Your Dream Emergency Department...

[LegzRN]

What kind of things would you have in your Dream Emergency Department?

I'll start. My dream ED would...

-never have admit holds because the hospital would always have open rooms and adequate staffing on the floors.

-all meds would be in the pyxis so I would never have to wait on pharmacy to ship them down (with the exception of meds that pharmacy needs to mix)

-labs would never hemolyze

-All IV lines would draw blood and never infiltrate

I think I could make this list go on for days...

[star77, MSN, RN]

1) Available inpatient rooms with RNs who WANT to fill them and are more than happy to take our ER patients.

2) Everyone likes helping out, isn't burnt out, and doesn't give anyone "the evil eye." (No lateral violence). In fact, maybe people pay it forward because they know how hard a shift can be (oh wait, I actually *almost* have this scenario, which is really cool).

3) Labs don't hemolyze. And if they do, the lab techs have to come draw them (oh wait, that was at my LAST hospital... and it was kind of awesome).

4) The docs keep acting exactly like they do, because I have to say, the attendings and residents I work with? Rather awesome.

5) Only people who want to work night shift work it. And if you work nights, you get extra vacation, extra medical benefits, a 30% differential and you only have to work 2 nights/week because 2 nights is really like 3 days. If only...

6) The techs actually do their jobs. And we actually have enough techs.

7) Everyone rotates through the trauma room and has an awesome call with enough help in any given night they're there.

8) Pediatric patients always make it. And their parents are appreciative of our efforts.

9) Magically, those with a DNI/DNR actually arrive with a perfect POLST in place and with family members/durable powers of attorney who agree with the patient's original plan of care and allow them to die peacefully.

10) Triage gets to say NO to the drug seekers/regulars. Oh and there's a 24 hour "urgent care" next door to take these folks. With a pain management team.

10a) There's a statewide narcotic management alert team who tracks those who receive narcotics cross-county and where they are purchased and by whom.

11) Management promotes appropriate people, instead of those who elicit eye rolls and sighs.

12) We pick our perfect schedules.

13) Free. Coffee. (If you're gonna go, go big, eh?)