ED vs other department pay

tarotale · Dec 12, 2014

I have been in three facilities so far and none payed greater in ICU or ER, although I heard of some that do, and I really think ER should be payed heck lot more than floors. Not to brag, but ER workload and intensity is a bed full more than floor nursing from my experience. I also feel that ER gets extra special attention and as you called it "hospital revolves around ER" feeling. because we are that awesome :)

DayDreamin ER CRNP · Dec 12, 2014

Supposedly, one of our administrative officers is coming in for a staff meeting to address this issue that was presented to the board a few months ago. I didn't know anything about it but someone from the department emailed stating that we are constantly being overloaded with really sick patients, caring for admit holds and a constant barrage of ambulance patients but we never turn anyone away. The floor, on the other hand, has been holding discharges and not putting rooms in for housekeeping so we have to jockey holds because the floor isn't doing their job.

One of our staff members when to one floor a few weeks ago and noted 5 nurses at the desk on cell phones and about 4-5 rooms that were empty of patients but weren't up for housekeeping in the system but the patient had been d/c'd over 4 hours prior. That is unacceptable.

We DO carry more stress and a higher acuity, unstable patient. It seems that we should be compensated for our work. We'll see.

HouTx, BSN, MSN, EdD · Dec 12, 2014

Salaries are market-driven. As long as there are nurses who would rather have a sharp stick in the eye than work anywhere but ED, the organization does not have to do any sort of salary adjustments. In my experience, changes are only made when it becomes hard to recruit/retain staff due to low wages. Sad but true... in many large urban areas, the highest level ED may have the worst compensation just because they have a waiting list of "wanna be hot-shot ED nurses" waiting in the wings whenever a position is open.

elkpark · Dec 12, 2014

Salaries are market-driven. As long as there are nurses who would rather have a sharp stick in the eye than work anywhere but ED, the organization does not have to do any sort of salary adjustments. In my experience, changes are only made when it becomes hard to recruit/retain staff due to low wages. Sad but true... in many large urban areas, the highest level ED may have the worst compensation just because they have a waiting list of "wanna be hot-shot ED nurses" waiting in the wings whenever a position is open.

This ^^. We've had multiple threads here in the past about why ICU nurses don't get paid more, or, in some cases, get paid less, than nurses on the regular med-surg floors. Typically, that's because the hospital has trouble staffing the med-surg floors but has a long line of applicants for ICU positions. It's all about supply and demand. Your administration doesn't care in the least about compensating some nurses for having harder, more demanding jobs than some of the other nurses (although I'm sure there are plenty of med-surg nurses here who would make a compelling case that their jobs are just as high-stress and high-demand as ED jobs); they just care about paying as little as they have to to staff the hospital. As long as you have plenty of candidates for the ED who are willing to accept the current wages, they're not going to get increased.

zmansc, ASN, RN · Dec 14, 2014

I don't think ER nurses are better or the ER is better than other nurses. I do think we have more experience and training with critical skills, and that we utilize a wider variety of our skills more often. My facility is small, and yes, folks from the floors call us for trivial things like IV starts to more serious issues like when a patient turns south and they need more help, so from that perspective we offer a safety net and are looked up at, especially by many of the newer nurses in other areas.

As for the "redheaded stepchild" there are a select few nurses in other areas of our facility who like to point out any and all "errors" they believe the ER did. Typically, they have an inferiority complex along with a set of "facts" that are usually incomplete and/or incorrect, yet they feel comfortable telling any and all what was wrong about some patients care they had nothing to do with. I think whenever someone looks up toward a group and puts them on a pedestal, then someone else is going to try to knock them off.

Typically, the best thing to do is to continue to help and do the best you can, your good deeds and skills will show through. As for those loud mouths, I typically laugh off their attempts to tear me down, and point out their total lack of knowledge of the situation to those who are asking what really happened.

Oh, as far as pay goes, admin has talked about a small increase for the critical care areas here. I don't know if it will happen, but it has been mentioned mostly because we have a shortage of good experienced nurses, especially in the critical care areas.