Is this common? The new face of the ED

Ernurse2012 · Aug 20, 2012

I have worked in the ED for 4 years. Anyone who works in an ED knows the current situation with ED care. Too many patients (esp with non-urgent complaints) and we are incredibly understaffed. The turnover is so high, like I said I have been there 4 years and I figure I am in the group of 10% of RNs who have been there the longest. I have seen waves of nurses come and go. Recently it has gotten even worse. Our management obviously is lacking. Many of the patients are "entitled". The services at our hospital keep decreasing to cut costs. I have not had a raise since I started, they always find a way out of it on a technicality. I love taking care of most of my patients ;-P and of course we are supposed to rate high on surveys for reimbursement reasons. On the other hand we are supposed to be fast and turn over the rooms quickly. It is an impossible situation. Either "too slow" for management and the patients love you, or too fast for patients and they feel neglected, "treated and streeted". I spend time educating my patients, making them feel comfortable understanding the care they receive, etc. Normally I do this while I am inserting and IV or some other task where I would already be in the room. To be honest, I can't keep up with 4 critical patients at once - literally as soon as a patient is out of a room they bring another one down the hall while someone is cleaning the room. I don't feel like I can give good care this way. Maybe it is just me - doesn't seem like it based on the number of nurses who have quit working at my ED, I've talked to them of course. And it seems to be getting worse - we never have adequate staffing (I think it is a danger to the patients) - we are not "rewarded" - a 1/2 hour uninterrupted break in a 12 hour shift is supposed to be reward enough, if we ever get it!
I am wondering what your experience is like. The good parts of my job are that I love most of my coworkers, I get to chose my own schedule - hours and days worked. And it is close to home. Is my experience common? I feel like with the current situation in healthcare it will not get any better and probably worse. Thinking of making a change.

I'm one of the new Ed nurses and I feel the same way u do and I've only been at my job for three months. I'm already looking for a new job.

thelema13 · Aug 20, 2012

I feel your pain. No raises here either, for 3 years (about to be 4) even though we were nationally recognized in Consumer Reports and US News, ranked in the top 20's in the state of Florida. We got cupcakes as a thank you. And no, we don't get our 30 minute break either.

The only way I can get a raise, is by graduating grad school. What a shame.

julianne.00 · Aug 22, 2012

I've been in the ED for a little over 2 years. It's exactly the same where I'm at.

brainkandy87 · Aug 22, 2012

There's a reason why nurses and, specifically emergency nurses, have a week dedicated to them. Ever notice how the only people who get weeks donated to them are the overworked and underpaid?

That being said, I love my job. Do we deserve to be paid more? Very much so. However, I'm not off trying to jump into some easier nursing gig where I could probably make double what I do in the ER, because I believe that loving your job is more important than a few extra dollars. Not a lot of people get to have a job they love. I feel fortunate to have that little perk.

LilgirlRN, ADN, RN · Aug 22, 2012

Identical to yours. I started in the ER 23 years ago. My big job was making sure everything was restocked. This was WAY before PYXIS. We used to do minor procedures like mole removal too so we had to scrub trays and repack them to be sent to the autoclave. One night we saw 16 patients. The staff was me, an lpn, a secretary and the doc. The doc quit in the morning. I worked 11-7 back then. As far as raises go, I got one in March for 72 cents. Better than nothing I suppose.

Dragonnurse1, ASN, RN · Aug 22, 2012

I spent 9+ years in one of the three ER's in my city. When I started we rotated "ER of the day" so that no one hospital bore the brunt of non-paying patients but that got to be a joke. No one liked one of the hospitals in the rotation because they collected five dollars every time the patient came in so we would get slammed 2 nights in a row. Staffing was horrible - try being night charge when you have less than 1 year experience, one nurse in triage until 3 AM, one nurse on the track, a unit clerk, a PA and a Doc. Of the 5 nurses that started together, I was the only one left after 3 months. I worked on a survey we did in house checking turn over time and our average was 2 hrs and 37 minutes - management decided that was too long. The survey was done with all charts for 7 days - that included true emergency's, chest pains and clinic patients. We also had to deal with interns (we called them baby docs). My first Christmas there we got a bonus from the hospital, a fifty dollar gift card from the physician's group and a 20 pound turkey but by the time I left we were being given a gift card to Walmart in the amount of ten dollars and then were expected to "donate" it back. We had 8 chest pain rooms, 4 trauma rooms, minor surgery/cast room (2 beds) and 12 fast tract beds for a total of 26 beds but if you added the hall beds we had 34 beds. On nights we averaged 6 RN's, 1 unit clerk, 1 PCT and the Doc but many nights we actually had 4 nurses, 2 PCT's and a unit clerk. That was 2005 so I guess nothing has really changed.

