Ummmm..are they ALLOWED to do that? - page 8

OK, I have worked in about 5-6 different ERS, both as staff and agency an I have never experienced this. Right now I am doing a contract in a dinky little community non-teaching hospital. The ER is... Read More

  1. by   MAISY, RN-ER
    All I can say is-Thank God for teaching hospitals!! The most we will take on as an assignment is 6 patients(believe me that is stretching it!) Our area dictates that people want every test under the sun, and our doctors capitulate. We have also seen our suburban hospital change from middle class to inner city clients as hospitals close. Many of our patients are admitted-this has caused the formation of 24 hour observation units-chest obs, abd obs, and stroke obs. Our telemetry has also been broken up into low risk, med risk and high risk cp. We also have many holds in our ER. I don't think a floor should ever be able to send a patient to the ER unless a medical hold is removed. I agree that ER nurses are used to using drips and have everything and everyone they could want in the event of a code on site. However, loading up an ER nurse with critical patients is also wrong.
    If ICU nurses can only have two patients due to the "critical nature of their patients" how do I have 4 patients that are going to ICU? I am so sick of hearing the issues these nurses have with everyone else! I am also sick of hearing the advanced degree nurses whine about their pay commensurate with education. THAT SHOULD BE THE LAST REASON WHY A NURSE IS CONSIDERED A GOOD NURSE! While education is worthwhile and may expand a person's horizon, being able to attend classes, lectures, write articles a paper is not helpful to a patient if the nurse is unable to bring her knowledge and action to the table when it is required! I have seen this happen many times during the past couple of years! On the other hand, I am also sick of hearing the floor nurses complain that orders have not been initiated on admitted patients. Everything I do must be entered by me-no secretary, no technicians, no assistants taking vitals, or doing BG readings or drawing blood. Meds must be sent by pharmacy at each administration-so add those phone calls as well as consults orders to my list of BS duties. We draw our own labs for everything when the patient is held in the ER(no phlebotomy here). Now imagine, having 2-4 hold patients with extensive orders and a cp roll through the door. I have one person who is possibly dying, and one who needs his ice water, or better yet bed bath(92 year old former physician last week). ER is becoming a mish mash floor that people stagnate as they wait for some type of resolution. What is becoming really ridiculous is that patients are being admitted to the hospital as patients and actually being discharged from er 2 days later. How pitiful is that?
    Sorry I went off the topic, but I believe many things could be better...the first step would be to remove nurse managers who have no business experience-they are no match for hospital administration. The second answer would be to have staffing available to open area that are closed due to low pt population-and I don't mean at shift change! Physicians with backbones who aren't cowed into ordering millions of tests due to fear of patients threats. How about direct admits-what happened to them? Almost forgot about the physicians who send pt to ER when they call and say they have high fever, sob, or any other ailment that is sent to ER and turns out to be benign. What happened to physicians who actually doctored their patients? How about educated consumers-educate patients about why you need an ER, and what constitutes a "real" visit.
    NOW I FEEL BETTER-good luck to all-keep plugging away!

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