ER Assigning rooms

[awongaemtcc]

Hello Everyone,

I work in a very busy Level One Trauma Center and was wondering what policy's or procedures you have as to how beds are assigned from triage. We have 4 different areas. An Acute area, two main areas, and a IC/Peds area. Each area for the most part of the day is staffed by one attending. The reason we have two main departments is to split the work for the attendings. Also location wise it's split due to construction. Within each of these area's nursing is split too. So we have a CA who is assigning patients to rooms according to whose up. So let's say a patient is going to Main 1 and nurse x, the next patient would be going to main 2 and nurse y, then the next to Main 1 again nurse Z and so on and so on. What does your department do? Is there a system or dedicated assignment person? Thanks!

[Katnip, RN]

I don't work in ED anymore, but we had one main, one peds, one psych and one urgent care. There was a NP/PA in the urgent care with one nurse, one tech and one secretary. Peds had 3-4 nurses, sometimes 5 and 1-2 certified ED peds docs. the main had anywhere from 1-4 physicians and one NP/PA. Nurses usually had no more than 4 beds to take care of. Each section in the main had a tech, plus one in triage.

We were usually very well staffed, and often had a float nurse to lend a hand to anyone who felt they were drowning or to cover for breaks.

Main was divided into acuity using the red, blue, black, and green color system. Psych didn't open until we had two or more psych patients, which was often, and we had hired a couple of regular psych nurses for that, though it seemed they didn't work there often. After Triage the charge nurse looks at the electronic board to see who was waiting and placed them into their zones according to acuity.

Sounds like great staffing. But The main had 14 beds. We saw over 86K patients a year in a 200 bed hospital. And when half our beds were taken up by ICU boarders the waiting room was outrageous. We were rarely allowed to close to ambulances because other hospitals would close at the slightest sign of being overwhelmed and we were all there was. It was insane.