Presenting Symptoms: Severe abdominal pain
Onset: 1 week ago

This was all I picked up from the triage screen before I walked in to do my assessment. We see our fair share of abdominal pain so that I didn't think anything of it. I hadn't received report yet but I wanted to at least eyeball my patients and do a quick assessment because the nurse giving me report was tied up with a patient.

This is a summary of our conversation:

Me: Hi, my name is ernurse and I will be taking over from other ernurse.

A 2 year old patient presented in our ED today with a runny nose and a fever of 102.1F, with no other symptoms. She was cranky, snotty, and tearful. The mother stated that her daughter had had this fever on and off for four days, and that she had been medicating her with Tylenol as instructed to by her doctor, but that the fever had been coming back and not subsiding.

So I recently noticed a trend in myself and my experience in the ER. I am just about to complete my seventh week in orientation, and have about 5 more to go.

The other day I had a patient come in who had basically all but shot off his "little man". For some strange reason known only to himself, mr.big man was carrying a loaded weapon in his belt, in close proximity to his little man. He was obviously either very new to carrying said loaded weapon (he was young), or he was just having a bad day, because somehow he fired the weapon while it was still in his belt.

A couple of weeks ago my friend became very ill and I had to rush her to the ER in a different hospital from the one I work at, simply for geographical reasons. Because she was vomitting almost constantly, we were rushed right to the triage nurse and then into the back, where they inserted an IV-line, took some vital signs, and told us to wait. We were parked in chairs in the hallway and then ignored for the next 4 hours or so without hanging any fluids or providing privacy for her given that she was also basically incontinent of stool by this point and had the worst diarrhea ever.

This past week I had an incident in which the concept of triage became very real to me. Let me first set the scenario. A lot of the nurses had called out sick, there was a bug going around. So there were only 7 RNs on staff that day, including myself, an orientee on my first week, working with my preceptor. We were also short on Physicians, and had only one attending and a couple of PAs at work.