You're not a floor nurse anymore

For some reason on one of my recent shifts, I ended up, with my two and half-plus years experience, being the most experienced nurse on my side of the ER. Scary, man. There were two floats and two people out of training less than 3 or 4 months.

I took over for one of the newly-minted ER types and report went something like this:

Yes, I have this type 1 diabetic patient whose blood sugar was "HI" in triage. She's breathing really fast and kinda pasty-looking. She was scheduled to go in to talk to a nurse today to have some of her questions about her pump answered since it doesn't seem to be working right, but woke up sick like this, so decided to come in. I have the number to the same diabetic educator, who just happens to be in the hospital today. I think you should call to have her come down and help the patient with her pump since she was worried about missing the appointment, happened to have all her pump stuff with her and is here anyway. She hasn't been seen by the doctor yet, but I'm friends with the diabetic educator from the floor, and I know she'll come down.

Meanwhile, I'm standing there dumbfounded. "Uh, you did what? This patient is probably in DKA. Is she lined? Does she have fluid going? Any signs of infection?"

No, I was working on this first. I thought I'd do something nice for the patient. Maybe you don't think it's nice, but I do! I can't help it, I think I'm still a floor nurse hahah.

So she gets offended at me for having the balls to mention that is not the job of the ER nurse, especially when it involves ignoring an actual medical emergency that's like bitch-smacking you across the face while saying "yo, look at me, I'm trying to kill your patient while you're on the phone".

Whatever, I go in there, watch the patient breathe really fast, put her on the monitor (hm, sinus tach at 145, thanks for mentioning that), draw 50 million tubes of blood, hang 2 liters of fluids, one liter each going into my newly-started #18 IVs (on the same arm so the other arm is free for the frequent lab draws), get the aide to throw in a cath and send a urine, and go tell the doctor to get his ass in there for the love of Jesus.

In the ER, we don't do diabetic educators, we don't do wound care consults (unless someone's colostomy bag explodes, then, by all means, please come down), we save lives. If you're not interested in telling patients that their relatively unimportant requests are going to have to wait or be done on their own time, you are not ready for this job.