RN burn out in ED

Glad to hear your enthusiasm. But, high/rapid turnover is usually a red flag indicating employee disatisfaction. You're in the honeymoon phase so you may be overlooking things that have experienced rns voting with their feet.

You mention great teamwork and then say pct's can never be found. That's a contradiction. Something is going on.

Do you know why people are leaving?

I can't figure out why people are leaving?

The great team work is between the RNs and the physicians but there is a disconnect between the RNs and NAs

I've only been in ER a year now.. Been in nursing much longer.. But if I had to guess, I'd say volume and patients.

Many left right before I started, some that were hired after me are already looking for jobs.

What I hear, is the volume, and the patients. Some people just don't like the fast pace and the chaos. The last 1 said to me they'd like to work less and make the same. This is true in nursing. Home care, a few pts a day, make the same amount as the icu nurse and the ER nurse.

I think it has a shelf life. The prn's are always happy.. They've been there forever.. But many only work 1-2 shifts every 2 weeks. No wknds or holidays.

That is a good point!

I guess what I am wondering is what kind of staffing models are used in your ER? What is the nurse patient ratio?

I've heard of team nursing where the nurses work in pairs?

We have a code nurse that is like a float and the nurse helps out in code strokes, sepsis, stemis, and traumas, etc. nurse patient ratio is 1:4 in our ER.

We're 1 to 4 but it's not based on acuity. Sometimes I have 5 pts. We try to have free charge.

we have 4 rns and 1 er tech from 7a-11a, then 11a-11p nurse and tech clocks in. so from 11a-11p ther will be 5 rn's and 2 er techs. thank god we dont see 400 pts q 24hrs! our 24hr avg is right at 94 pts, which about 65 of them will be seen during 7a-7p. our er functions well too, though we have poor leadership over our er. both the manager and 2nd in command are basically absentee bosses. i came to this er about 8mos ago and the ones who trained me have long gone and basically there are few faces still here that were here when i came. im considered a old timer here now!

We have a code nurse that is like a float and the nurse helps out in code strokes, sepsis, stemis, and traumas, etc. nurse patient ratio is 1:4 in our ER.

Your ratios sound good, so the reason for turnover lies someplace else. Keep doing what you're doing, learn as much as you can and have fun. With more experience (and when the glow wears off) you'll probably be able to discern the reason for folks leaving.