ED support

[ERnurse1983Ontario]

Hi all,

I work in a busy 40 bed ED. In our ED nurse to patient ratio is 1:5 unless you are in the trauma bay where there are 2 nurses to 5 beds. As the RN, each new patient presenting to the ER you are responsible for doing the bloodwork, ECG, secondary assessments, etc. If the patients happen to be admitted than lab techs will do the bloodwork and ECG techs will do the ECG's. what kind of support staff do you have in your ED's?

[Runner1989]

I work in a busy level one with about 70-80 beds depending on our hallways... We have ED techs that transport pts , do EKGs, can straight stick for blood, and do vitals. However, it is our ultimate responsibility to complete these tasks. Usually our techs are so busy either with a trauma that just came in or transporting our admitted pts upstairs that we are to complete these ourselves. It can get hectic at times..

[brainkandy87]

Level 3, 20 bed main ER, 10 bed fast track. We have a nurse-patient ratio of 4:1. Typically we have 1-2 float nurses/medics (3 on a fully staffed midshift) and 1 am tech, 1 mid tech, 1 pm tech, along with a free charge nurse. If needed, we have lab techs available to come draw blood (and they have to be present for t&s and codes). If we are extremely busy, we can call a code purple, which means that the floors have to come transport their own admits and radiology transports all of the pts for scans and films.

[DC Collins, ASN]

We have 1:3 ratio as standard, but if things get nuts sometimes it reaches 1:4, and it often reaches 1:4 if we get drunks, suicides/other mental health evals. (Fast Track is another matter entirely)

But the only floats we have are those who give breaks for the most part. If all breaks are covered then we might get a little extra assist for a short time. We do have Techs (we are usually short on them though) who can do straight sticks, but 9/10 times if we are going to have to poke someone in the main ED we usually just start an IV just in case we have to give meds.

Almost always a tech is doing ECGs, mostly because they do so many of them they are better and faster at them than we RNs are.

On the other hand, since our techs (again, usually short on them) are usually busy doing 'real work', once our d/c charting is finished we RNs are quite often busy cleaning the rooms to get the next pt back quickly. /shrug

DC :-)

[VICEDRN, BSN, RN]

I work in a Level I trauma center; 100 bed unit. We have:

Two phlebs. One of which remains in triage.

Two EKG techs. They do all of the EKGs. We have no access to the machines.

We have several techs and paramedics as well as float nurses on good days.

Having said all of that:

We almost always draw all of our own labs unless the patient had labs drawn in triage. IT is difficult, if not impossible to find a tech and thus, nurses here anticipate doing all of their own patient care for the patients though they are supposed to take vitals and assist with trips to bathroom, changing patient, etc.

Our paramedics may transport patients or hook up to monitor. OTherwise, we do everything.