Besides the fact that many times, there is a critical patient being worked on while a non-critical patient is waiting to be dispo'd, the biggest barrier I find to admit to removal from ER is the floor.
If I had a shot of vodka for every time I was lectured about door to floor time (we're not dumb, we know what it truly boils down to), I'd be intoxicated every shift I work.
The bed is dirty, although I think it's funny that I can wipe an entire ER room down with sani/bleach wipes in 5 minutes.. The nurse has not been assigned, the nurse is on lunch. The nurse is off the floor, the nurse is in report, the nurse is busy with a patient (again, I know floor nurses are busy), This patient is not appropriate for the floor and we are calling the supervisor, ect.
What have we done about it? There's really nothing to be done about it. This is just how it goes. We've gone up the ladder and nothing changes. I guess when reimbursement plummets, maybe we'll see a change