Number Ten

Or Numba ten. I thought that you nurses out there would like to know what in the hell they teach us in EMS schools. Well you're in luck! I dug deep into my archives and found a few of the on line CE videos I watched a short while back:

And you're welcome now go forth and well...whatever.

Number Nine

A waste of training, time and talent.

I know I said a couple of entries ago that “Deserve’s got nothing to do with it” when it comes to getting shit assignments in the ER. It does no good whining about it, it least of all does no good asking for a different assignment unless there is some sort of friction with another person (I.E CN15) In spite of all of that shit that I said I have to whine about constantly getting the shit end of the stick.

Let me say here I do not mind doing the dirty, hard, thankless tasks that encompass a tech’s every shift, sometimes though it gets ridiculous. For awhile after I started big urban trauma hospital (my most recent job) the crew there took full advantage of my training and talent. I got to work things I had never worked before. I worked with a great crew and made a difference. I was actually once again excited about the health care profession in the ER after a mind numbing, soul trying 2 years of west of the Mississippi low level hospital.

Then I somehow pissed off a charge nurse by being associated with a hard working bunch and by pissing off this charge nurse I also angered her cronies. For the next year despite the knowledge that I was caring for a dying father at home they worked to make my life miserable on the job, they succeeded. I was then routinely assigned away from the hard working crew and stuck in the triage area. That was pretty good I hung out with ambulance crews and I jumped in on things that truly needed my help. But then I got put there EVERY shift and eventually her cronies as directed by her put the screws down tight on me. Which consisted of and I shit you not a special list of tasks for me and only me to do when I was seen to have free time. Any truly dirty frustrating job that came up I got stuck with often in spite of the other techs saying that they’d do it for me.

A great example of that is cleaning the same urban outdoorsman (homeless guy aka hobo) 2-3 times per shift when he was there, because once despite spending nearly an hour scrubbing this dude down was not good enough. It became comical after awhile “I ain’t ever coming back here again cause your faggot ass keeps cleaning my ass over and over and over…get away from me motherfucka! I ain’t got no skin left.” I seriously started keeping lava soap in my locker after awhile for these folks. This supervisor and her cronies would pull the dirtiest people out of their rooms bring them to triage for me to clean 2-3 times a shift. That means out of other techs areas of responsibility, this was not done to anyone else just me. When this did not work and I began to develop a rapport with the local homeless she thought of another assignment. I did this assignment every shift 3x a week for months.

The psych-obs unit, which I do not mind either but after every shift for weeks of dealing with clinically insane violent patients you begin to crack, you start in a sense acting like the psych patients to a degree because that’s your reality 36-40 hours a week. This is alright because you learn to deal with these unfortunates better. I was even written up for defending myself against a violent patient ,it did not help her case that she did not know the patients name or check the chart to see that I was documenting this patient’s escalating behavior or the patient’s violent past, fortunately the nurse assigned to that patient explained the situation to the manager. The object was to make me quit or change shifts, normally I would say something but at the time I had a lot going on outside of work, I decided to go to day shifts instead, they won.

But the thing is that after awhile of being assigned low acuity areas your skills start to die off. I knew EKG’s pretty well for a while there now I CRS (can’t remember shit) I was assigned the monitor room to relive a lunch the other day and I was terrified. I really do not even how to use the new monitor equipment in there and could not find numbers to call nurses when their patients threw funky rhythms. There was a long while where I hardly ever missed an IV now I still get the IV but it’s not as effortless as it use to be. IV’s are very few and far between. I knew lab values off the top of my head. I knew where nearly everything was in the department and depending on the shift, knew who to get in touch with for anything from wrangling crutches from the ortho floor to a stray set of rib spreaders when the open chest tray did not have any while cracking a chest (this happened more than a few times). Heavens help me if I ever have to run a Level 1 infuser again. I knew what parts of the hospital were under construction and where to find the ultrasound tech at 0100 in the morning. It’s a damn big hospital I work in now so knowing that shit is a feat. All that knowledge is gone now.

That’s the point I’m at. The hard working crew has gone on to other things in other hospitals and I’m on a different shift working PRN. Since I am a stranger to the day shift charge nurse I am assigned to two areas constantly. I am either in triage or psych-obs, because those are the shit assignments and I’m the new guy on the shift, despite having more experience as a tech than any other tech on shift. Hell I have more healthcare experience than many of our new herd of new hires. I know nurses and techs are VASTLY different but experience plays a role in team work and patient care. I don’t blame her, I need to prove myself to her, but I’m tired of this proving myself over and over again thing, its old very old.

