Uptoherern

In my job no matter what you do it isn't good enough. Our "mandatory" meetings are always at 7a. We are constantly lectured about lwbs percentages and what we are doing wrong. We hardly ever hear about what we are doing right!

It's usually not the case that there aren't any beds. It's because they staff so tight (wad) that there aren't enough nurses to take admits. Nobody on call either. So the patients lay in the Er and it causes a trickle down effect. Increases left without being seens (such horror!) and waiting times and complaints. It's so obvious what the solution is but apparently no one can see it from the ivory towers.

seriously???????????????? get a life.

I triaged an elderly man whose complaint showed up in the computer as "hand injury". When I asked how, he proceeded to tell me that he had had some severe chest pain and collapsed to the ground, thus injuring his hand............we have no cath lab.......acute MI........flown out by helicopter for an "injured hand."

EEEKS! no one addressed EMTALA that I can see. Your ER is responsible for everyone in the ER and for everyone WITHIN 250 FEET OF THE ER. Call security.

i agree; it is confusing. We just started it & were basically given no "ground rules"; just get them to a bed, "maybe" put the cuff on them, push the button & walk away. So far the nurses are ******, the patient's seem confused & the docs want "at least a set of vitals and a weight" before they go in the rm. Ideally athe assigned nurse & a doc are supposed to go in the room at the same time. How often does that happen? Not very; actually more closer to never. I hate press gainey!

we have been told in the past that only an RN can get initial sets of vitals. this is in AZ......are there other states that require this ? (Or maybe this is only required in the mind of our old director??)

guy up probably 30 feet, trimming a palm tree with chainsaw.........this is how they do it all the time. He fell, hitting his head on top of 6' block fence. doa. chainsaw missed.

our hospital has now started a "bedside triage" rule. If there is an open bed, pt gets thrown into it. Am willing to try.......since we were told basically we would be fired if we don't. mgmt seems to be breathing down our neck. If 10 pts and 3 ambulances all arrive at once, and there are 4-5 nurses total in the ER, then someone is probably gonna have to wait at least a little bit, aren't they? Apparently not. Throw them in a bed. The nurse assigned to that bed is supposed to triage (sometimes, I geuss, the doc might get there first). I don't know how this is supposed to work, haven't had any formal meeting about it. What about the "ankle injury" sign in who actually had a syncopal episode due to an underlying heart px who is thrown into a fast track bed? Move 'em out, I geuss. Hope you have a bed in main ER, because it may hold a 15 year old "chest Pain" who has a cough. Sometimes, pt's are moved in the computer and look as though they are in a bed,, but aren't. Where are they? Does a nurse have them in the bathroom? are they in the waiting room still? If this works at your hospital, please offer some encouragement. I geuss the bottom line somewhere has to be $. Move faster, work harder, get em in, get em out.

I've been in my current ER for about 6 years. In that time we have had 6 ER directors. Some awful, some trying . Is this normal????? Our ER main doc says it's the worst job; if you try to please mgmt, all the nurses hate you. If you try to please the nurses, you get fired. I find this to be true. The ones who were "pro nurse" lasted a very short time. The ones who were "pro mgmt" lasted longer; but were so terrible. Is this the same in all ER's? or is my mgmt just worse?

I had an emergency with my dog and took her to the vet office. When I got there, the girl at the counter got on an overhead speaker and called for the "triage nurse". !!! I asked if she was really a "nurse", and the girl at the counter said no, that's just what they call them. I wasn't very happy about this, and she sort of ran away. A vet tech = a nurse. Puhlease.

[ It does not matter how you are treated by an employer, you should always do your best and follow the rules unless there are extreme circumstances. To not do so is unprofessional. you have got to be kidding me.

at least you didn't go to the ER.......................

Arizona can get a ratio bill passed, IF nurses support it and help it pass. It is HB2041. you can do an allnurses search for more info. There is a rally at the Phoenix capital bldg THIS thursday (valentine's day) at noon. Do your research, and support this bill!

i read somewhere that for every hour of diversion, an er looses approx $1800 an hour. So yeseree bob.........the bottom line is colored green.

question please! I was told today, by fellow nurses that since AZ is a "right to work" state that unions here have no "teeth". We can be fired for "no reason". I was also told that a certain hospital "chain" told it's nurses in no uncertain terms that they would be fired for "talking to union members, talking about unions, distributing info about unions" "at the drop of a hat". Isn't this illegal? Even in a right to work state? I guess they can make up some sort of excuse to fire a nurse, but isn't it illegal to fire a nurse related to union organizing activities? One nurse opioned that the reason this chain is so big in AZ is because we ARE a "right to work" state, and therefore a very weak union state. opinions please!!!!

