crabalot

Thanx Larry77. That's what we all are familiar with. It may be that something has to happen(God forbid) to get this point accross. For the record, I don't really care if I float as a matter of principle. I did that alot on med-surg/tele and in the units. The ER is a different animal. 'nuff said.

To momof3lv- our hospital is one of many in a national chain. In our division, we are the only ER who floats. One person said there are only 3 in the entire chain who floats ER Nurses! We did not float until this past year so this is a new thing for us. We went to the ER for the nature of the beast as well as not having to float! To Msn10- I know of a rural hospital where the ER Doc becomes the Attending if admitted and Nurses rotate all over the place. They knew this when they hired on, so this is no surprise. If it was a matter of sharing the float wealth with the rest of the hospital, we could probably adapt and get over it. We are the whipping post kids for the entire hospital for floating, and maybe we get help on out of 14 days. Whatever.

To highlandlass-I did contact the ENA and they don't have a position on ER NUrses who float. Thanx for the advice anyway. To those who asked, there is a perception our ER is fat while the rest of the hospital is lean as far as staffing. While that may or may not be true at the beginning of the shift, we will be full by noon. The problem is we are floated to areas with notoriously low staffing, then they refuse to let us return if the excrement strikes the blades of the rotary wind device. Sometimes we are used as sitters for psych 1:1 patients, or our Techs are used for the same which leaves us strapped. One day on the other rotation they floated all but three Nurses which left one Nurse for Triage (no Tech), one for patient care (we have 26 beds), and the Charge Nurse manned the phones and Telemetry. Any given day we could have 5 or 6 psych pts on 1:1 waiting on a bed either here or transferring out, 20 patients not eligible for Urgent Care, and 5 Nurses available for care. If they already floated our Techs (usually 4), we have to use Nurses for 1:1 in the ER. This is a normal day! My position is the ER can change from calm to tornado in one hour and we need to be ready for just that. Management is now offering orientation to the floors so we will lose if we refuse to float there. We feel that management sees us as a float pool instead of creating a float pool for that reason. We call in sick to keep others from floating. The burnout rate is accelerating. We have a useless union. I wonder if showing evidence supporting our position will effect change. Maybe if anyone knows court cases where low ER staffing resulted in bad patient outcomes . Or reports of med errors, adverse events, etc R/T poor ER staffing where an ER Nurse had to answer to their License Board?

As ER Nurses, are you required to float to wherever in your hospital? I have never been asked to float because of the dynamic nature of the ER until I started working where I am now. (Sorry, not telling where!) Anyway, I have been tasked with presenting our arguement as an evidenced based research paper but I'm having a hard time finding studies where ER Nurses are not floated because of the nature of the ER. There are plenty of articles supporting the general idea of floating, but none that I've found generic to the ER. Can anyone send me any AJN, RN, ANA or any other journal article that proves why it isn't a prudent idea to short the ER for any reaon? I'm not opposed to floating as a matter of principle. I feel we are the front line Nurses and we should never be in a position where a life is at stake because we had to sit 1:1 with a suicidal patient (yes, we frequently are called to do just that). If I do a good enough job, I'll try to publish in AJN or wherever so all may see the light! lol.

You really have to pick your battles. Not treating a 212 BS is not earth-shattering. That was petty. On the other hand...you really should have addressed the K+ of 2.7. I'm not being mean by saying that. Especially because if someone does treat the 212 BS with insulin, it could cause the K+ to go even lower because insulin can "chase" the K+ into the body cells thereby lowering the available potassium. If you ever have a DOA because of hypokalemia, you will appreciate why this needs to be corrected. We usually give a bolus of D50 along with an amp of NaCO3 and 10 units of insulin which can greatly treat hyperkalemia. That's just food for thought for the next time. As far as not prepping for a cath..is this a policy to do so? Or is this just Cath Nurses who feel they should have a maid and a butler? As far as not geting consent, you were absolutely in the right. It is not like signing your voter's card. It is called INFORMED CONSENT meaning the MD informed the pt of the risks and benefits of having a heart cath. It is not within your scope of practice to legally give the skinny on a procedure and get the pt to sign. If something went wrong, you would be on the other side of a courtroom. That's all.:redbeathe