New nurse, need some more info on ER

Specialties Emergency

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I’m a new nurse and I was recently offered an ER position. Can some ER nurses here share what is their nurse to patient ratios in the hospital? What specific tasks do nurses in your ER routinely do for each patient or what are the main responsibilities of the ER nurse? Which assistive personnel work on your floor and what tasks do they typically complete? How does the night shift in the ER, compare to the day shift (workload and staffing)?

Thanks in advance!

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Specializes in Emergency.

Welcome to the darkside. You might want to check the stickies at the top of the er forum lot of good information there.

Assessment is the primary responsibility of er nursing. Constantly assessing our peeps. Not head to toe but specific to their reason for the visit. The follow-up to those assessments is intervening as needed, whether with existing orders or getting new ones. Implementing then re-assessing.

Tasks? Iv access, tubes into every possible orifice, labs, vs, meds, transport, cleaning rooms when housekeeping or tech not available, making sure the docs don't kill anyone (you sure you want to give rm 45 2 of dilaudid?), charting everything, reprioritizing priorities and more. Such as codes. We are the code team. Stabilizing pts so they can get to the unit.

Ratios? Mmmmm, doors never close. Depends on acuity. Can be 1:1 or as nutty as 10:1. Depends. Our nm basically staffs for a 4:1 ratio.

Our techs do vs, ekgs, ortho stuff (crutch teaching, slings), wound cleaning, pt cleaning. We work as a team.

Nights less management, fewer pts (but not always), less staff, less families (but not always).

Hope this helps. I'm sure there will be more articulate reponses.

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Wow, thanks, that info is very helpful!

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Usually 3:1 or 4:1, 1:1 if critical. We have techs, but they are in short supply, so we frequently do our own IV sticks and lab draws, transport to CT, VS, cleaning/toileting, etc. Basically the nurses do everything.

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In my ED, ratios are 5:1, 6:1, or 8:1 depending on the assignment. We have only 1 tech for days or nights. During our busiest hours, the tech is usually tied up primarily with transport, either with admissions or to radiology, so I do pretty much everything there is to do for my patients, except for ECGs and respiratory, and there is an RT for those things.

We also have no tube system, so we have to go to pharmacy to pick up anything that isn't kept in the ED, and we sometimes have to run our own specimens to the lab. Going to the lab isn't really much of an issue when we are busy since the phleb is usually in the department often enough to pick them up.

When the tech has time, she is able to do foleys, IVs, and splints, along with the usual stuff like cleaning rooms, wiping butts, and helping to toilet patients, among a myriad of other tasks.

I almost forgot, ratios don't vary between days or nights, but we start to lose nurses at 23:00, so if we happen to be extra busy or are short staffed, the charge nurse will have to pick up an assignment early, which shouldn't happen until 03:00. There have also been occasions when the charge has had to take more than one assignment.

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Specializes in CEN, CPEN, RN-BC.
welcome to the darkside. you might want to check the stickies at the top of the er forum lot of good information there.

assessment is the primary responsibility of er nursing. constantly assessing our peeps. not head to toe but specific to their reason for the visit. the follow-up to those assessments is intervening as needed, whether with existing orders or getting new ones. implementing then re-assessing.

agree!

tasks? iv access, tubes into every possible orifice, labs, vs, meds, transport, cleaning rooms when housekeeping or tech not available, making sure the docs don't kill anyone (you sure you want to give rm 45 2 of dilaudid?), charting everything, reprioritizing priorities and more. such as codes. we are the code team. stabilizing pts so they can get to the unit.

very much agree! does that 90 year old lady really need dilaudid 2mg and ativan 1mg?

ratios? mmmmm, doors never close. depends on acuity. can be 1:1 or as nutty as 10:1. depends. our nm basically staffs for a 4:1 ratio.

agree again!

our techs do vs, ekgs, ortho stuff (crutch teaching, slings), wound cleaning, pt cleaning. we work as a team.

teamwork, learn it and love it

nights less management, fewer pts (but not always), less staff, less families (but not always).

agree with the not always part

hope this helps. i'm sure there will be more articulate reponses.

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