Nurse Quality Manager of the ED

Nursinist · Oct 5, 2004

I became an ER nurse because I intuitively knew it was the right fit for me. After 28 years, I still believe that my touch, eye contact & smile are as important as my education and experience. There is still some naitivity left inside, but it is rapidly being ripped to shreds in the fast changing economics of today's ER.

MrsWampthang, BSN, RN · Oct 5, 2004

so going into ER nursing seemed like the natural progression. As for patient satisfaction, one of the things we have focused on is keeping patients and families informed about what is going on. One thing I wish we could do is get all the docs to turn over patients in a decent amount of time. We have some patients down in our ER for HOURS! Waiting on tests that could be done after admit, waiting on the admitting doc to come in and see them, etc, etc. Oh and then there is the famous, we've got all the tests back and they're all normal so lets add something else on instead of letting them go because there is NOTHING wrong with them, let's add enough stuff on so we don't miss ANYTHING the patient might have wrong with them, even if it has nothing to do with their original complaint! :angryfire Sorry about the rant, just a little pet peeve of mine. I do love the ER, I love the fast paced turn-over of it. Anyway, I'm not sure I answered your question, but that's my $0.02 worth.

Pam :)

ERNurse752, RN · Oct 5, 2004

Not exactly on topic, but...

Apparenlty our "customer satisfaction" has gone down lately. So all ER staff members, including MDs, have to attend an 8 hour class. I won't get into the cheesy title, but we have dubbed it "ER Charm School."

I'll post again after I get my turn on Wednesday. We're all a little disgruntled about it, obviously. It doesn't seem to matter *why* we might have decreased satisfaction all 'round, not just our "customers."

tridil2000, MSN, RN · Oct 5, 2004

I am a Nurse Quality Manager for the Emergency Room at a large teaching facility. Our ER sees approx. 60,000 patients a year.
Here is my question: It appears that patient satisfaction and patient throughout is a constant issue no matter where you are located. However, some hospitals have experienced a miraculous turn around in these areas.
So far I have seen hospital leadership make some good decisions but they appear to be poorly implemented. The action plan does not appear to include the people that do the work everyday. In addition, the ED has been labeled as having a negative attitude... which may be true...but there has to be a reason.
With that being said, I am interested in your opinion (good and bad) on how you think Emergency Departments can improve in patient satisfaction and getting patients in and out.
Why did you choose to be an Emergency Room Nurse?
Do you have good working relationships with the floor staff? Or is it a battle all the way?

i am not sure how long you've done this, or if you are in a teaching hospital, but i will share with you my experience.

i have been a critical care nurse for 17 years. i am usually in the er, but i also go to the icus etc. the nurses in icu, and on other units for that matter, work there and not in er, bc the environment is a little more controlled. they pace themselves and their workloads according to the patients they have. an admission from the er throws this system off for many of them. they have to reshuffle assignments and reprioritize their workload bc of the admission. an admission upsets most floor nurses bc they prefer a more predictable environment. unlike your er nurse who knows you could get 3 or 4 patients in, and you just have to adjust. so, although WE find it easy to cope with with constant change, they would rather deal with very little.

now, of course, sooner or later, they do accept the admission, but it's as if they 'blame' the er staff for having to do that. a typical case of blaming the messenger for the message, if you will.

this is one of the biggest sources of friction between the er and the floors. having worked both, i know both have ligitimate reasons for their frustration. if your patient in icu is infarcting and needs to go to the cath lab now, the er has to understand that you can't possible take the admission. and on the flip side, if the er has another trauma coming in, the icu needs to take their admission now.

what i can suggest to help with this situation, is to have monthly meetings gathering 1 person from each floor to discuss this. the er doesn't work in a vaccuum, but neither do the floors. the patient's journey begins in the er and travels down the road to the icu, or maybe imcu, and eventually to the med surg floor before being discharged. let the staff open up the dialogue between themselves and formulate relationships with each other. soon, each will come to understand and respect each other's situation and appreciate what the other is doing. this will eventually create an atmosphere, that when mary in the er calls nancy in the icu, they know each other and respect one another's situation. again, eventually, when er needs to move the patient upstairs quickly, or the icu needs 30 minutes to prepare, each will trust one another, and respect that request.