tknrn

Hello, I was wondering if anyone has a policy on discharging patients from the ED. A PA that was employed at our hospital had wirtten as policy that all patients were to be taken to and discharged from the ED via WC. Our CEO is now concerned because this policy is not being followed. It seems to be a little restrictive to me. ANy help would be appreciated. Thanks.

Thanks for your reply. I guess to explain this better. We are a rural hospital (CAH) with acute beds totaling 18, ICU, OB and ER. They nurses are staffed usually with 2 Rn's, 1 LPN, and 2 CNA's..1 RN is charge nurse and 1 nurse is ER. Other then myself no one nurse is scheduled just for ER. Usually on the 7A-7P shift there are 3 or more RN's in house..doing supervisory or "paper"..if the ER is busy instead of having these nurses that have ER experience come back to help the PA has the unexperienced RN come back to help as she thinks the reason this nurse is not working the ER is because she is unliked..the PA covers the ER during office hours so the physicians can stay in their offices and not have to cover ER...at this point I feel that the best option is a policy signed by the Medical Director of ER and the CEO. the DON has been on vacation and during this time is when the nurse has been in ER since we have told the PA no nurse without training can be in the ER. I am really not whining..just looking for input to try and fix this problem.:)

I am the ER Supervisor in a rural hospital. The ER is staffed by a PA in the day from 9-5 Mon-Fri. My dilemma is that she seems to insist on taking a RN that is not trained to work in the ER back to the ER when it is busy to "train her". This has been done after being asked not to by the DON and myself. Part of the problem is that I work the night shift and am rarely there during the day. At this time I am working on a new policy for the orientation of new nurses to the ER. This includes at the least PALS, ACLS, and TNCC. The plicy states that orientation will include 30 days of orientation with a preceptor. The preceptor is to be an experienced ER nurse. Does this seem adequate or not adequate enough. Thanks for your input. I am at the end of my rope with the PA's interference.

Thanks for the quick reply. I did do the EMT route at one time but didn't keep up my license. I will check into the Prehospital RN and see if that is available in Missouri.

I work at a rural hospital in the Emergency Room. I also have filled in as an ALS provider for the ambulance. I am wondering if there is any benefit to doing a RN-Paramedi bridge program. If so, is there any information on such a program? I live in Missouri. Thanks!:)

Thanks for all of your input. It has been very informative.:) I hope to put together a list of skills that can be evaluated and checked off on fot the ER staff.

Thanks for your input. The skills that you mentioned are physician only skills at our facility. The nearest level 1 trauma center is an hour away by air evac. My concern is that the nurses working in the ER should have competency skills that address both medical and trauma emergencies. I agree that ACLS is not sufficient for the ER. We have been sending our nurses to TNCC courses. Rural medicine is a challenge in itself, I'm just looking for ways to help the nursing staff become more competent with the skills expected of them in the ER setting.

Thanks for your response. We are fortunate to have CT available to us. Since the nursing staff that work in the ER also work the MEd-Surg area of the hospital, I want them to feel comfortable with the skills needed for the ER. I will add your input to the growing list I have to discuss with the Medical Director of the ER and the DON. Thanks:)

I am the ER Supervisor in a rural hospital. The only certification required to work in the ER is ACLS. I feel that the nursing staff should be expected to show competency in emergency situations prior to working the ER. Any feedback about what competencies the nurses should be expected to demonstrate would be most helpful.:)