Quote from gonzo1
the er i work in is 1:4 99% of the time. once in a while i might have 5 if one of my very stable patients has to sit in the hallway to finish up. most of our aids are pretty good, but there is always one or two that clock in and then dissappear for their entire shift. i have seen that everywhere.
i was on here a couple of weeks ago because i had been given 7 rooms at an er i went to for agency.
i checked with many, many people that i come in contact with and they all say 7 is way too much, 4 is the norm.
now some people really dig the desparate situations and choose to work at the
ers where you have an unlimited number of patients. and there are places like that around here. but it is not the norm.
i and my other er nursing friends are not nuts and we want to work in a safe, reasonable environment. we love our licenses and want to keep them.
i love the er i work at. it is really well run, the docs and people are great. it is almost always a joy to go to work.
pm me if you are interested in more information on jobs available in my area since you say you are interested in relocationing if needed. we have tons of hospitals around here. and a couple new ones are opening.
i too love the er and don't want to do any other kind of nursing in the foreseeable future.
i do plan on doing some travel nursing. er of course
i agree with most of this, the er where i work is much the same, and we can't be the only two ers that work the same way.
the only times i can remember having more than 4 patients, it was because of a choice i made. sometimes my four are taking a while to work up, or are waiting on a floor bed with none in site, or might be an overnight obs patient for chest pain.
when these things happen, i will frequently try to put some of the minor/fast track stuff in the hall to get them seen and discharged. (i work nights, and our fast track closes at 10pm.)
i really have a hard time sitting still, esp when i know that work needs to be done. if i can find a doc willing to see a bunch of minor stuff, then i will line them up in any spare space i can find.
of course, i only do this when i have the time -- not when i have a critically ill patient i'm taking care of. and, it is always voluntary -- never because someone tells me i have to take the patients.
i wouldn't go as far as saying that i love to go to work, but most of our docs are pretty good to work with. management isn't too bad. we do have problems some nights getting beds in a timely fashion. we also have problems with supplies -- lately it has been oxygen sat probes, and (as of last night) suture trays.
we're better off than most hospitals in the area as far as ratios. and i really do love our manager. some of the middle managers, though, leave some to be desired. no place is perfect, though, right?
anyway, seven patients per nurse on a regular basis is insane -- i'm not going to go so far and say it isn't safe, because with many of the patients we see, 7:1 is
safe -- stds, coughs, utis, and menstrual cramps arn't exactly life-threatening emergencies, and a nurse can safely
give care to seven of these types of patients. even toss in a hypertensive crisis, and you can make it.
but much more than that, and you have very neatly crossed the line into "unsafe." and that line is very easy to cross, and just not worth the risk.
the other problem is "timely" care. with the extreme push to decrease ed los, it can be very difficult to take care of seven non-critically ill patients and get them discharged as quickly as management would like. so even if you can safely take care of your six patients, plus a hypertensive crisis, those other six patients arn't going to be seen and dispositioned as quickly as they could be.
anyway, my understanding is that ena recomends a 4pt:1 nurse ratio. though that isn't a legally-mandiated ratio like there are in california; since the ena is the professional organization for emergency nurses, that is a standard
that has been set. your employer is foolish for violating a national practice standard on a regular basis.
(hope this all makes sense -- it is time for bed and i don't always convey my thoughts clearly when i'm tired)