Placing Emergency Department Crowding on the Decision Agenda

[NRSKarenRN]

found at medscape.com- nursing economics article.

free registration required

placing emergency department crowding on the decision agenda

introduction

you crash your car and need immediate emergency care. the closest level 1 trauma center is closed. your ambulance is diverted to an open ed, farther away. your odds of survival diminish as the seconds...minutes tick by.

you are an emergency nurse. your assignment is to care for a patient with a myocardial infarction until an intensive care unit (icu) bed can be found, for a trauma patient, and for a patient in the hallway with the gunshot wound to his leg awaiting surgery. another ambulance with a patient in respiratory distress has just arrived. did you go into nursing to have many more patients than you can safely care for?

these dangerous situations are a result of emergency department crowding (edc). edc is a complex, serious problem with no easy solutions. this is a call for nurses to form coalitions with other disciplines to influence policy related to edc at the hospital, community, and national levels. this is a call to the nursing profession to promote adding edc to the decision agenda. the decision agenda is where an issue is about to be acted upon (birkland, 2001). the purpose of this article is to provide nursing with a review of the available research and expert opinion on edc causes, resolution efforts, and recommendations for future actions.

[hrtprncss]

it's not only er nurses, but also icu nurses. it happens all the time where er gets so busy that they try to ''board'' patients, shuffling patients around while an intubated trauma waits on hallway. there would not be much solution to this, patients would still come in, er would still be backed up. on our hospital, the administration ran an idea thru us the icu nurses that they would board er/icu patients in the gmf/gsf with portable monitors. and they expected the icu nurses to be ''on-call'' for the overflow patients in the floor that requires icu care. they wanted us on the go and able to assist and provide care which could be floors away, and still be responsible for our own patients that are unit bound. needless to say it didn't pan out. and the reason why er nurses would have to take care of icu patients down there is that we're swamped upstairs and there's nothing we can do about it.

[teeituptom, BSN, RN]

it's not only er nurses, but also icu nurses. it happens all the time where er gets so busy that they try to ''board'' patients, shuffling patients around while an intubated trauma waits on hallway. there would not be much solution to this, patients would still come in, er would still be backed up. on our hospital, the administration ran an idea thru us the icu nurses that they would board er/icu patients in the gmf/gsf with portable monitors. and they expected the icu nurses to be ''on-call'' for the overflow patients in the floor that requires icu care. they wanted us on the go and able to assist and provide care which could be floors away, and still be responsible for our own patients that are unit bound. needless to say it didn't pan out. and the reason why er nurses would have to take care of icu patients down there is that we're swamped upstairs and there's nothing we can do about it.

While there is always someway for those ER Nurses to handle whatever comes in the doors, We can always take more.