hi! my name is jean and i work in memphis, tn. our hospital is one of the
smallest in the city; we have 23 beds in our er. 4 of them are designated as
chest pain center. we just started this a year and a half ago. these beds are
to sleep patients that come in complaining of chest pain and get serial
troponins and then a treadmill. this was started to reduce the # of unnecessary
admits. BUT, the last 6 months we have not used the chest pain center for this
purpose. it has become a holdover area. needless to say, the chest pain center
patients are now kept out in the er and are miserable along with the nurses that
have to try to keep up with the labs and q 1 hr rhthm strips (not to mention the
c/o the patients about having to sleep in the er). the reason we have started
holding all of a sudden is b/c parts of our 2nd and 3rd floor have been shut
down due to staffing shortages. we have adjusted pretty well to being floor
nurses again along with caring for acute er pts. it
gets hairy when 20 of our beds are holdovers, but we always manage. the
hospital has recruited nurses from other facilities and offer them crises pay to
come and care for the holdovers. so far, this has helped alot!!!!!

Ralph Cochran <rcochran9867@...> wrote:Robert I agree with you...in part;
I have worked the floors and in
the ER and the work load is busy on both but very different. One of
the greates differences is on the floor when you're full you're
full in the ER the wall smust expand to full the need beds are
placed in hallways cubby holes and the closet if necessary to get
patients in to be seen. The positive aspects of ER nursing is you
actually have a doctor in the inmmediate area and don't need to wake
ont up at 2 in the morning and listen to them rant and rave about
it. Another different aspect is when we hold patienst in the ER it
takes up bed space for patients coming in to the ER to be seen.
Emergency rooms are designed to get the most patinets in and out as
physically possible . They are not designed to hold patients; there
are no bathrooms in each room. most don't have televisions or phones
in every room - some rooms are not even rooms, but curtained off
areas with no provacy whatsoever they are not designed with
comfortable beds but thin mattressed stretchers. there are no chairs
for visitors to utilize in these areas and if they are they are in
the way of staff and subject to be moved out of the way and stuck in
a closet somewhere. When a pt comes up from the floor or is a direct
admit yto you you know what the diagnosis is and the patient has
been stabilized foir the most part. In the ER the only warning we
get is, at best, a fractured report over a scratchy radio by a
frazzled medic or first responder with limited training in patient
assessment. While I have great respect for EMS personell, and was
one myself for a long time, (as with our profession) some are better
at it than others. Sometimes the only warning is a loud sound at the
ambulance bay door as someone bangs at the door trying to get in.
The pull issue from the floors doesn't usually happen because
staffing is kept to a minimumon the floor to keep costs down. if the
ER is busy, chances are that the floors are filling up as well from
admissions from the ER so no help is available to be pulled. If
there is available help, the newest nurse on the floor usually a new
grad, is sent because nobody likes to be out of their comfort zone
fromtheir normal unit. The unwriten law of "send the newbie
prevails" To get back to the point. I DO agree with you on the
principal issue...AS ER nurses, we KNOW about the things that I just
spoke about and we chose to work in the ER anyway...Either deal with
it or switch to a more controlled environment. I get job offers
weekly via the US Post office in all areas of nursing so there is no
shortage of opportunities out there. Before anyone gets mad at me
let me temper my comments by saying that I don't like the situation
any better than anyone else but we have to remember, the patient
comes first. It has to be that way or we are no better than
the "pencil pushers" we get angry with every day that institue the
insane staffing guidelines and cost saving measures that are forced
on us, making our job just a little harder than it should be.



--- In emergency-nurse@yahoogroups.com, Robert Jellings
<robertjellings@y...> wrote:
> I'm sorry to say but I think your nurses may need to grow up a
little. I realize the job in the ER is difficult but it is just as
bad on the floor. I'm sorry if I offend anyone. I have seen many
nurses complain about their needs and then neglect the needs of
their patient. That is why we are doing this. I don't think nurses
should take whatever abuse they get from their
patients/superiors/family or other staff but I do think that putting
a patients needs before their own, as long as it's safe to do so, is
important. That being said. Maybe you could see if some floor nurses
would like to float down or come in on those days when you can't get
anybody. Of course they would need some orientation. But some may be
up for it because burnout happens there also. And it would be
cheaper than Agency nurses.
>
> "Sherry Walter, ECC" <slwalter@n...> wrote:Are there any hospitals
out there who have very high patient satisfaction scores with
>60,000 visits that would be willing to
> share what they are doing to achieve high scores. If so please
contact me via email or telephone.
>
> Also, does anyone have any suggestions on how to handle boarding
pts in the ER? Any creative strategies...as you all know ER nurses
are not Floor nurses and it leads to burnout.
>
> Sherry S. Walter, RN, MSN
> Clinical Director Emergency Care Center
> Phone 783-1648
> Pager 789-6836
> Fax 783-2384
> slwalter@n...
>
>
>
> www.Emergency-Nurse.org - the home of Emergency Nursing on the
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