Unsafe ER - any suggestions?

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Specializes in ER,Neurology, Endocrinology, Pulmonology.

Hi guys. I haven't been here in a really long time due to my intense ER training and overtime.

Something happened in my ER and it is bothering me a lot. For the past 6 months our hospital made some changes by eleminating bidding and weekend track. Most of the staff in our ER (where we were already short) quit. New grads were not allowed to enter ER and we found ourselves in a horrible situation. Local staffing agencies only had a few good nurses availble for us.

To make the long story short every day pretty much I am dealing with unsafe amounts of patients and nothing is changing.

The other day I came in to work and there was an incident where a DNR cancer patient in her 50s A+O came in to the room in am for chest pain. Shift changed at 3 pm and a new nurse coming on found the pt off monitor and dead. last nursing chart entry was from 9 am.

I have not been able to find out exactly what happened, but I am seriously worried about the safety fo my career. I have mentioned this to my management, but there is no real gameplan of what they are going to do for immediate issues. I am still being slammed with patients, sometimes I have to tell CN twice than I can not handle the paitiens I already have when ambulances keep coming in.

I do not want to leave because I love my job, but I am wondering if anyone has encountered similar situations and what has been done about the staffing problem.

The management now is brining track back and we are allowed to bring in new grads, unfortunately we are royally s---d at this point already.

Any ideas?

Nat

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I understand you love your job and don't want to leave- but- you can always find another job. You only get one license.

Maybe you can talk to your manager- a sit-down, door-closed, serious talk- and tell her what you've told us- you love your job but feel your license is in jeopardy. Tell them they need to address the problem NOW if they want you to stay. Maybe you only have new grads and agency available, but they could increase the number of nurses on duty at any given time for this reason.

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When it's that bad, I think I myself would become so concerned, both for the patients and selfishly for my own license and life of my career, and I'd be out of there as fast as freaking possible. Sorry, that's me. I have to be able to pay my bills and put food on the table -- no administration's poor decisions are going to interfere with that. In the end, they will still get paid -- it's the nurses who everything is going to come back on. Just my own opinion. Wouldn't hurt to get the state to come in and see what's going on, either. Perhaps AFTER you have left.

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What's s---d? LOL.

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s-c-r-e-w-e-d

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Anagray,

Your situation is unfortunate but also as unfortunate is that fact that under-staffing has become almost the norm. The ONE thing I know and am learning as a nursing student is YOU are the ONLY ONE who truly cares about your license. If you get a summoning from the BON your employer won't be there for you. You have to protect what you worked so hard for. Sometimes the walking away is the hardest but smartest thing to do. Again, unfortunately the patients, as always in these circumstances, are the ones who suffer.......One day, I pray, this will get better.

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Specializes in Hospital Education Coordinator.

This is when hospitals need to go on divert. Unsafe is unsafe at any cost.

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Specializes in ER.

I must agree with all who comment on the nursing shortage, understaffing and possible unsafe practice that can occur. The most prevalent comment i see and hear is " Im not going to lose my license because of this". I totally agree, BUT remember you can only be held accountable for what you do, period. if you feel that you cant handle that extra patient, dont take them.( i understand easier said then done) trust me ive been their. but i see alot of comments that say get out while you can. the problem is everywhere in every specialty. not just E.R and if you run it just makes the problem worse. and who suffers from that. (patients). this may sound synical but im a nurse because i love it, i love what i do and it makes be who i am. just like many of you, it not just what you do its who you are. ive worked E.R for 12years starting as a tech and worked my way up and the challenges ive faced have made me the nurse i am today and i dont mind sounding arrogant when i say im a good one. yes the staffing sucks and the pay is not the best and somedays i just feel totally beat down. But that life i helped save and that thank you i recieved and that hug that little girl gave me cause i made her feel better beats any paycheck i could have recieved. Im not an advocate of perpetuating negativity, and im sure all of you out there arn't either, but as it stands now, we as a whole are not making the nursing profession look like something that the next generation would want to go into. ergo the problem gets worse. Although venting is a good outlet we have to remember what brought us to this field of work. as for your license. your smart and educated, do what you do best, make the decisions to keep you and your patients safe and youll be fine.

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Specializes in ER, Infusion therapy, Oncology.

I worked in the ER for 12 years and encountered what you are going through many times. There has to be a nurse/patient ratio set. Trauma rooms should never be more than 2-3/1, and if the patient is very critical it has to be 1/1. Medical patients should be 4-5/1. A fast track can take a lot of the minor stuff off your hands. If there are not enough nurses for the rooms then they should close some them, or your managers should be putting on a pair of scrubs. If none of these measures are in place then I would find some where else to work. There are lots of openings for a good ER nurse. If you don't you will burn out very fast.

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There are good reasons why the other nurses left. It sounds like a very dangerous e.r., I would look for something else. Your not happy there, and they do not seem to care about the nurses they have left. Get out!

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Specializes in ER/Trauma.
This is when hospitals need to go on divert. Unsafe is unsafe at any cost.

Yeah... I work at a county level 1 trauma ER and when WE go on divert.. so do all the other hospitals... divert doesn't mean anything in my city unless your a private hospital that has the ability to dump patients that cant pay onto the county hospital.... private hospitals get such a thing as divert... We will be on trauma/ICU/tele/med surg divert and we will get ambulance after ambulance after ambulance of critical pts because all the other hospitals go on divert as soon as they hear our hospital is on divert... We will be putting ICU patients in front of the nurses station on portable monitors because we are so overrun with ICU admits that thats all we can do...

Our staffing is ridiculous... You can easily split a team of 30-40 pts with two RNs... thats a typical night... So I totally understand... I've been to management several times about the issue.... It finally took 5 RNs to threaten filing safe harbor if we did not get more staff for the unit managers to actually put that RN license to use ONE NIGHT...

You can only handle what you can handle.. You have the right to NOT accept care of a patient at any time and file safe harbor... I'd also looked into getting as well... just to protect myself.. I feel your pain... trust me =)

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Specializes in ER/ medical telemetry.

Well,

I am sure this can happen, but who is responsible?

This issue would not get away without investigation.

I too am in a risky situation.

I am a new grad, back on orientation, because I felt I needed to be able to handle these crazy intense situations.

I know I have left my patients a couple hours without charting, but I have to eyeball them, and if I'm stuck on a one on one, I ask someone to look at them and tell me how they are, I can even send a volunteer, even though they are not skilled they know what distress looks like, and they may be able to fetch the appropriate person to tend to them.

You cannot leave.

What happens if every person were to leave when any type of incident were to come about?

I'm sure administration will have their hands in this one.

As long as you klnow you did not leave this patient, and had not checked in on them for 6 hours then you know you are alright, no matter how busy it is one must check on all patients to see if they are still breathing...

I can see where it could get so crazy that one would be unable to see their patients.

Sounds like things are out of control there, and how long can it continue?

Can all the nurses take a stand agaist working in an unsafe environment?

Common sense tells us that this should not continue.

What can the nurses do as a whole to make a difference?

There has to be something you can do.

This is not your fault... I too would worry about my licence if I were in your situation. I do wish you much luck...

=steelcityrn;2499940]There are good reasons why the other nurses left. It sounds like a very dangerous e.r., I would look for something else. Your not happy there, and they do not seem to care about the nurses they have left. Get out!

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