Long time since I've been here.  Cut my hand on some craft shears tonight.  Couldn't get the bleeding stopped.  Not a very big cut.  V-shaped and in the pad (palm side) below my ring finger.  Beth couldn't find any steri-strips or Dermabond (special glue for cuts) in my medical supply stash.  SSSSOOOO had to go to the ER at RMC to get a couple of stitches.  That place was packed.  This was 9 p.m.  There was a guy there with a fishing lure in his head.  I asked him if he was trying to start a new trend for people who like piercings.  There was a woman there that was throwing up continuously.  I left at 12:30 a.m. and she was still there.  There was a woman with chest pain who had been waiting 4 hours.  There was a man there with a kidney stone who had been waiting for 4+ hours.  A man with cirrhosis of the liver with fluid in his abd. and high blood pressure who was there before I got there and was finally called to the back a midnight.  Ambulances were coming in at a rate of 3 per hour.  They are having to hold patients in the ER because half of the hospital is closed because of no nurses.  I asked them if they ever heard of travel nurses.  The girl who checked me in said she thought they did.  I told her that I had worked there back in the day in the ER.  That torture lasted about 4 months.  I had a friend who barely got out of orientation and quit (that was in ER too).  The charge nurse was about to pull her hair out.  New grads do not need to start out in the ER.  They need at least a year of working on the floor then move to a critical care area.  There was a male new grad there who came into the triage room (at the time it was my treatment room) to complain about his 4 patients.  I can't remember the last time I took care of only 4 patients in the ER.  She had already changed his patients once.  I would have put him in with 4 of the patients they were holding and let him take care of them.  At least he would learn how the floor works with only a few patients.  What a reality check they get when they get their license.  It is nothing like when you are in school.  All of a sudden critical thinking and judgements calls are your responsibility, and you are responsible for the outcome--not someone else.  No one else to blame your mistakes on.  If you have never worked a critical care area where you have to make life-sustaining or life-threatening decisions in an instant, you have no idea of the stress you are under.  It is so intense.  That was why I worked the ER for so long.  I thrived on those adrenalin rushes when a true emergency came in.  When the ER became a clinic, I knew it was time for me to retire.  That was not what I signed up for.  The triage system is not what I am accustomed to.  You don't let a chest pain sit in the lobby for 4 hours and never once come to check on them.  And besides.  It's not up to me to decide whether it is heart related or not.  That is not in my scope of practice.  Get an EKG, show it to one of the docs to rule out heart attack, explain it to the patient, and put them back in the waiting room.  Someone who has high blood pressure with a history of heart disease needs to be checked every 15-30 minutes to make sure his symptoms aren't escalating.  Someone needs to let the patients in the waiting room know what is going on periodically.  They have a fast track section but never opened it up.  Three fourths of  those waiting could have been seen and discharged in less than 2 hours.  Some things you don't learn in nursing school.  Common sense is one of them.  You can't blame the doctors or nurses for the delays.  There are ambulances coming in who are suppose to get priority.  That where your triage comes in.  If they are not a true emergency, put them in the waiting room and let them wait.  Just because an ambulance brings you is should not determine whether you get a room or not.  People have learned that if they call an ambulance they don't have to wait.  Apparenetly that does not happen at RMC.  I don't understand their triage system.  Because it really is not one.  If patient #1 is not as sick as patient #9, then patient #9 should go before patient #1.  Thanks for letting me vent.  Oh.  They didn't even clean my laceration and steri-stripped it with a gap in the top part.  As soon as I got home, I took off the steri-strips, found some dermabond, and Beth and I glued it back together.  Just thought you would appreciate that.  Have a great day and may God bless.