Thanks for clarifying. You're right, I interpreted you completely wrong. I thought you were thinking ALL ER's are like that one; they're not, most allow/encourage autonomy amongst the nurses, and the doctors treat the nurses more like colleagues than subordinates. These are major reasons I have only done ER my entire career, I could not imagine doing med/surg. I cringe when we are holding patients for days and I have to try to figure out the floor med.schedules to keep their meds up to date while they're waiting for their floor beds!
Sounds like you have a handle on the situation. Those old-timers do not like you or those like you who try to change the way they've been doing things. I suspect, like you, that much idle time is spent with the justification that "the doctor didn't see the patient yet", and don't forget, if the beds are filled, no more patients can be brought in from triage! Will it change? Only with enough "new blood" to push the issue! I don't know what your personality is like, but many ER nurses I know kind of "go to the beat of their own drum". The nurses currently working who are from the 60's will have to change eventually, or retire. You should stick it out for as long as you can so it does not look like it is YOU that can't cut it. Do the per-diems as they come up on the med-surg floors to keep yourself sane. If things don't change in a reasonable time limit, or you don't feel able to practice in your own way, try to find another ER. Just from your short note, I think that you may be happier in a more aggressive ER. No matter what "Level" an ER is, if it is in a large, urban area, the nurses may be more your type. Patients must be moved along, and everyone benefits from more aggressive workers. Don't forget, those RN's are not above you no matter how long they've worked there. They depend more on the techs because they can delegate to them what they must do and not do. They cannot delegate to you, as RN's cannot delegate to RN's. They are probably intimidated by you. Again, stick it out if you can, but if it's torture, try and find another ER position. Having the chance to literally save people's lives and see the fruits of your labor (or unfortunately the failings at times) is probably the most rewarding aspect that I've come to love in ER nursing. Remember, even the dinosaurs became extinct eventually; yours will too!!
Good Luck! Patty