I am an RN in rural Oklahoma. I have been in ER 11 years and have seen LOTS of changes! We see on an average of 1200 a month, the most of which is on the day shift, 7A-7P. However, we staff 2 RN's each shift, around the clock. We have admissions clerks who register the patient and do all the chart break down and copying. Lab and respiratory care are in house and Xray is in house 3 nights a week(weekends). The rest of the time, they are on call and all live fairly close. We do not have a triage nurse or a ward clerk and I think we need them, especially on the day shift! Myself and another RN do all the QA and the trauma registry.