the schedule isn’t bad, I am really good at ER nursing, most other types of nursing seem boring in comparison, and complacency. For me, this type of nursing seems to be losing its appeal. What I don’t love anymore is the chaos…controlled chaos is one thing but the chaos of yesterday, and the all too frequency of those days, is another…and for this 45 year old nurse I’ve about reached my limit.
The self-care routine that I have been doing has allowed me to stay sane while working and has allowed me to feel less burned out with nursing all together…but what if yesterday is the wave of our future in the ER…Our hospital is building a new hospital in another town, merging another hospital… and this ER is going to remain open but with no beds to admit them to…so the ER will be full at all times with critical patients that need to be transferred to the new hospital for admission(and we all know how long that takes!!!!)…call outs are ongoing as is not being able to find anyone to come in… and on and on it goes…
For now I will be increasing my self-care in order to remain where I am until another plan unfolds…and I do have a plan~~ Praise God!!


  1. I am sorry to hear you were feeling so burned out from your shift. I think that's the nature of the beast of nursing, not just the ER.. I will also say, though, that as a med surg RN, I don't think I could do emergency nursing because of the sheer unpredictability you mention (not that med surg is predictable, but at least my patients are usually stable), so I really admire your ability to be a great ER nurse. What is this self care regimen you are referring to? I struggle frequently with an inability to sleep (I have to take Ambien before bed on work nights) and I have stopped being able to sleep through the night entirely. I wake up at 4 with my head swimming with labs and things I forgot to do (like flu shot/pneumonia screening sheets.. nothing life or death). I think I am dealing with things better now that I work in a lower volume hospital and less critical patients and less work hours, but I still feel like I'm losing myself sometimes. Nursing is definitely a love/hate relationship- I can't see myself doing anything else and yet, I feel like I'm hurting myself by giving so much to my patients. Anyway.. thanks for sharing your experiences and insights. I feel less crazy reading them. ♥

  2. Thank you so much for your sharing your thoughts here...I soooo understand them! I was very burnt out a couple of years the point of wanting to quit nursing all-together...but instead I started taking classes for my BSN at my local Univ. and it was a God send! The curriculum was holistic and largely focused on the nurse developing self-love and practicing self-care... in order to have a sustainable practice...So for the last 2 years Ive been taking classes (just finished the BSN program this week!!!!) and working on self care...its been amazing. I eat healthier...I do yoga 2-3 times a week (which has helped me sleep much better!)and do cardio 2x week... and no longer drink wine nightly!! I also have some aromatherpy at work and take my breaks!! I also have done many meditative exercises through the classes and learned that I can say to myself, "well that was an interesting thought or judgement that just passed through my mind." and then let it self hate talk and no judgement, take each day as it comes.
    I realize that the ER at times gets me down, and sucks the life out of me~ I posted this after a particularly hard shift...thankfully those are not every shift! I am keeping my options open and realize that I do not have to stay in the ER...thought I have such love for it as well~~ I am starting with a Masters program in June so I will have many more options...that always makes things seem better...
    I think that med-surg nursing has its own set of tough days I'm sure...maybe a bit more
    Your comment "I think I'm hurting myself by giving so much to my patients" is how many of us felt when we started in the BSN program...the curriculum, the professor and the self-care routines helped us see that in order to continue to give to our patients in a way that is holistic, we MUST give to ourselves first and in a consistent loving manner...if you only pour out of yourself without pouring into yourself you will run dry!
    Im so happy you enjoy my blog~ and that it helps you feel less crazy...writing them helps me feel less crazy as well :)

  3. Congrats on obtaining your BSN!! I plan on returning to school in a few years and enrolling in an RN-MSN bridge program, but financially, I can't swing it just yet... plus I really want to spend as much time as I can with my kids while they are still young. I missed out on a lot with them when I returned for (and completed) my RN degree.
    I just started using my elliptical again and I'm going to see my PCP for some labs to make sure I'm not anemic or low in Vitamin D (again). I will definitely your suggestions in addition to that. I really need to develop better coping mechanisms than what I currently have been doing. I'm not sure I'm quite ready to give up my evening glass of wine yet though.(I'm Italian IT'S IN MY BLOOD!!) ;)

  4. Code Babe~.... lol~~~ I so understand the nightly glass of wine addiction, as Im married to an Italian/Irish guy...but I do know now that the wine interrupts Ive given it up, except for the special occassion... I did not go back to school until my kids were grown and gone so I totally understand this...and its important!! I have an incredibly hectic work week and Im stressing about not getting to the gym and my aerobics class....bummin over that... but its all good, I will just eat well and do some yoga at home~ Ive learned that you roll with the punches and it will all work out.
    Good for you using your elliptical~ plug your ipod into some kid rock and just fly!!!!!!!!!!!!!!!!!!!!

  5. Haha!! That is SO me! (Kid Rock and iPod) lol Didn't have any wine last night and I did sleep pretty well, actually. I won't swear it off entirely, but it does seem to make a difference, so I'm defintiely curring back. Thank you. :)

  6. I LOVE that you like KID ROCK... I just love him...and a little BON JOVI...that's what Im talking about!!!
    Well good for you, with no wine and finding out you slept okay... yay....I couldnt believe it either~ cuz I started drinking the wine to sleep better!!! lol
    Had a really busy ER day...sniffed some orange and lavender incense, took my breaks and now home playing with the puppy!! is good!!