[John Dodge]

I'm interested in talking with nurses who would see the advantage of RN teams privately running rural ER's. It seems that the profession has a general apathy. Nurse's become defensive, hoard authority and shun responsibility, as a result of the lack of authority in the profession. A growing shortage has left many ER's without managers. Only a fool would take on a rural ER in the current state of shortages and underpayment. Education, risk and responsibilty level dictate that the ER nurse should recieve greater compensation. This is aparent with the lack of quality ER nurses.
I feel that small hospitals will soon find themselves negotiating with nurses to provided private coverage of the ER. These nurses will manage the staffing issues, clean up paper work and streamline billing. They will forge an effective environment with the doctor to provide rapid definative care to the masses. They will not tolerate ineffective policies and DON micromanagement. What is a DON in a rural health facility anyway? She oversees a glorified SNF! And we will demand six figure salaries for are trouble.
Ancillary departments will begain responding to urgent situations in a timely manner. These ancillary departments will find themselves with policies that support the ER. The ER nurse will not look at a policy that states they are to disrobe, and remove jewlery from an urgent chest pain. Med-i-cal and Medicare will be billed repeatedly as people find the emergency room as a quick solution to their "problem".
The emergency room will be a source of pride in the community much like the hospital of years past, the high school and the City Hall. The AM-PM and the Wal-Mart are the structures we pay homeage to today. Consumerism may be slowing down in the near future. God, or someone, save us.
If this sounds like more than ranting to you, and you are a quality ER RN please E-mail me with your thoughts on self managment.