After seeing our tax bill every year, my wife stopped working the ED.
Outpatient surgery is where it's at.

Oh, yes. I HATED hearing about the patient satisfaction bullshit. The FSA know about it and expect to be treated like Queen Elizabeth.

Cardiac/transplant ICU RN ftw!!!!!!!!

This. I never want to deal with an awake patient again. FSA scum and addicts have ruined it for everyone else.

Yep,   they're going to make the health care providers responsible for the patient's health and satisfaction.    Doesn't matter that they walk in 200+ lbs overweight, haven't taken their meds because they couldn't 'afford' them (the minimal copay went towards more booze and candy and cigarettes)...that bone sticking out of the bottom of their foot is now MY problem.   If I don't get it better, I get poor reviews or listed as having poor outcomes...which then will change my reimbursements.   Oh, and I better give that patient all the Percocets they want (for their pain from the neuropathic foot that they can't feel anyway) or I'll get a bad review....

I originally started working in dietary then housekeeping and have a app in for a tech in our ED and every time I read the satisfaction reports I about have a aneurysm from the negative reviews.

You really need to learn the scams. I suggest working in the car business for a few months to master them, but here's the most obvious. Get a pc with an independent connection.

"I want more drugs."
"Fill out this survey and I'll write the scrip." (you're going to write it anyway)
"Dr. Afarr is the most wonderful doctor in Pennsylvania."
"Here are the prescriptions for your infections, high blood pressure, and hyperglycemia which you will not fill. Here is the prescription for Percocet which you will consume like they are M&Ms. Have a nice day."

So does my wife.  Neuro ICU, intubated, sedated, and paralyzed, just how she likes them.  

Wife has been an RN for 35 years.  Spent 17 years working weekends (her late husband manned for fort).  She spent 7 years as a charge nurse.

She exclusively works weekdays in OR with such things as orthopedics and cancer.  

She is fed up trying to take care of the land whales.  She is 4'11" and 105.  Wheeling the fatties around has screwed up her back.  When she hits 59.5 and can withdraw from her retirement plan she is going to cut back to just enough to qualify for health insurance.  That in and of itself is a crock.  She will have to work simply to have stupidly expensive health insurance.

Personally, I believe the morbidly obese ought to be denied care until they slim down.

And might just come in your room holding a catheter. [Curly] WOO-WOO-WOO![/Curly]

I actually requested one once during an ER visit.

Came in with bad kidney stones. Was blocked and couldn't piss and was in serious pain. The desk nurse looked at me when I said "I need a catheter!"

Got into the treatment room, got taken care of and got another look when I turned down the pain meds.


The only time I ever lost my temper was when I went to the ER with a pulmonary embolism. Had bad chest pains and the local ER in Germany ignored me for about 3 hours, so I drove home and got a friend to take me tot he Army hospital. By that time it hurt so bad, I could barely stand up and after another hour wait, finally lost my shit on the desk nurse. The treatment after that was top notch and the desk nurse heated up his own lean cuisine meal for me since I missed the dinner meal while being admitted. I made a point of asking my buddy to get all of their names so I could come back and thank them. Hell, I was ready to propose to the nurse that put me on the morphine drip.

I did threaten to stab the guy who tried to take my breakfast away from me. But I hadn't eaten in 12 hours and those tiny pieces of toast weren't leaving that room, except in my stomach.

Edit: Question for the nurses here. What's the protocol on patients asking out a nurse? Obviously I wasn't going to toss game on the woman sticking a catheter up my penis, it's too late to lie. But is there ever a good time to ask, or better to come back later, or just forget about it?

I work in the OR the Dbag attendings and know it all residents aren't too much better.

Not an easy answer.  Remember that nurses are nice to you because they're nice people, not because they have an interest in you.

In the successful cases I've seen, the guy asked out the nurse when he was close to being discharged.  It helps a lot to be clean and not in the hospital for something bad.  If you are creepy or have made passes at or comments to the other nurses, you are going to get turned down.  Nurses talk.  I'm a 6'5" male nurse.  I've been asked to take over those creepy patients because nurses just don't care to deal with creeps.  Don't be creepy.

I guess I'm lucky in that regard, I'm on the heart team and all our attending surgeons are actually decent guys to work with. I work pretty much all the time with our pediatric heart surgeon, and even he is a good guy. He's a little high maintenance at times, but a really nice guy once you get used to him. Having good attendings means our residents and fellows are usually decent too, because they see how the attendings behave and know a-hole behavior won't be tolerated.

Why I love my nurses.
I am almost 20 years in as an ED MD
I am out ASAP

I refuse to write narcs or antibiotics off the menu. I would rather practice good medicine.