Nurse Assignments in your ER

[jsoed9582]

I am looking to see how different hospitals set up their nurse assignments in the ER. Most ERs are assigning rooms to nurses. The ER I work in does not assign rooms, but lets nurses pick up patients when they want. I feel this is not a very good method... Any comments?

Does anyone know of any literature on this topic? Id like to propose assigning rooms to my manager, but would like literature to back it up. Please help!

[matcgrad]

We had room assignments before we went to team nursing. We now have 3 nurses, a doc and an EST on a team. Rooms are not assigned. If there is a patient then they go to any open room. I like this better than having assigned rooms.

[sbyramRN]

we have assigned rooms. Some parts it is three rooms to one nurse and some parts it is four rooms to one nurse. The "fast track" area has 10 rooms and 2 nurses. We have about 6 attendings at one time and about 10 residents at one time. Sometimes there are a couple of fellows on the floor, too.

[Lunah, MSN, RN]

We do zone nursing, so we're each assigned a block of rooms (five) as our zone.

[taz628, BSN, RN]

we're assigned to "areas" in our ED. We have blocks of rooms that accomodate different levels of acuity for the most part. Our "cardiac room" has the least amount of open beds, but is used for the highest acuity pt's. each area is staffed with an RN and an LPN (except our one hall with the most beds, two RNs and 1 LPN generally). our assigned trauma nurse floats the dept when there are no traumas and helps in triage or in any area getting hammered.

[bjaeram]

I've done it both ways and I much prefer to not have assigned rooms. It is easy to get uneven loads with assigned rooms. You could be assigned four rooms that are all full and all very sick people while your co-workers four rooms are half empty or full of coughs and earaches. Granted the nurse with the easier load should help the one drowning but a lot of people have the not my room attitude. It's hard for the triage nurse to keep track of who has what rooms and who is getting killed and who isn't. We take patients as we are able. Sometimes you have one sick one and sometimes you have 5 minor ones but I think the workload ends up more even this way. It can be hard if you have lazy nurses who refuse to pick up the next patient. It is also hard when an undesirable pt comes in and everyone is suddenly too busy to take it but I think for the most part we play fair.

[LilgirlRN, ADN, RN]

Zone nursing here. We used to do team nursing which worked well if both nurses on the team actually worked. If you were paired with someone lazy you were screwed.

[Jennifer, RN]

We used to do "pod" nursing, where we had a block of 5 rooms and up to 2 hallway beds. We switched to team nursing, with 2 RNs, 1 tech and 1 doc, but usually one nurse would end up doing all the work. So, now, we still do team nursing, but we are assigned rooms, even/odds. That way, one nurse is the primary nurse, assesses the pt, keeps track of labs and outstanding meds and tests, but still has help from the other nurse. We aren't isolated from each other like we were with pod nursing. Team nursing was a difficult transition for a lot of our nurses, but I think it has brought all the staff closer together and we really feel like more of a family