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For the nurse that doesn't know of an ICU nurse that is paid more than an ER nurse, then you haven't been to my hospital. The ER isn't considered a specialty area. Go figure! AT least I'm short timing it now in this hospital. They have a great group of nurses to work with and it is one of the most organized ERs I have seen. Upper management treats the ER like lower class, at least that is my preception. And this is an ER that not only pays for it's self but makes a 2 million a year profit. So what is that all about. Welcome to ARkansas.

I can diffinitely relate to ridiculous complaints AND HAVE FOUND THE CURE. It is called zoloft. Since we have no Ativan fountain in the lobby I decided to medicate myself. Now I just don't care. I can do my job and keep my blood pressure under control at the same time. Seriously though, this profession is getting out of control. What happened to the people of 20 years ago that were thankful for their care and understood you were only human?

We are looking at starting an ER patient education campaign to see if this improves our press ganey scores. We are looking at a loop video of educational material in the waiting room. posters in the hallways and patient rooms. I am putting together posters to use and would like any ideas of what all ER nurses think would benefit patient satisfaction. (in addition to the one that is to say strive for 5, we want your comments, or some such *#$#@) As you can tell, I'm just elated to have this new job. Do any of your ER's have similiar such things and if so what types?

You all were so great with my last question that I immediately thought of this forum when a new issue popped up in my ER. The current director of the ED is adverse to any of the nurses working more than 4 shifts in a row (12 hour shifts). All the nurses I have had a chance to talk to are for 5+ days in a row which enables you to have more off days in a row. The director feels we will get too tired and be more apt to make mistakes. Currently I work 12 hour night shifts with my shift starting at 1830 the one night and ending at 0700 the next morning. As it stands I work 4 nights and am off 1 then back 2 off 2 on 2 etc. I feel that this is more inclined to make me tired than having 4-5 days off and working 5 in a row. We have just started self scheduling and with us 3 nurses short we are working over time every week. If we can get them to allow us to work more than 4 in a row we could and would be more willing to work even more. As it stands, if I get off at 7 this morning and have to go back tomorrow night at 1830 then I haven't even had a true 24 hours off but on paper it is a day off. PLEASE, EVERY ONE LET ME KNOW WHAT YOU THINK OF THIS POLICY AND I WILL TAKE IN SOME LEVERAGE TO MY NEXT MEETING. In advance I thank you so much. Continue to treat 'em and street 'em.

I can really relate to the scenario you spell out. We have a group of ER physcians and there are 3 that are very fast (we all just love working with them) then there is one that is close to retirement and can be fast but after all those years in the ER he doesn't really care, there 1 that can go either way depending on his mood, 2 that are just plain slow(the admit king and the "anything the patient wants" docs) then 1 that is so unsure of herself that she is slow for that reason only. The sad part of the whole process is that as nurses our judgment is trusted (for the most part, there are a few that aren't) to order the tests before they are seen yet it is by the fastest docs. You need it with the slower ones. Most of the time we just do it any way. Sadly enough the ones with the higher patient volumne have the lowest patient satisfaction scores( yeah I'm still on that) Since there is nothing we have found to speed up the snails I have just got to where I dread working those nights. Last night I worked I got into it with one of the slow docs because a patient was chewing me out for having to wait so long to be seen by a doctor when our docs ( 2 of the slow ones together,eghh) were dragging their heels getting anything done. It got him up finally but at what cost, we were mildly hostile for the rest of the night, glad he doesn't hold grudges. Wish only type a personalities were allowed to work in the ER sometimes. Oh well , life goes on.

Thanks to all for the advice I got. Alot of the things we already do, such as have a patient liason that keeps them updates and get warm blankets and ice. The irony of that is that is one of our worse press ganey score times. Like every one else I begining to think that staff moral might be hurting us some. I mean we are told constantly that we aren't doing a good enough job, need to do better. I did some research on the internet and found that hospitals with consistently high press ganey are the hotel Hilton meets ER. They provide tv's in all patient rooms(yes , exam rooms), they provide snacks for patients that aren't npo. the list goes on and if you want the articles for yourself they are on elibrary under "emergency room satisfaction" search. I am armed with them and plan on lowering the boom on the big wigs at our next meeting. If high scores are what they want it looks like they are going to have to open their wallets and increase monies to the ER to pay for the nurses so patients won't have to wait so long,as well as making more room to put patients in , then we need more doctors so ours aren't stressed by keeping up with this load of patients , then there is the all out education campaign that we need to do to educate people about the difference between a virus and an infection, an emergency vs urgent medical status, and again the list goes on. Once again thank you all, I am going to take your comments to this committee and let them know that it isn't only "OUR" ER that is having the same problems. I feel that with all every has told me so far it will show so moral problems in our ER also. THANX.!!! " AND YOUR EMERGENCY IS?"

