smrk

I currently work at a County hospital that truly treats a special patient population. We treat many homeless, prisoners, patients with addictions and psych issues. As you can imagine there are some complicated issues associated with each patient. Sometimes one patient can feel like 2 or 3 considering all the factors associated with a special patient population. About three years ago our ratio changed from 1:4 to 1:5 and just recently due to many patients requiring sitters, most of the CNAs are sitters instead of working the floor. The other night I didn't have a CNA to help and had 4 patients with the possibility of going to 5. My main concern is patient safety and missing something because we are doing both CNA and RN duties. I'm frustrated because I feel that this organization is putting patient safety at risk and my license at risk as well. I'm afraid of retaliation if I speak up and don't know what to do.

I recently graduated from nursing school and I'm not quite sure which path to follow.I'm a decisive person but at this point I feel very indecisive and I am seeking your advice. I know working on a Medical/Surgical floor or in the ER will be a valuable learning experience either way but I have this internal struggle as to where to start initially. What is your opinion on new grads in the ER? I have heard various opinions of Med/Surg being a great foundation to any specialty and others have told me to jump right into ER if that is what I really want to do. I would love to hear your thoughts on the matter. P.S. I thought I would mention that I absolutely LOVED my ER rotations. I loved the unknown, variety, and pace. It was all so exciting and absolutely terrifying at the same time. Working in the ER would challenge me in ways I am unaware of at this point and it scares me as well. Is it normal to wonder if you are ER material?