Assigned to TWO units simultaneously, anyone else?

Thank God there hasn't been a code here yet that I know of, but they certainly wouldnt work well. I'd have to run it with the MD and have the guard call 911 for emergency transport to our sister facility.

Legally permitted meal breaks (or any break for that matter); that may be a good talking point for me to take this to upper administration. It definitely has the potential for safe harbor territory, just been blessed that every patient has been stable so far.

It's a shame to be put in position where I may have to move on down the road due to safety concerns. This is an otherwise great gig. Where else do you get the luxury to spend 30 minutes getting a history for and ER patient then still have enough time to make sure all their needs are attended to without feeling stressed?

This sounds crazy. I mean I'm sure it's typically fine, but it has the potential to go so bad, so fast.

How/why are they keeping an ER which typically sees 0-2 patients/day open? And how can they possibly think it's safe to staff an ER (even one as underutilized as that) with *no* dedicated staff?

I think that this ER exists to fulfill the requirements of CMS. I'm not certain if this is correct, but I believe that to participate in medicare and medicaid billing a facility has to comply with EMTALA. So they keep the ER for billing/legal reasons.

My understanding is that all hospitals are required under EMTALA to have the policies and capacity to *evaluate*, triage, and provide initial care for patients presenting with emergencies, but not to actually have an ED. Having an ED that isn't actually equipped for emergencies (which is what I would call an ED with only one nurse who sometimes also has another full assignment) seems substantially worse than not having an ED at all, as it gives the public a false sense of what care is available.

You'd be in deep water if something serious came in and you were by yourself, especially if your other patients were unstable... what *would* you do in a code? Even with a doc, just two people for compressions, bagging, getting access, drugs, intubating, watching the monitor, recording? How long could you each do compressions before you dropped from exhaustion? Is the doc going to bag and give meds at the same time? Heck, how do you even waste narcs when you're the only one there?

I mean, you do what you have to do, I guess, but it sounds... less than ideal. I'd get out of there, personally. It seems like a disaster waiting to happen.

OMG, promise I feel a majority of the time that nurses are treated so unfair, but yet we are needed, it makes it difficult because you want to prove you are capable of doing your job but at what cost? Truly not at the cost of some patients life, and neither at the cost of one's license!