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I wrote to Jane Fonda today.

I won’t get a response, but I wrote to her anyway. Why not? One of my favorite films is They Shoot Horses, Don’t They? It’s a classic from 1969. If you haven't seen it, then I advise you to rent it. It’s not about nurses but it could be. It's about dancing as fast as you can.

Last week at my ER, and probably like many ERs in the country, the night shift was extremely short staffed. Seven registered nurses to be exact and the hospital did not divert the ambulance patients. Is this safe practice?

Nobody minds a real emergency, in fact nurses welcome it. Bring on the sick, the strokes, the heart attacks, the congestive heart failures, the accident victims, and the stab wounds.

Bring it!

This is an ER and we are ER nurses, trained and prepared for all “notifications.” In fact we will work together to make sure patients are safe and comfortable. Healing is our job.

But what happens when the emergency medical service brings in the drunks and drug addicts to an already exhausted staff?

It takes three nurses to strip an alcoholic, clean the patient, list the property, restrain the combative patient for safety reasons, draw bloods, start an IV, give Ativan, Haldol, Oxygen, monitor vital signs, and listen to the shouts and insults for hours to come. All because of the endemic failures of the healthcare system.

A drunk is not allowed to sleep it off on the streets of NYC. The ER has become a bed and breakfast. What happens to the truly sick when nurses are wrestling with the bullshit of a healthcare system that needs to be re-evaluated? Who is monitoring this, anyone?

The EMS recently brought in a well-known homeless patient to our ER who had literally flagged down the ambulance from the street as if it were a cab. The chief complaint in triage was, “Patient reports, ‘I want a sandwich.’”

When I did my assessment of the patient, he was alert, oriented to person, time and place, ambulated well, and denied any chest pain or problems. Nothing, except, “I want a sandwich.”

The EMS knew this and still brought the patient as an emergency. By law, they have to. If the ambulance is not to blame, who is?

We have a broken healthcare system that does not care about our professional licenses. A license that we as registered nurses worked so hard to get and maintain.

The patient with the sandwich got the best possible care with a clean stretcher to sleep in, Tylenol for a hangover, and fresh clothes from the volunteer office. This patient was still our responsibility and left a happy man.

(By the way, I didn’t write to Jane about my work issues. I wrote to her for personal diversion. She happened to remind me of a cancer patient I loved and adored…one of the reasons I stayed a nurse.)

So RNs, be careful, wise, and safe. When you are short staffed, take your time with medications and take time out for hydration. We have to take care of ourselves, because they shoot horses, don’t they?

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