Sadly we would "stack 'em, pack 'em and rack 'em until we could muddle through - it often felt like we were running cattle, BUT I would have never left had it not been for latex. I loved my job, we had not had a raise in 3 years even though management managed to provide all the upper suits with brand new Lincoln Navigators yearly, I still miss the job just not the way we were having to do it. I made those special patient's I was privileged to care for into moments of clarity - This is why I do this, this is why I stay- it was not the money. It was the Zebadee's of the world that kept me there. Damn latex.

Natkat, BSN, MSN, RN · Aug 22, 2012

I would have never left had it not been for latex. Damn latex.

Why is that? Are you allergic to latex?

billyboblewis · Aug 22, 2012

Sorry ER nurses. I have worked off and on in ER for many years and it is a much lighter job than working the floors. I am sure there are many times you get plenty of time to eat and someone goes out and picks food up. No one in the nursing field is getting giant raises. Is there some reason you think ER would be singled out?

Now as a patient on occasion in the ER I can say that I have found nurses and Doctors to be on the lazy side and very disrespectful to patients when they dont see blood and guts or compound fractures or chest pain. So I have a headache and it doesnt go away. The pain is what made me go to er in the middle of the night not an urge to get narcotics. I dont have to hear an RN say you just ran out of your prescription. It is really sad that you can go to an urgent care and get better treatment of staff with less training. So to make things clear I almost lost my life because nurses and doctors in the local er did not diagnose my subdural hematoma with all the standard symptoms and history.. ER people get your act together and treat all patients well.

I have worked in the ED for 4 years. Anyone who works in an ED knows the current situation with ED care. Too many patients (esp with non-urgent complaints) and we are incredibly understaffed. The turnover is so high, like I said I have been there 4 years and I figure I am in the group of 10% of RNs who have been there the longest. I have seen waves of nurses come and go. Recently it has gotten even worse.
Our management obviously is lacking. Many of the patients are "entitled". The services at our hospital keep decreasing to cut costs. I have not had a raise since I started, they always find a way out of it on a technicality. I love taking care of most of my patients ;-P and of course we are supposed to rate high on surveys for reimbursement reasons. On the other hand we are supposed to be fast and turn over the rooms quickly. It is an impossible situation. Either "too slow" for management and the patients love you, or too fast for patients and they feel neglected, "treated and streeted".
I spend time educating my patients, making them feel comfortable understanding the care they receive, etc. Normally I do this while I am inserting and IV or some other task where I would already be in the room. To be honest, I can't keep up with 4 critical patients at once - literally as soon as a patient is out of a room they bring another one down the hall while someone is cleaning the room. I don't feel like I can give good care this way.
Maybe it is just me - doesn't seem like it based on the number of nurses who have quit working at my ED, I've talked to them of course. And it seems to be getting worse - we never have adequate staffing (I think it is a danger to the patients) - we are not "rewarded" - a 1/2 hour uninterrupted break in a 12 hour shift is supposed to be reward enough, if we ever get it!
I am wondering what your experience is like. The good parts of my job are that I love most of my coworkers, I get to chose my own schedule - hours and days worked. And it is close to home.
Is my experience common? I feel like with the current situation in healthcare it will not get any better and probably worse. Thinking of making a change.

billyboblewis · Aug 22, 2012

The ada can force your department to go latex free. It is considered an economical remedy

rhellner57 · Aug 22, 2012

that is why I started traveling, most places I feel needed and have a bit of a say, then there are others where I am a body and they don't even acknowledge me in the most part but I can do anything for 13 weeks and move on or stay my choice

redhead_NURSE98!, ADN, BSN · Aug 22, 2012

Maybe it is just me - doesn't seem like it based on the number of nurses who have quit working at my ED, I've talked to them of course. And it seems to be getting worse - we never have adequate staffing (I think it is a danger to the patients) - we are not "rewarded" - a 1/2 hour uninterrupted break in a 12 hour shift is supposed to be reward enough, if we ever get it!

I don't work in the ED, so I don't know what it should be like, but I just wanted to say that if you're not getting an unpaid 1/2 hour lunch and two paid 15 minute breaks, REFUSE to clock out for lunch. That's illegal if you are paid hourly, and the reason that they continue to treat us that way is because we tolerate it. I'm tired of it. If I clock out for a lunch and I don't get my full one-hour throughout a 12 HOUR DAY I edit my time sheet so they can pay me for my "lunch" (during which I usually get interrupted with work stuff anyway.) I DARE anyone to call me on it, and they never have.