Dear America, you need to be nice.

Dear America,

I have gratefully and proudly been an Emergency Department and Trauma Travel Nurse for the past 4 years.  I have held your love ones hands as they have passed.  I have laughed with you when you came in for the boo-boos and the “hold my beer and watch this” mess-ups.  I have put my blood, sweat and tears into working as efficiently and effectively as I can to make sure your wait out in the triage room is not as long as it already is.  Someone dies, and I do my 30 seconds of silence next to them. Within minutes I am in another patient’s room smiling and holding my composure as if the last few minutes haven’t been difficult.

People don’t come into the ER because they feel great and sunshine is coming out their butts. If you come into the ER, it’s because you ARE in pain, and think you are in distress.  But emergent distress to us, is lack of oxygen, lack of circulation, organs injured, or potential loss of life and limb.  Doesn’t mean we don’t believe your pain, but pain doesn’t kill you. We know in the ER that your emergency feels more important than the person’s emergency next to you.  But what you need to know America, is that in the ER you don’t ever want to be first.  First means you have a chance of not walking out of those double doors.  First means that your family may not see you again.

I look around and I can see my co-workers running just as fast as I am.  All of them with the same intention; continuously asking who needs help or another thing they can do, in order to help see you, America, faster.  But I am struggling America.  I am struggling with the pace that I run at, and the difficulty of coming to work and continuing to smile when I walk into your room and you are already mad at me.  Your wait was an hour before you got to your room?  So you take this aggression out on me as I am diligently collecting your blood and determined to find out why you came in as you expect top-rate smiling customer service.  You are hungry.  You are thirsty.  You now have a cat scan ordered and are additionally mad at me for telling you not to eat or drink. I continue running room to room, with you still frustrated with me, America.  Frustrated that you had to wait on your blood work.  Frustrated you had to wait on the cat scan report.  Frustrated you are still hungry.  Frustrated the doctor hasn’t been back in.  Frustrated you didn’t get a warm blanket immediately after asking the first time.  And frustrated that your trip to the Emergency Department hasn’t ran as quickly as a McDonald’s drive-thru.

What you didn’t see during your wait is the ambulances coming in back-to-back.  The lady next to your room in respiratory distress requiring a team to stabilize her. The radiologist having 27 reports ahead of yours with a delay if another trauma patient comes in.  Even the patients not breathing or heart’s not beating still do not receive full-report scans or blood work faster than yours.  They get stabilized and their tests get bumped up the line before everyone. But the results take just as long as your tests.

But our chaos doesn’t stop.  Not in the full five hours that you’ve been visiting.  Not because it’s 0300 and you thought this would be the best time to get in-and-out.  Our staffing is cut in half at night, and sometimes to a third.  Not because it’s the hospital’s problem of inadequate staffing, but because it shouldn’t be staffing at 100% capacity through the night, health-care workers need rest too.Grandma needs help to the restroom.  Little Johnny just had a seizure.  Uncle Tom has kidney, liver, and heart failure in addition to his diabetes, COPD, and 10 other diagnosis’.  Pregnant Sarah continues to vaginally bleed.  And the nurse taking care of all of these people is getting heat from the doctor about the laboratory not running a blood specimen yet.  As the nurse sits down to chart Little Johnny’s seizure while calling the lab, a pass-by family member starkly comments, “look, they are just sitting there”.  Our jobs dilemmas are not like a computer malfunctioning. In fact, we can still operate really well if our charting systems go down.  We train for it.  But YOU AS PATIENTS are not computers.  You’re humans, and our every quick critically-thinking decision can mean life or death to a person.  It’s a heavy weight to carry at times.  And sometimes we don’t make a lightning speed plans of care when you don’t present so black-and-white. We don’t give you a medication ‘just because’ or withhold ‘just because’.  And for the love of God I do not know if you will be admitted without your tests back.  

We don’t do this job for the praise, because we don’t get it. We don’t do this for the insane vacation or money benefits, because it’s not insane.  If we weren’t passionate about our specific positions then trust me, we would have never made it through school.  When you come into our establishment with a lot of non-emergencies while treating us impolitely or ignorantly, it is wearing down our passion to want to help you.  It is just as frustrating as your really, really, really, bad days at work.  Just because you are in lack of control in the Emergency department, does not mean you can take it out on us that are here trying to HELP YOU.  And so I ask you America, if you’re going to visit me, and don’t have the best story or YouTube video to back up the cuss words coming out of your mouth from the pain, then you need to be nice.

And so I leave you,

The exhausted Emergency Nurse.