The frustrations of an Emergency Room

You ever wonder what life is like for someone? What they are feeling or thinking? So you try to put yourself in their shoes.

I had a thought while I working the last three days. Why not share the thought process of a nurse. I'm am not speaking for all nurses as they are entitled to their own thoughts and opinions, but I felt that maybe an explanation of my thought process would help give insight and ease frustrations. Working in the ER can be very wearing on the body, heart, and mind. You are meeting people when they are feeling their worst. Some have ails of the body, others of the mind, others of the soul and it is often a feat attempting to manage the needs of multiple patients at one time.

The Setting
As you all know hospitals and Emergency Rooms are open 24/7. We are often understaffed and in a setting like the ER, the flow of patients can either usually be steady or overwhelming depending on acuity (how sick patients are) and timing (how many patients are waiting at one time and how many more are arriving including the number of EMS). If there are no rooms left in the hospital not only do we manage the patients being held for admit but, we are also managing the people who are coming in to be seen. Sometimes we can have a lobby full of people, every bed filled (including halls), and a line of EMS waiting against a wall. When this happens its a domino effect, nurse to patient ratios increase and quality of care can often be affected.

Mixed feelings
It's a constant battle within yourself to choose who to see first and what is a priority. How long a patient has been waiting is not usually the determination of how fast the patient will be seen. It's the accumulation of vitals signs, signs and symptoms, comorbidities (medical hx) and how those symptoms relate to medical hx and emergency situations that determine who a physician and nurse will see first. I wish I could be in more than one place at a time, that I could take care of all the needs of my patients 100% of the time, all the time, but the truth is, it's not possible. We are taught to critically think, to consistently reevaluate and do the most important thing first. As a nurse who chose this career to provide compassionate care, I value YOU! I never want any of my patients to feel ignored or forgotten. I promise you if it's taking a bit to address your needs we are not ignoring you.

We the nurses are the "doers." We can advocate for you, but we can't order. We can start the process of drawing labs, starting IV's, completing EKGs, etc., but there are some things we cannot do and ordering medications is one of them. We can ask, but asking will not always guarantee an order will be given. More than often if a physician or midlevel provider does not give an order its because they must see you first. Medications are filtered though different organs and systems. While they can relieve symptoms they can also cause damage if used inappropriately.

We also will often put patients on NPO status which means nothing by mouth. I promise we are not trying to starve you of water and/or food. We do this because in many cases we are not aware of the complete diagnosis until tests like ultrasound or CT scans are complete. For example: If a patient were to need surgical intervention we will have delayed care by offering food or water. Any food or water prior to surgery could cause complications during surgery including and not limited to aspiration (food or water traveling into lungs) which could lead to pneumonia or other more serious problems.

Also forgive us if you were given a hall bed. We value your privacy, but even a hall bed is better than no bed. If you're in a hallway its because we've exhausted our resources and all other beds are full.

The Thinking Process...
One patient may ask for a blanket or a drink, another for medication to treat their pain, another for an update, but if lets say someone is brought in by EMS and is short of breath, we as nurses gather our resources and depend on each other to help when such an emergency arises. The inability to breath means the inability to live. The body more than often exhibits a persons distress with symptoms although I acknowledge that is not always the case. Our resources and staff are pulled together to stabilize these kinds of patients often leaving other patients feeling like their needs were ignored, especially if they had used their call bell and lacked an immediate response. By all means remind us of things because I have in the chaos of it all forgotten a request, but it is not a purposeful act. I indeed value your patience and the reminder.

The Trickle Down Effect
Once a patient feels ignored, they become frustrated. It's understandable that your needs are just as important as anyone elses. I completely agree and it is always my hope to deliver the best care possible. When frustrations brew and they often do, its important to remain calm and act like responsible adults. Removing lifesaving equipment such as the blood pressure cuff, pulse oximeter that reads oxygen levels, and heart leads can endanger you. Families, friends, and patients should advocate for themselves and each other, but please remember we may not seem efficient, but we are trying. I've been struck, kicked, punched, spat at, called names, and told I have no compassion. I insist that I do, that we who took an oath and entered the profession of nursing did so because we care. We give of ourselves each day and we go home questioning, "Is there anything I could have done better?"

I chose to pour out my bleeding heart because its honest and real. I was trying to figure out some content to share when another Steemian @sammosk gave me some advice. He said the best stories are shared when we peel back the layers (he called it "the onion man").

We all deserve respect and if we could find it in our hearts to understand each other we may be able to accomplish more. Please by all means post your frustrations as a patient, friend, or family member. I want to share the feedback I get with my peers and fellow nurses to improve patient experiences and to improve my nursing care. Nursing is a field of constant learning and who better to learn it from than the people we serve.

I came home from my 3rd 12hr shift in a row and couldn't fall asleep till I put my thoughts into words. As always Steemians, thanks for listening!

If you enjoy my work don't forget to follow or upvote if you so choose. Peace, Love, Prosperity -V-

Image credits:
https://pixabay.com/en/emergency-emergency-services-1137137/
http://www.cnbc.com/id/100369848?view=story&$DEVICE$=native-android-mobile
https://pixabay.com/en/emotions-mixed-emotions-feelings-401406/
https://pixabay.com/en/question-mark-face-silhouette-bokeh-2405207/ https://blog.smartthings.com/stories/avoiding-costly-water-damage-in-your-home/