I am well aware of fair, right and deserve has nothing to do with it. It’s a big damn cup full of vicious diarrhea and I gotta keep taking long pulls from it for the foreseeable future, maybe until one of the violent patients kills or seriously injuries me.

I had a now ex-girlfriend tell me I should go to another hospital or quit the field altogether. I told her what’s the point, I’d just have to prove myself over again and I’m tired of that shit and quit and do what in this horrid economy. Besides it’s best to stick with the demon you know rather than the demon you don’t know anything about. Funny thing is that she’s now an ex-girlfriend and I’m still on the job.

I take comfort in the knowledge that the charge nurse that started all this mess at urban trauma center was forced out and left this hospital but her cronies on night shift remain. One even now has moved into her vacant charge nurse position. Things change but stay the same. If we had a manager now I’d go talk to them about moving up to the ICU in hopes of learning something different. I have applied to another hospital for a PRN ICU tech position and heard nothing. I’ve considered going to paramedic school recently and returning to the trucks. That thought of going back to the ambulance has bounced around in my little skull for years, I know better.

So where does that put the crusty one. Well, the same place I started. In a damn dead end job working to roll away the stone in college so I can get a nursing degree and get out of the damn emergency department. Here’s a bit of advice for you folks who want to be an ER tech or just started the game. It’s good for a couple of years but then move on to something else, get educated and get out of being a tech, it’s only worth it for a little while.

Cynical and tired is what I am. I am the Crusty ER Tech.

Number Eight

Screaming female patient is brought in via ambulance after an altercation with police. Well not so much an altercation, the police just did not want to deal with her. The patient is a middle aged female wheel chair bound schizophrenic. This woman went off her meds and smoked crack the entire night before. She then deteriorated into a true menace to her neighborhood. Menace is probably the wrong word to describe this woman but the only one my small tech mind can think of at the moment.

In just a few hours of the early morning this woman said she saw UFOs flying in the sky and she needed to shoot them down. She fired several shots in the air and shot one of these UFOs down (and no I do not know the type of gun or the caliber of the gun.)  She then claimed to have seen this UFO crash land in a neighbor’s back yard where the unscathed alien escaped the wrecked UFO and went into a neighbor’s house. The wheelchair woman seeing this decided to confront the neighbor about them harboring an alien from outer space. Naturally the neighbor would not answer the door when they saw and heard the wheelchair bound woman screaming at them and waving a gun around.

The wheelchair bound woman now is determined to finish this alien off whom she shot down.  No one will come out so she decides in the interest of saving us humans that she should burn the neighbor’s house down.  She somehow procures some sort of flammable fluid and sets fire to the house which has the outer space alien in it. As the house begins to really catch fire the police arrive and call the fire department. Fortunately the woman ran out of ammo shooting at the UFO’s earlier and decided to as a last resort after confronting the neighbor throw her gun at the then burning house.

The neighbor’s house sustains minor damage; no one is injured during this incident. The woman is brought to the urban city hospital where she is removed from the wheel chair and placed on a bed and proceeds to scream at everyone for the next hour until the attending decides that yes, this woman needs to be chemically restrained, only after she has torn everything off her bed and is close to tipping this bed over from her violent rocking of the bed back and forth.

The alien from outer space was never found nor was the UFO.

Number Seven

Something I said stuck.

I had a shift recently where a fairly new nurse told me something I said once stuck. It was about working in an emergency department and continually getting the worst assignments. She told me one shift that she thought it was not "Fair or right" that she got stuck in a crap assignment and that she "deserved" to be in a better assignment so she could learn more.

She's been a nurse for about 18 months now, all at this particular large urban ED.

I told her that fair, right or deserve has nothing to do with it. I told her that even the most experienced people get the shit end of the stick, that's the way it is. Trust me I know. I myself just hope one day to be out of this dead end tech job and move onto something better once I get my nursing degree.

Remember folks you can have a shit ton of experience, education be the smartest person on shift but if for some reason the supervisors wanna shit on you because they don't know or like you there is little you can do. Suck it up and do your job as best you can.

To quote William Munny from "Unforgiven"

"Deserve's got nothing to do with it."

It's so very true in the ER whether you are the victim of an accident or the tech doing your 7-8th code brown of the night.