running42km

Our emerg is frequently incapacitated with admitted patients. We have a curtained divided four stretcher area behind the triage desk that is staffed with a RN to act as triage support ... responsibilities include possibly making a list of patients needing to be triaged, triaging ambulance influxes, caring for the patients in triage holding. At times the four stretcher area assignment expands into a hallway that connects triage with the ambulance bay and the trauma room, filled with stretcher bound debilitated patients, triaged but no where to progress; at least four times last week that assignment became 7-13 patients for 8 or more hours. One nurse for 7-13 debilitated patients, while the remaining nursing staff (eight ER RN's, four med/surg RN's, one orthotech lpn) thank heaven for their 3-5 patient assignment. I struggle with the mentality that we can all drop our assignments to deal with an intubated post-arrest in the trauma room, nurses stumbling over each other, but we can't deal with sudden capacity surging in a cooperative manner. I've spoken to the manager but only received a doe eyes caught in the headlights response. Any similar scenarios? Solutions?

Our emerg has an open to the waiting room triage desk with plexi-glass that separates the nurse from the patient, with only a small slot to pass a wrist or paperwork. The nurse has to get up and walk through a lockable door each time anything besides a radial pulse is warranted ... perhaps 99% of the time. Sounds tiresome, especially considering we triage up to 150 people a day, but we see a lot of aggressive people and it does provide some security if necessary. I suggest that anything less secure should not be isolated from other staff working areas.