I have been an ER nurse for 22 years now and this has to be one of the hardest parts of my job, customer satisfaction and Press Ganey. I work in an ED that sees 135 patients daily with the highest volumne during my shift 7p-7a. The problem I am having as well as many of my co-workers is that the hospital has decided for the last two years to use the Press Ganey survey company to evaluate our hospital. That in its self isn't much of a problem but when they start staying on us to the point it is interfering with our jobs it gets to be quite a head ache. We as an ER have an average wait time of 2 hours or so. I think that is very good considing there are only 5 nurses on each shift . We have 2 doctors during peak times with a fast track open on weekends for even higher volumne. My question is if anyone else has similiar problems keeping patients happy while still covering the TRUE emergencies. Even when I have a great day and don't let anyone fluster me I still can't seem to make the majority of patients happy. They get mad about the wait time, the lab wait time, the doctor attitude and the list goes on. Has any one out there got any ideas that I can take back to my ED customer satisfaction comittee to improve our scores. This is getting so old and it definitely takes the little bit of fun out of a very demanding job. Thanks for any help any one can provide.

I'm a 19yr nurse who's ashamed to say that after being out of acute care for 7 years that I can't remeber my five R's of medication administration.All I can remeber is right parient, right drug,right dose, right route,and ???? please help. let me know if I have any wrong also. thanks

I worked for an agency for several years as extra job and loved it. The best advice I could offer is to make sure you are ready to work hard and long. Maybe it isn't like this any more (I worked in agency in 1987,88 and 89) but then everyone knew that I made more money than the staff nurse and they made sure I worked for it by giving me just about all the patient load I could handle. I really don't think I could have handle it it my specialty wasn't ER. I was used to a fast paced work enviroment and to "any and everything" coming my way. Also being able to really junp in and get things done is a beg plus. Sounds like you have the necessary qualifications so GO FOR IT! Wish you the best,,oh yea, agency usually pays anywhere from 30-50% more an hour. ------------------ katia

The only opinion I can express is mine from personal experience. I have found that the more confident a person, whether nurse or not, then the less likely that person is to find fault with others rather than to try to help those that might be "not up to par" according to them. I have worked with both types of nurses and this holds true in the nursing field also. The more compentent and confident the nurse the less likely that nurse was to fault others. AND... this isn't the only field that has this type of behavior.Just ask anyone in management and you'll find much the same response. Sadly enough it seems to be the only way for some to feel better about themselves. To these people the best response is no response! ------------------ katia

I agree with you 100%. What really changed my way of thinking was after I had a subarch hemmorage and had the constant vomiting. I will never forget finally getting to rest through some of the vomiting and in walks a nurse with perfume on and I started all over again. wasn't able to tell her to leave so take it from someone that's been there, save the perfume/cologne for your dates/mates

thanks for the vote of confidence. this is a general med test for all new hires and my biggest worry is that I have been out so long I don't know the new medications. I will be re-certing in ACLS soon and I worked ER so long before I stopped that isn't my worry. I know there are two chemo drugs on the test but I can't name a one. I've worked ER and home care for the last 11 years!I regularly take rhythm strip tests and dosage calculation tests just to stay sharp. BUT WHAT KIND OF DRUGS THERE ARE OUT THERE I HAVE NO IDEA.

first a background: I am a 19 yr nurse but have been out of acute care for the last 7yrs. I have recently applied for my old job back in the ED. Every thing looks good for the job except I'm told I have to take a medication test. SCAREY! There are so many new drugs out in the last 7 years I don't know where to start. Does any one have any idea what I can expect on this type of test. Would appreciate any help.