The ER kicked my butt.

I doesn't happen often. 

Yesterday, the ER won. 

I am good at my job.  Much of that arises from a time when I wasn't very good at my job.  Not being very good at your job when someone's life or health depends on your proficiency is a very stressful situation.  That stress leads you to work hard on getting better or it burns you out.  I worked hard and got better and my stress level at work decreased to an acceptable level. 

But. 

And that is the nature of the emergency room.  You never know what is going to happen. 

Yesterday started off well enough.  I was busy, but nothing too bad.  Then a DKA arrived.  For those who don't know, these are somewhat personal for me.  These are possibly life threatening emergencies and they deserve as much of your attention as you can spare if you are the nurse.  While I was getting that all settled in, my sepsis arrived.  Systemic infection that can be life threatening.  Good times.  Dehydrated to the point that I couldn't find an IV site.  Luckily, my co-worker came to my aid with an ultrasound, just in time for them to tell me about the STEMI that was arriving into my other room.  Everything else stops for the STEMI.  This is an evolving heart attack.  Time is tissue.  We had a lot of work to do to get this guy to the cath lab within the window.  Again, without a couple of co-workers, this could have gone badly.  Even with all the help, I was starting to get a bit overwhelmed. 

We get the STEMI out and up.  I walk back over to my sepsis, to try to get back up to speed with where I was and what needed to done.  They tell me there is now a code stroke coming into the room where the STEMI just left.  It isn't even clean yet.  Oh yeah, I have another room with another patient I haven't even mentioned. 

This is the point where I realized something has to give. 

Mind you, this happened on a good day, in a good hospital.  At the morning meeting they informed us that we were 'upstaffed' today.  And even though we had an extra nurse, my charge wasn't going to send anyone home  just in case. 

So, working in my favor was an extra ED nurse, a charge nurse that was good at recognizing and fixing problems as they crop up, and a pretty well run hospital.  Without any one of these things, this could have been a lot worse.  It reminded me of other places and other times when I was not so fortunate.  Sometimes these things happen when you are down a nurse, with a green charge in a place that cares more about saving money.  I've been there too. 

I'm tired.  I need a break from all of this.  Is it weird that I am looking for a more sane work environment in a prison?  Probably.

I am pretty sure though, that I won't have to do urinary catheters on 2 year old kids and CPR on 90 year old people.  I guess I will see. 

Yesterday, everything worked out thanks largely to my coworkers.  We got everything settled and I even got sent of to lunch.  Then I returned to the new patient that wouldn't stop pooping on himself.  Some days.

And on this day I broke a little.  As I have before.  When I got home my family put me back together again, like they do.  I will go back again later in the week and try again. 

It's time for a change.

I'm ready.