We recently had two *major* med errors in my ER in the past four months with DPH involved both times. Staff turnover is at an all-time high in my magnet hospital and the staff who remain are burnt out. We have an extremely busy ER with somewhat limited resources. There are never enough beds and there is never a time where every room isn't filled. Ever. Our door-to-door times are being reported to DPH now too, which has only added fuel to the fire. Staff consistently report feeling overwhelmed because clinical lead/charge nurses are trying to do their jobs and as a result will give nurses 3 new patients at once to clear the waiting room, without regard for acuity (because if that's the only room available that's where the patient has to go). That might help the wait time a little, but it's not going to help the patient see a nurse or doctor any faster. There are almost never lunch breaks, the nurses are constantly RUNNING, and team work is diminishing because there just isn't time. Admin has responded to the med errors by creating more mandatory policies (some warranted, some for CYA) and education. In my opinion, it's lack of staff and resources, not education. The department is staffed as well as possible, we even a float but it's just not enough for the volume and we are out of places to put patients. The ER was renovated over the past few years but there's nowhere else to grow and the town will not approve expansion, but yet the residents complain about the long waits. I think if we could staff a 1:3 or 1:4 ratio with regard for acuity, our med error rate would diminish to almost nothing. Our nurses are smart and give 110%, but I feel like the system is failing them with patient safety.