What is your ER like?

[rachelgp]

Well, I'm a new grad, and this is the only ER I've ever worked in, but there are some issues here, and I was wondering if this is a facility/regional problem, or if it's like this everywhere. The main problem I'm interested in right now is that we seem to be admitting a huge number of patients, and when we get admission orders, there are not enough staff/rooms on the floors or ICU, so we end up holding patients in the ER, sometimes for hours (the longest I've seen is 32 hours). We regularly are holding 7-10 admitted patients (in a 12-bed ER) and it makes it very difficult to continue moving new patients through the ER. How widespread is this problem? Thanks for the input!

Rachel

[JoshuaAdamsRN]

I'm guessing your place isn't a teaching hospital with residents to muck things up?

[phiposurde]

Back home ( Montreal), when i use to work there it was nightmare. My understanding is that it didn't improved. Minimal stay in the ER before admitting was almost 2 days I even saw one staying 6 days. I remember , she Had bed sore cause we were to busy to turn her q 2 hour. We had 17 actual bed. We would go up to 45 patient sometimes. Some of them the "cardiac monitoring" was to be hook on a defibrillator. Sometimes the authority would announce on the radio to stay home cause we didn't have any more space in the ER during flu season. Now here ( Calgary) It is better. Still overcrowded and there still some waiting but the region works very hard to improved things. The last statistics showed that we decrease our waiting time and admitting time by almost 50% compare to last year!!

http://www.calgaryhealthregion.ca/newslink/emergencydepartment/performance_measures.html

[CraigBSN02]

*cracks knuckles*

24 bed ER with a 7-bay holding area (12 if you could hallway holding bays). We see on average 250 persons/day, admit rate is 25-30% (lower than other facilities).

Trauma and Peds go to separate units, so all we see are chronic problems: HIV, HTN crisis, CHF, diabetes, and voluntary psych admits. The patient population is 90% dirt-poor and uninsured/underinsured.

Patients hate the place like poison; staff is largely made up of travelers (including yours truly), and the regular staff is protected by a union. Mind you this is a "premier academically-affiliated institution of 900+ beds"

The place is a nightmare; you never have everything you need; cardiac monitoring is a joke, nothing works as it should. Although the security staff are excellent... and fullly armed with sidearms.

Essentially, you days goes like this: belly pain, admit hold for chest pain, HTN, dizzyiness, seizure, Etoh, Etoh, weakness, "my hair hurts and my teeth itch"... and so on.

Can you tell I won't be re-signing to a new contract?