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Love, love, love the ER but hate it too

Emergency   (2,492 Views | 10 Replies)

2,818 Profile Views; 17 Posts

I worked in the ER for about 6 years and I truly loved what I did and thoroughly enjoyed the satisfaction of helping those in need. That "feeling", I'm getting goose bumps now even thinking about it, that you get when those doors open up or that stretcher comes rolling into your room and you know you have to act NOW or risk losing someone. That teamwork/family/love relationship with your colleagues in an emergent situation is priceless and I terribly miss it. That critical thinking that you have to do within seconds or risk undesired outcomes. That drive that keeps you hungry to learn more and be better. I miss those days walking out feeling exhausted but content that I made a BIG difference in someones life.

Unfortunately, I cant do it anymore. I couldn't keep risking my license day in and day out. That love for the ER did not supersede my license. I could no longer accept the unsafe practices of having 3 vented vaso-drip patients and have an additional 4-5 patients on top of that, with no assistance (often "tubed" a person and helped stabilize with just one doc and no other staff). I could no longer tolerate the unpractical belief that you have 6-8 beds and regardless of what you have in there, you must take another. Obviously an emergency is an emergency but not offering sufficient assistance and expecting perfection is a quagmire to me. Risking safety for dollars is crazy and i could no longer do it.

Has anyone felt this way so badly you had to walk away from your love? I terribly miss my "love", but I felt I had to to leave to maintain my license and sanity- went into management now. Mixed feelings..... God do I miss those code red (ER/OR come together) situations....:yes:

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zmansc is a ASN, RN and specializes in Emergency.

867 Posts; 11,239 Profile Views

I'd look for a better facility. ER nursing does not have to mean you are risking your license, that is a direct result of a bad facility.

Granted I have never worked in a big ER, but I've worked in two smaller ERs and there was a huge difference in how one facility handled things vs the other. One was unsafe in much the way you described, I saw that risk, and how they treated patients and I didn't stay long. The other was night and day different, when you get overloaded, the rest of the team picks up some of your load. When everyone in the ER gets overloaded, hospital admin finds someone somehow to help. I've had house supervisors grab nurses off the floor, from OR, or L&D, the ICU, etc. They can hang bags, do compressions, discharge 4s & 5s, and document codes. I've had my DON and three directors all doing direct patient care at times. When all hell breaks loose, the facility knows anyone and everyone has to react. Facilities like that exist, I hope you find the right one.

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emtb2rn has 21 years experience as a BSN, RN, EMT-B and specializes in Emergency.

2,653 Posts; 29,167 Profile Views

Agree with zmansc, find another er.

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mamagui has 1+ years experience and specializes in Eventually Midwifery.

434 Posts; 13,158 Profile Views

Ditto- find another ER. If that is what you love, there is no reason that you should not be doing it :) Good Luck and keep us posted when you find a new home

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Carlitos has 15 years experience and specializes in ER, ICU.

12 Posts; 845 Profile Views

Ask for help following your chain of command... Team Leader, Charge Nurse, Clinical Manager, Department Manager, Director/House Supervisor. If all else fails call Safe Harbor. Trust me, if safety is a longstanding problem in your ER, safe harbor will not go unnoticed and will get the ball rolling for a safer ER. Sometimes you just need to put your foot down...

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trackhead has 20 years experience and specializes in Flight nurse, flight medic, ER, ICU, NP school now.

137 Posts; 2,971 Profile Views

What state? Let me guess, NY? That's where all the horror stories with unbelievable staffing ratios seem to come from.

I've worked ER for 17 years, with a fair bit of travel and per-diem over those years. I've never had more than 5:1 ratio in ER, unless it was sub-acute urgent care stuff.

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zulu5150 has 18 years experience and specializes in Emergency/Trauma, Teaching, Faculty.

2 Posts; 438 Profile Views

I have over 18 years of ER/Trauma experience and I would agree that your management team is not paying attention if the RN to pt ratio is so insane you feel that your license is in jeopardy. I am not certain of the state that you live in, however you may look at other local facilities and possibly a Level I or II Trauma Center that is a teaching facility would be a better place to work. Talk to other RN's in the area and see who loves where they work. I agree you shouldn't have to leave ER just because your management team sucks.

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48 Posts; 2,643 Profile Views

Is there such thing as claiming safe harbor in your state?

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Aggie RN has 18 years experience as a ADN and specializes in ER, HH, Case Management.

49 Posts; 3,715 Profile Views

I'll jump on the dog pile and say find another facility. Your description suggests a horrible corporate culture which ain't an easy fix. Good luck!

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RN_rescue_ninja specializes in ER.

46 Posts; 1,002 Profile Views

Sounds like it's not a problem with ER nursing, it's a problem with THAT facility's ER.

Investigate and find another ER that is not like that one!

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tarotale has 1 years experience.

453 Posts; 11,206 Profile Views

I hear that my facility does not allow critical staffing status even though it is critically staffed, which means when I might have 2 criticals, they could easily give me 1-2 other pts and say "well, we are sorry, but..."; doesn't allow divert either. Plus we all know for sure safe harbor=kiss the job goodbye. What could someone do about this situation? I have insurance but I don't think that's enough for saving my neck (because once you accept assignment, you're liable).

What have you done in those situations? Has any of you called safe harbor before or refused a patient??

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