I have 4 years under my belt which most of it has been in the Prison. I have seen stabbing, suicide, trauma first hand and let me tell you my first two days in the Emergency Department were CRAZY.
I think the hardest thing so far has not necessarily been the acuity but how fast things go. You go from having 1-2 patients to 4 patients within minutes. You get a short history and their chief complaint. You have to get a line in, draw labs administer meds, coordinate care with (radiology, lab, respiratory). Charge nurse and providers are pushing these patients in and out. Charting is a pain, they want to see a timeline of all interventions. Along with this you have to document your assessments/interventions and continue to check for orders and lab results. The CNAs are amazing! They do EKGs, collect urines, transport without being told! They see the order and they do it!
Example..
0805 Patient brought to room (they have probably been in the waiting room 3-4 hours)
0813 provider in room doing assessment
0820 labs drawn and sent
0845 pain medication given
0849 patient brought to CT
0900 back from CT
0915 informed patient we are waiting on the lab results and CT results. Could be up to an hour. Pain re-assessed.
Here Is What I Had On My First
First Day 6:45-7pm. They kept are acuity low since it was my first day
Alcohol Withdrawal – CIWA Q2 hours. There’s an algorithm to administer medication (librium). He also tried to elope from the ED.
I had 3 patients with muscularskeletal pain (treated mostly with toradol)
Abdominal Pain with Hx of bladder cancer
UTI
Elderly man with multiple falls, shingles – Admitted to the hospital, not safe to return home alone.
I’m really hoping to get this under my belt soon, I have seen some amazing nurses in this unit and can’t wait to move up to Trauma!! What’s really great with this organization is they have so many classes that they automatically put you in! Can’t wait!
CONTINUE TO CHECK IN TO SEE HOW MY EMERGENCY DEPARTMENT EXPERIENCE IS GOING!!