Facilities & Bargaining NNOC Nursing Practice Media Center Press Releases In The News YouTube Videos Legislative Advocacy Research Photo Albums Employment Contact Us California Nurses Association >> Media Center >> Press Releases >> 2008 >> January For Immediate Release January 4, 2008 Print Text Only Tell-a-Friend Arizona Patient Protection Act Introduced - HB 2041 Sets Safe Nurse-to-Patient Staffing Ratios, Ability for Nurses to Advocate for Urgent Patient Safety Measures Arizona registered nurse leaders today announced the historic introduction of major legislation to make Arizona hospitals safer for patients and strengthen the ability of RNs to expose unsafe conditions and advocate for patient protections. HB 2041, the Arizona Patient Protection Act, is sponsored by House member Tom Prezelski at the request of the National Nurses Organizing Committee/California Nurses Association. Introduction of the bill was greeted by nurses across the state who have voiced increasing alarm about the erosion of care conditions in Arizona hospitals that they say put patients at risk and fan the nursing shortage as many RNs will no longer work in unsafe hospitals. Among its major provisions, the Act: Mandates minimum, specific RN-to-patient staffing ratios which are widely seen by nurses and health care experts to be the most effective standard for safer nursing care and for promoting the retention and recruitment of RNs. Whistleblower protection for RNs who report unsafe hospital conditions or for refusing unsafe patient care assignments. Legal recognition of the right of RNs to act as advocates for their patients rather than for the economic interests of their hospital employer. "Hospitals have a responsibility to staff properly in order for nurses to provide quality care for patients. Hospitals aren't doing that," said Diane Baker, an RN at Flagstaff Medical Center. "The Arizona Patient Protection Act requires staffing levels, at all times, based on the acuity of the patient. This will save lives and allow us to provide the care that our fellow Arizonians deserve." "A legal mandate is the safest way to establish staffing ratios and real whistleblower protection for nurses," said Phoenix metro RN Lindy Abts. "I know many nurses have left hospitals because of the staffing ratios; those same nurses have said they would return if ratios were safe for patients and for themselves." "I have been a nurse since 1993 and have worked in different hospitals in Arizona. I know that when I worked in a Skilled Nursing unit inside of a hospital, I was assigned up to 25 patients on the night shift," said Kirk Herbert, RN at Yavapai Regional Medical Center. "On many occasions I had a patient developed a life threatening complication. While I cared for this patient, the other 24 patients would end up with delayed care. With better staffing ratios, patients would receive better care and the life that is saved might be yours," Herbert said. "The nursing care hospitalized patients need is increasingly complex. In Arizona, mandated nurse-to-patient ratios would improve the nurses' ability to safely care for patients according to their individual needs," said Tucson Medical Center, RN Jane Black. The APPA's ratios are modeled after the successful 1999 law in California that was strengthened again on January 1. Ratios differ by hospital area, such as a minimum of no less than one RN for every five patients in general medical or post-surgical care units, 1:4 in pediatrics, and 1:4 in emergency rooms. The ratios are a floor, not a ceiling, with hospitals also required to increase registered nurse staffing as needed based on individual patient illness or acuity. "California's ratios are a spectacular success story," said Zenei Cortez, RN, member of the NNOC/CNA Council of Presidents. "Under our ratio law, lives are being saved, our ability to be effective advocates for our patients is stronger, and more RNs are entering the work force and staying at the bedside longer mitigating the nursing shortage." Since the law was signed, 80,000 more licensed RNs have come into California's workforce. In addition to Arizona, NNOC/CNA members are promoting similar bills in Illinois, Maine, Ohio, and Texas, and working with the Massachusetts Nurses Association on a proposed ratio law in their state. "RNs across the nation have seen the future, and the enormous benefits of this law. They know it works for patients, nurses, and communities," said Cortez. CNA/NNOC 2000 Franklin Street, Oakland, CA 94612 Tel: (510) 273-2200 | Fax: (510) 663-1625 © 2005 California Nurses Association / National Nurses Organizing Committee. All rights reserved.

protonix was iv push bolus, then gtt. Thanks for all your responses. Last I heard pt had a successful TIPS and was out of ICU and on a tele floor.:w00t:

what is it with nurse's and this guilt ridden thought process? and why are we so treated like dirt by so many manager's. IS it because as a collective group we are mostly female? Just a thought.........

er doc for whatever reason just didn't want to put in a cvc. Pt wasn't in the er long. By the time blood was hanging, helicopter was on ground, and pt. was flown out. Thanks for your responses!

this is why nursing is a 24 hour a day profession. Nothing is ever "done". Pass it on, don't feel guilty.

hemoglobin and hematocrit,,,,,,as in about 1/4th to 1/5 th of the amount of blood this gentleman SHOULD have had in his body. He came in violently vomiting BRB. (bright red blood, oh no.) hx. etoh.

i find that older people actually think about that stupid 1-10 pain scale, and then will report a pain level of 2 or 3. Younger people don't even take the time to think about it and will exclaim "20!" Since when is vomiting x 1 hour an emergency? Or back pain x 2 wks? People ARE wimps, and they are in my er. Call your damn pcp, get an appointment, follow thru. If I was vomiting for an hour the LAST thing I would want to do is get dressed and drive to the ER. Puhlease.

you can't suggest a central line, cuz it didn't happen. pt was flown out of our little biddy er to a trauma 1:uhoh21:

If you have a pt. with limited iv access....is it ever ok to give blood with, say, sandostatin? Seeing as how the pt has h/h of 3/10 with diprovan going in #2 line and protonix going in #3 line and no central line (and no other access?). Blood was not typed/crossed due to h/h. silly me, I thought blood reaction was better than certain death, but would like your opinions.