ER Orientation

[tknrn]

I am the ER Supervisor in a rural hospital. The ER is staffed by a PA in the day from 9-5 Mon-Fri. My dilemma is that she seems to insist on taking a RN that is not trained to work in the ER back to the ER when it is busy to "train her". This has been done after being asked not to by the DON and myself. Part of the problem is that I work the night shift and am rarely there during the day.

At this time I am working on a new policy for the orientation of new nurses to the ER. This includes at the least PALS, ACLS, and TNCC. The plicy states that orientation will include 30 days of orientation with a preceptor. The preceptor is to be an experienced ER nurse. Does this seem adequate or not adequate enough. Thanks for your input. I am at the end of my rope with the PA's interference.

[magicman]

AFA your question, the minimum 30 day time frame sounds pretty good overall (although longer might be better depending on your daily census). The certs you want nurses to have are good, but requiring them before being hired will diminsh the pool of available nurses to choose from. you might want to make it that they obtain those certs within a certain time frame once hired (i.e. one year, 6 months, etc.). Although a minimum of ACLS wouldn't be too stringent IMHO.

I Do however have a few questions. First, why is a PA pulling a nurse from anywhere to do orientation? Is that not the nursing departments function? Second, if the PA pulls a nurse in to do orientation, does that not count against the nursing departments budget? How can someone outside of the nursing department do this without any consequence? It sounds as though either the department manager (I'm guessing that's not you) and/or the DON of the facility need to do something official (i.e. incident report, disciplinary action, official discussion with the medical director, etc.) based on your facility's policies. The PA should have NO control over nursing staffing or scheduling whatsoever. Again, IMHO. :)

Good luck and I hope you get this sticky problem solved soon! :)

[tknrn]

Thanks for your reply. I guess to explain this better. We are a rural hospital (CAH) with acute beds totaling 18, ICU, OB and ER. They nurses are staffed usually with 2 Rn's, 1 LPN, and 2 CNA's..1 RN is charge nurse and 1 nurse is ER.

Other then myself no one nurse is scheduled just for ER. Usually on the 7A-7P shift there are 3 or more RN's in house..doing supervisory or "paper"..if the ER is busy instead of having these nurses that have ER experience come back to help the PA has the unexperienced RN come back to help as she thinks the reason this nurse is not working the ER is because she is unliked..the PA covers the ER during office hours so the physicians can stay in their offices and not have to cover ER...at this point I feel that the best option is a policy signed by the Medical Director of ER and the CEO. the DON has been on vacation and during this time is when the nurse has been in ER since we have told the PA no nurse without training can be in the ER.

I am really not whining..just looking for input to try and fix this problem.:)

[teeituptom, BSN, RN]

Wowsa Orientation just keeps getting longer

My first day in this current ER almost 18 yrs ago. I was introduced to my preceptor on the first day. Went on to work, saw her at the end of the shift. She asked me if I killed anyone. I said no. That was the end of my orientation.

Things keep changing