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I wear healing hands purple label tops and greys anatomy 5 pocket petite bottoms. Honestly, the pants are a little short, but being in my ER I would rather wear floods than pants that are closer to the dirty floor any day. Plus the pocket at the knee is perfect for quick access to iv needles and flushes. Greys and healing hands use suuuper soft, comfortable fabrics that don't wrinkle as much as others. I think healing hands has the most flattering scrubs of any I've tried. I'm 5'6 and 124 lbs for reference

As a new grad, my preceptorship required a group study of something we thought could be improved or investigated further in our ED, and we picked 4:1 vs 3:1 nurse to pt ratio. The national approved ratio is 4:1, which is the norm in my ED, but we fight for 3:1 regardless, because of how difficult it truly is to manage 4 technically "unstable and unpredictable" patients because they are in the ER. When we initially presented this project for approval we were told that the average was 4:1 but in some places it is 8-10, and pretty much to (politely) stop ******** about it lol. I've been assigned 5 acute care patients max, and at times I would refuse the 5th, even as a new grad, because I was uncomfortable with the responsibility. It is way more dangerous for the patient (and my nursing license) for us to be stretched that thin, and you actually have the right to turn down an assignment that you don't feel comfortable with. I have been told by preceptors and coworkers to only take on what you can manage because it is easier to find a new job than a new license. Your manager at least owes you guys the respect and support to investigate the problem further. Crazy stuff with management goes on in all EDs from what I've gathered, but this doesn't mean that employees don't deserve protection from dangerous situations like the above^ At the end of the day always speak up if you feel unsafe, because we worked way too hard for our licenses to not protect them, and patients are in danger of having something critical missed. I have a question in return, does the ratio vary in different areas of the ED? For example, in triage technically one nurse could have 20 something people they signed up to see, acute care ranges from 3-4, and express care is 4. Anyone else's EDs similar?

Yes, this is all true and logically it makes sense for a person to do this. I think the only way for this issue to improve is for ability for hospitals to hold outside establishments accountable for sending patients under non-emergent circumstances. I have had countless patients sent by pcps for routine blood work/scans and nursing homes sending asymptomatic patients with slightly abnormal labs/vitals (with a hr that got up to 115 with EMS reporting that the home called in a "cardiac arrest" lol), with the thought that "oh well everything gets done faster in the ER." Yeah, well, since every order from the ED is stat, one patient's CBC for sniffles are run as "stat" next to a trop for chest pain. When everything is stat, nothing is stat.

Yeah, and it counteracts transparency in healthcare. Patients want and deserve the honesty of healthcare professionals/institutions, but refuse to accept the concept of a medical emergency or acknowledge that the same room they are complaining about because it doesn't have a tv just had someone's mother die in it an hour before.

Do you mean EMTALA? It sounds more like whoever told you that saying the above things are illegal is talking about violating EMTALA rules of coercion, i.e. somehow alluding to a patient in any way shape or form that they should not pursue care in an Emergency Department. This prevents hospitals from turning away patients for reasons like inability to pay, lack of health insurance, legal status, etc. However, this can include posting wait times, stating that an ED will refuse to perform certain services (like preg/std tests or med refills), and some of the things you included above because it is considered coercion. From my experience, "coercion" is broad and loosely defined, and many healthcare professionals/institutions fear legal consequences for violationing this, and for that reason EDs have become hypersensitive to providing the smallest amount of general information to patients about wait times, care in the ED, triage process, etc. for fear of legal ramifications by patients (which is understandable; people threaten legal action/violence because they have to wait three hours for pregnancy results in an EMERGENCY DEPT). But to prevent my futher ranting and hopefully answer your question, I explaining triage process to patients and that patients are seen in order of severity of illness is not illegal. In fact, my ED has this posted EVERYWHERE. On the contrary, we were forced to take down the "wait time" clock in our dept, but I've seen on websites of other local hospitals the ED wait times on the home page. Damned if you do, damned if you don't? EMTALA is a great safety net, but damn, sometimes it makes patient advocacy/compassion about as fun as sticking my hand in a hot toaster. I hope this helps, and I would LOVE to hear the insight of fellow nurses!