Wednesday, September 26, 2007

The things we do...

OK, our management has finally decided that there has been a big issue since we have moved into our new ER, namely nurses are disappearing faster than than free food left in the break room. And not just the new nurses either. Nurses that have worked 10+ and 20+ years in our ER have and are leaving. Some of the reasons I have posted in previous blogs.

Which brings us to their solution. Let's pay incentive. They are offering 6.25 extra an hour for each additional shift picked up along with a 500 bonus if you work 60 extra hours in a 6 week period. Oh, they get us where it hurts! They know most nurses will not turn down an incentive like that. So for 6 weeks, we might be fully staffed, although it will be with tired, overworked, grumpy nurses. And the clincher is that you will lose everything if you call in even 1 day. So our call ins will go down as well.

But I have been doing the math here, pretaxes, I will only make an extra 875, and the OT. Now my OT is pretty good, but I would rather make it in a less stressful department, i.e in my old unit. There they pay 75 for a 8 hour or less shift and 125 for a 8 hour or more shift, straight up, this averages to somewhere around 10 more an hour. Now they are not offering the 500 dollar incentive for 60 hours in 6 weeks, but as for straight up overtime, you can not beat it. I have 2 and only 2 patients, the same 2 patients all night long. And these patients are either intubated, recovering from open heart surgery or both, so they do not whine very much and are very appreciative. It is a strictly nurses run unit at night, we have a practitioner that handles all of the problems that we cant (which are few and far between, we are expected to be able to handle pretty much anything), she calls the MD if she cant handle it. We can eat at the nurses desk. we have the radio playing in the background. We surf the web when we are not busy. We carry morphine and syringes in our pockets with out "the joint" Nazis making a scene, We have techs that stock and check off crash carts and do all of those non patient care things that we are required to do in the ER, every last one of our patients is truly sick, it is heaven.

BUT.... i am a trauma junkie. I love it. There is no rush like the rush you get from a GSW or bringing back a car crash victim that has coded on scene, or a full arrest that actually makes it, not just a rhythm, but with full function. Or a stroke that get tPa'd and you start seeing them regain what they had lost a few hours before. A heart attack that survives because they get to the cath lab in less than 20 minutes and the blockage is removed. I like never knowing what is going to come through the door next.

I love my people in the ER, quirkiness reigns. Not just anyone can work there. It is also the only place I have seen where the docs and nurses work like a true team. Even in my small unit with 4 docs, it just isn't the same. Our ER docs have our backs, and we have theirs. We hang out after work, we know each others families, we celebrate birthdays, life and death. We drown our weekend sorrows on Monday mornings in margaritas with each other at 0700. We laugh over the stupidity of patients and each other and cry over the defeats. We tell dirty jokes, are inappropriate, and the lot of us could be the poster children for sexual harassment and how not to be politically correct.

I guess i am pulling my extras in the ER the next few weeks. Single parent with Christmas just around the corner, can't look a gift horse in the mouth. I just wish management would come up with a longer lasting plan, ie hire more people, more support staff, and slow down the flow. Wait for my bed to be clean and dry before you throw a 21 year old on it whose "emergency" is a cut left pinkie toe. Waiting 10 more minutes so I can chart, pee, or drink something will not make this guy die. I will probably be shooting myself in the foot come next month, but oh well, I start next week on my extras. Pray for me.

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