Wednesday, June 23, 2010

What in the World?

What a strange shift it was last night. I don't know what is going on this week, but we seem to have every alcoholic around walking into the ED drunk & wanting a room. As if it's a hotel or a shelter. And they admit them...every time. I certainly didn't go into nursing to babysit drunks. And I'm not talking about drunks who have decided they've had enough of drinking and want to stop. No, all they want is to leave as quickly as they came in so they can resume their lifestyle. Only we can't let them leave because now 3 days later, they are detoxing, confused & not a whole lot of fun to be around.

One of mine almost escaped this morning. I'm not kidding when I say his hand was on the door of the stairway to leave the building. Whew. Close one. And wouldn't you know it's when I wasn't the last one in his room when the bed alarm went off every 15 min. Whoever it was, they forgot to reset the bed alarm...thus the reason he was nearly able to get away. Luckily he was pleasantly confused & walked back to his room with a little bit of coaxing. All while dripping blood up & down the hallways because he pulled out his IV. Did I mention all of this went down around 6:40 am...right as the change of shift was starting to happen.

The one good thing about that.........makes me very eager to go home. And so very thankful my work week is over until next Monday. I have no ill will towards these unfortunate individuals. I try to understand what led them to where they are today & they all have a troubling past.

What I am a bit resentful towards is that this isn't nursing. And it's not so much this fact it's hardly got anything to do with it other than for a few seconds I think about what if he did leave & no one had noticed? What kind of liability does that put on me? Ugh, don't want to think about it too much. Too scary.

It seems more & more that the hospital as well as the Joint Commission or maybe the hospital is changing simply because of the Joint Commission & all of their changes/requirements/b.s as well as Medicare. Whatever it is, it's not nursing. It's not what I was doing 5 years ago as a nurse. Certainly I can't be the only one that has seen how much other work has been dumped in our laps.

Rarely do we have the time to really be a nurse to our patients. We are expected to be everything....friend, family member, secretary, maid, social worker, counselor, assistant, concierge, detox professional, pharmacists, sleep apnea goes on & on. How did all of that somehow get lumped into what a nurse is?

Or maybe it's just the dynamics of my unit now that we have no techs and we are basically the only ones the patient interacts with other than the doctors popping in for 30 to 60 seconds & disappearing again. I don't know. Maybe it was just a crazy week & it's got me thinking too much.

Hopefully next week will be a better week.


newnurseinthehood said...

Pfft. On the subject of the AWOLs, it totally whatevs. As I always say in the ER- this is a hospital, not a prison. It'd be one thing if you were a psych unit, but a PCU? Oh, okay, you wanna leave? Are you bigger than me? Are you suicidal and require a sitter? If not, later. You don't get paid to babysit adults. If someone's had their banana bag and still decide they don't want treatment, sweet. Can't physically hold you here, and I may give you a 3 minute head start before I call the police. You have actual sick patients that want to get better who require your time. Just sayin.

Rachedy said...

Unless they have been Baker Acted, or whatever it is called in your state, they have the right to leave. They have the right to be stupid, too. Once their ETOH level is down after the initial ED visit, we discharge them. They are confused and wandering around your unit because they haven't had alcohol. Why are they admitting them? Hospital need some medicaid money or something?

Jen said...

Yeah, they do have the right to leave and if he had really verbally pushed to leave, I would have gotten the AMA form & let him go. But he was all drugged up on IV Ativan and hearing voices...I'm just glad he didn't fall or climb into someone else's bed!

I don't know why they are admitting them like they are. I wish they'd stop. It's feeling more & more like a psych ward rather than a PCU. For some reason they decided my floor will be where all the Baker Acts go. Guess they think we should get all the detoxers too. It's too much.