ednurseeducator

We have had multiple problems with violence in our ER. We are a suburban hospital that sees approximately 65,000 patients a year. Our biggest problem is the psych patients. However, in the last two months, we have had a patient come in and take out a knife at the nurses station and threaten to kill himself and anyone who came near him. The 2nd incident occurred when a jack knife was pulled on me by an alzheimers patient. But the worst happened three weeks ago. We had a patient who died. 2 years old. The godmother wanted to go back and see the child (again: she had already been back twice). We have a strict policy for visiots. They have to have a badge on. The triage nurse told her to hand on a second while she took care of an ill patient. The women went across the triage desk, grabbed her, punched her several times in the face and tried to choke her. In front of the whole waiting room. The nurse is now on PTSD leave. I sure do not feel safe.

We have 2 triage nurses, a rapid and a comprehensive. We use the 5 level triage system (CTAS). The rapid nurse greets the pt at the door and does a quick eyeball assessment and acuity rating based on CC. The comp nurse does the rest. The pre-registration clerk, pre-regs them and bands them, (three bands: one for name, one for allergies and a color coded band that tells the nurse what triage level they are). We have an any open bed policy, which means that if there is a bed open, the pt. skips comp and goes straight back. Copmp can be done anywhere. The tech in triage does the patients VS. We see approx. 150-175 a day.

I do not know what your budbet is but we are purchasing and giving all of our nurses the LWW pocket handbook "ER NURSING FACTS INCREDIBLY EASY". It retails for 21.95, but if you call Lippincott, williams and Wilkins, they will give you 20% off and free shipping. For 100 pocketguides it cost $1700. We are asking the MD's to pay for them.

The ENA Core Curriculum is a must. That was the most useful book in terms of the overall material needed. For test taking practice, the ENA CEN review book is the best IMHO.