I work in a small rural hospital in the EMS department. Our hospital runs the local EMS service and we are considered hospital employees. I've noticed when we go down to the ED to help during major traumas, codes, or critical patients, the room is always a cluster with 6 people running around.
There's very little organization, things don't flow well and it's hard to keep tracking of who is supposed to do what and if its actually being done.
When I worked in large cities and went to multiple hospitals, I often saw a large chart high on the wall of the trauma room at the head of the patient. It had a simple drawing of a bed with a patient on it and then different roles next to the bed. The charts were often labeled with "Primary nurse, secondary nurse, scribe" or "RN 1, RN 2, RT, ED Tech, MD, etc".
Along with pictures of where people were supposed to stand, there was also a short list of jobs. Who was in charge of venous access, in charge of meds, in charge of compressions, etc. I think it kept the team working on critical patients organized and kept unneeded people out of the room.
I want to find a copy (or several) of these charts/pictures/diagrams to show to our ED Director to see if we can implement it here. My Google-fu is failing me today. Anyone have copies of or links to this kind of diagram?
Tell you a story to contrast what ESME says...
When I was a new grad, I pitched a fit at the small rural ER I started at. Too many people running into the code or trauma when they came in. It was like a free for all. Total chaos in the room. They did this because most of the RNs had left big urban hospitals for a quieter life but still missed the excitement as they were only getting codes every three days or so in this hospital.
I got ignored by the staff but the management and my preceptor agreed with me that there should be a uniform response to codes in the ER. I came in one day and my preceptor told me that I had managed to save a life even while not on duty. A code came in, all the nurses ran into it to "help." This meant four RNs in the room with the code and no RNs for the rest of the unit. Seeing the number of nurses in the room, my preceptor left the room and returned to her patients. She sat down at her desk and noticed a call light and a cry for help from a room.
She went into to find a gi bleeder who had just broken his clot loose and put two liters into the hat. She went and told the ER doc and started fluids immediately.
"Be the change you seek." Gandhi
Last edit by VICEDRN on Nov 1, '12
: Reason: typo