Are there "well staffed" ERs?

neneRN, BSN, RN · May 8, 2008

I think our ER is very well staffed, this has really changed over the past year and a half as we have a new manager who is really committed to staffing. We don't use agency in our ER. There are not times when we ever have to close down areas...Our staffing includes a supervisor and a charge nurse who do not take patient assignments, as well as 2 float RNs who do not take assignments, but float to help the ER nurses. The float RNs are staffed from 1p-1a only (our busiest times). So are always an extra set of hands. (minimum staffing is 9 RNs, 4 LPNs, and 3 techs for 27 beds/15 hall beds on our critical care side of the ER; our ER is separated into critical care/intermediate care/pediatrics/fastrac/triage, with separate staffing and charge nurses for each of those areas)

RN1980 · May 8, 2008

only in 2 places, in the mind of hospital administrators and tv land.

BrnEyedGirl, BSN, MSN, RN, APRN · May 9, 2008

The ER where I work is staffed!! We don't use agency nurses. We also had a change of management about 2 years ago,..she has done wonders for the place!! I transfered to ER about 6 months after she took over and created 30 new RN positions!! We always have a charge nurse that doesn't take rooms and we almost always have 5 floats! My new coworkers laugh at me when I say the ER is less stressful than my job upstairs in the cardiac/stepdown unit,...it's because we are staffed!!!

Dixielee, BSN, RN · May 9, 2008

We are fairly well staffed, although we have been holding so many patients in the ER for 12-24 hours or more, we could use more.....generally we start out with 18 RN's, peak at about 24, then wind down some. We have 50 or so beds, depending if you count hall beds, then 64. We try to close all but 25 of them after 2300, but tonight we still had 53 pts when I left.

We have no agency or travelers right now, but have had travelers in the past (I came as one :wink2:).

This is the busiest but best ER/hospital I have ever worked in.

BTW...we were informed we all got raises today, I got .20/hr.! Several got .12/hr. We are all going to splurge with all that extra money, and buy something nice for ourselves, like maybe.....a Coke! :yeah:

RNcDreams · May 9, 2008

We have 30 beds, plus 4 wall beds. Charge nurse doesn't take an assignment- 1 traige nurse- 7 nurses take assignments on days, then one more nurse for the psych rooms & floating = Total of 8 RN's......and if there happens to be an extra nurse, each nurse will only have to take 3 beds because the extra (9th) nurse will take one from each person.

It makes a HUGE difference!!

You can certainly feel the tension in the air when staffing is bad, the board is full, the wall beds are occupied, the waiting room is packed, and the ambulances are pulling up....

But, if there are enough nurses, even if it's busy, that feeling isn't there. People remain calm, and help each other, and the work gets done.

P.S.

At one point, the nurse manager was actually letting it go when there were only going to be 4 RN's on nights.... um, hello?!?!!

A few "unsafe" shifts went by in the face on the winter craziness, and that was eventually addressed, thank goodness.

TraumaNurseRN · May 10, 2008

We have days where there isn't enough staffing, there have been call offs or multiple traumas come in and there isn't enough staffing. We have an on call system too which covers each shift every day of the month. It's only to be used when there are mutlitple traumas / or when we are extremely busy. But lately it has been used when staffing is low. We have to sign up for 2 shifts per month and get paid time and a half when called in. Our hospital does not use agency nursing. I wonder how a facility even does that in an ER? We have 52 bed ED and open PODS at different times of the day. By 11am all pods are open and staffing is normally between 17-20, depending. We have multiple shifts ranging from 3a/3p, 7a/7p,9a/9p, 10a/10p,11a/11p,3p/3a and so on for 12hour shifts. I only work 2 (8s) (7/3 and 11/7) I am always asked to stay over or come in on a day off until recently when I told them I would not. (They screwed me one time too many doing that, and I don't really need the money...there is plenty to do around the house and thankfully hubby's job affords me to work part time.) When staffing is low in the ED your license becomes at risk and I am not willing to do that. Before, I would go in to help my fellow nurses, but when the Docs and the PAs become nasty with us, that's where I drew the line. :smokin: ........Sometimes the money just isn't worth the grief.

SteveNNP, MSN, NP · May 12, 2008

The ED I used to work in had 80 beds, and the N/P ratio was usually 4 rooms per RN except for traumas and chest pains, which were adjusted by acuity. The charge nurse did not have an assignment, and we never had hall beds. The only time I got overwhelmed was when I got a code STEMI and a code stroke at the same time, and needed to be in the cath lab and CT all at once within that magical 20 minutes.

em_elle · May 12, 2008

i once worked in the public hospital... ER in particular... nurses are like one is to WARD! shud it be... one is to one...

Natingale, EdD, RN · May 15, 2008

OMG Our ER is terrible then, we have literally 4 nurses on average at night. That includes the charge nurse who does triage, ambulance triage, and charge. We have 25 beds, and a few chair patients here and there (for sore throats, finger injuries etc etc) We sometimes have 3 techs at night. AND ME!! the only unit coordinator. We do have transport and a BHA once in a while to help stock and transport patients ..or do 1:1s

A lot of people on nights are resigning because of this, I want to get my license already and help out! Just 2 nights ago we were holding 4 step down patients, and one ICU (because we had 3 earlier that shift and they all went up to the floor) On top of all the incoming patients, that kept coming and coming and coming. :hdvwl: