View Full Version : Get This Party Started!


KimRN
06-22-2007, 04:29 PM
Well, someone had to start the ball rolling! Might as well be me!:D

What size ER does everyone work in?

Mine is an 11 bed community hospital department. If we see over 68 patients in 24 hours, we consider it a hectic day! It can still get hairy, but after thirty years I don't have the energy for a large teaching hospital environment!

What is your department like?

sue-rn
06-23-2007, 06:54 PM
I'm jealous kim ... we have 40 beds ... but typically have 30 in use throughout the day (rest are reserved for trauma, isolation, eye, flex ...). we see 170-200 patients daily. because of my schedule i'm usually assigned to either triage or low acuity ... it's not unheard of to have 20 patients run thru my team in 8 hours (teams have 4-5 rooms per RN, and typically 1 tech for every 2-3 rns). ... and our managers are trying to improve "through-put" ... wont that just mean even more patients?? yikes

that being said ... wont work in any other department ... love the variety, the speed, the autonomy ...

KimRN
06-24-2007, 03:18 PM
LOL - yeah, I love the term "through-put". Only in ER do you get paid for efficiency by having your workload increased!;)

MeghanMU
06-24-2007, 04:35 PM
Yeah, my ER is about the size of Sue's. Except from 11-11 we have a 16 bed unit in which we see fast tracks and light medicals (so that puts us over 50 beds for those hours). I thought I heard someone say we see about 60,000 a year. For us, we usually have 3-4 patients, and if you're in an area where you have 4 patients, they try to make at least 1 of the patients an "easy" patient. We usually have one tech for 6-8 patients. When I come on at 7p there are 6 doctors there, and only one doc by morning (depending on how busy we are, the doc that leaves at 5am will stay if needed). I love night shift! The night crew is always a little different :D I worked tele for two years prior to coming to the ER and I don't think I could ever, ever go back to the floor. I love ER! In your ER do you have mid shifts? We do, and I guess that was started only a few years ago when a new manager came in (our manager is awesome). I can't imagine the ER running without midshifts. I like this nursing voices! I hope lots of people start posting.

Meghan

sue-rn
06-24-2007, 08:19 PM
megan .. midshifts?? if you mean people coming and going at funky hours .. yup ... we have them coming in at 6am, 9am, 11am, 3pm, 6pm, and 10pm. I work per-diem so often work even weirder shifts ... have been known to just do 10-2 and cover lunches. 3 of our teams are only open from 9am-1am ... supposedly for "low" acuity. a couple of weeks ago my "lo" team beds consisted of a "lo-speed mva" ... turned into cardiac tampenade. a chestpain (with heart hx), a bowel obstruction (94 yo), a change in LOC cancer patient ... and a flank pain/kidney stone ... guess who did not get lunch for that shift!

I too worked tele for 3 years before going to ER ... I teach med-surg now .. but i cannot imagine going back to working the floor.

GuitarGirlRN
06-25-2007, 01:12 AM
Just wanted to add my two cents! I'm an RN in a 50-plus bed level II ED in an urban area. Just got home from my midshift job--11:30 am to midnight. And I'm back again in the am.

Glad to know this forum is here!

KimRN
06-25-2007, 04:38 AM
megan .. midshifts?? if you mean people coming and going at funky hours .. yup ... we have them coming in at 6am, 9am, 11am, 3pm, 6pm, and 10pm. I work per-diem so often work even weirder shifts ... have been known to just do 10-2 and cover lunches. 3 of our teams are only open from 9am-1am ... supposedly for "low" acuity. a couple of weeks ago my "lo" team beds consisted of a "lo-speed mva" ... turned into cardiac tampenade. a chestpain (with heart hx), a bowel obstruction (94 yo), a change in LOC cancer patient ... and a flank pain/kidney stone ... guess who did not get lunch for that shift!

I too worked tele for 3 years before going to ER ... I teach med-surg now .. but i cannot imagine going back to working the floor.

Sue!! First of all, welcome! Second of all...you teach?? That is what I am hoping to do after I get my Masters (I'm just NOW going back for BSN after 29 years). I would love to know what it is like - it has been so long since I've been on the floors (I'm in ER), I would have to relearn med-surg all over again!:rolleyes:

KimRN
06-25-2007, 04:40 AM
Just wanted to add my two cents! I'm an RN in a 50-plus bed level II ED in an urban area. Just got home from my midshift job--11:30 am to midnight. And I'm back again in the am.

Glad to know this forum is here!

Guitar Girl! Welcome! With that user name, you HAVE to be into music!!! Who is your favorite guitarist? :)

KimRN
06-25-2007, 04:44 AM
Hi Meghan!

We do some odd shifts. We have a shift just for lunch relief and a shift that does 3 pm to 3 am. Some of us do eight hours and some 12 hours. I think ER nursing lends itself to flexible shifts and hours better than other departments. I can't imagine working with five docs. We only have one - but you are right, for some reason the best folks work at night!;)

MyOwnWoman
06-25-2007, 09:02 AM
I work in a 30 bed ER that is terribly understaffed and terribly mismanaged. (Hmmm, sounds like about 75% of the ER's across the nation.) We do our patient care in what is called a "team" approach. The team consists of 2 RN's. Now, of those two RN's one of them is assigned to the trauma team or the STEMI team. If we get a trauma or STEMI in the ER, the other nurse is resposible for all 10 patients. Now you may not think that happens often, but it happens at least twice in any 12 hour shift. The STEMI's take the nurse away from the other patients for a max of 90 minutes, while the traumas can be for hours. Our beds are always full, with the overflow out in the hallway. (I'm sure HIPPA would have a field day with that.) Triage generally has about 4-6 patients waiting (and wailing) to get back to a room.

To be an ER nurse you have to have the right "fit." Not many do, but those that do, stay...and stay...and stay....and love it.
I love it.

KimRN
06-25-2007, 05:51 PM
>>>To be an ER nurse you have to have the right "fit." Not many do, but those that do, stay...and stay...and stay....and love it.
I love it.<<<<

Welcome to Nursing Voices - what you have written is so true. In fact, you just inspired a blog post! :)

Thanks! :)

MeghanMU
06-25-2007, 06:27 PM
Yeah- there certainly is a fit for ER! Crazy, weird and masochistic maybe? :D As for midshifts, yeah, I meant off hours. The majority of our nurses work either 7a-7p or 7p-7a, and we all work 12 hrs, but there are also 9a, 10a, 11a, 12p, 1p, 3p, and 5p shifts. It works out well because when we have our highest census, we have the most nurses, and then as the census dwindles, the amt of nurses does too. It doesnt always work out so well (like when we still have a full board at 0300!). But I think the idea is right, and it would certainly work better if no nurses ever got sick, and we were never short-staffed- but that's life in any hospital :) I wish I could stay at this hospital forever, they certainly have short-comings, but for the most part, i think they have the right idea, and our ED manager always fights the good fight for us. But, I'm not a fan of southern california, and I miss my home and family. I'll be headed back to Milwauke in a year and a half or so. Any Milwauke ED nurses out there? Where do you work, and do you like it? I went to school in Milwaukee, so I somewhat know the hospitals from clinicals, but I've never worked there as a nurse. Hope everyone is having a good week!

GuitarGirlRN
06-26-2007, 01:40 AM
Guitar Girl! Welcome! With that user name, you HAVE to be into music!!! Who is your favorite guitarist? :)

There are so many! (I know my hubby would love it if I said it was him!)

KimRN
06-26-2007, 02:02 AM
There are so many! (I know my hubby would love it if I said it was him!)

Aw man, don't tell me you snagged Richie Sambora.... :D

Yeah, I'm married, but he's a cutie.

GuitarGirlRN
06-27-2007, 02:29 PM
I AM married to Richie Sambora! NOT! (I wish!)

No, my hubby is the diametric opposite of Mr. Sambora--a minor alternative music celebrity who now plays "noise rock" and avant-garde hoo haa.

But I still love him!

KimRN
06-28-2007, 01:57 AM
I AM married to Richie Sambora! NOT! (I wish!)

No, my hubby is the diametric opposite of Mr. Sambora--a minor alternative music celebrity who now plays "noise rock" and avant-garde hoo haa.

But I still love him!

"Noise rock" and "avant-garde hoo haa"?

Bwahahahah! I love it! :D

Mother Jones, RN
06-28-2007, 01:09 PM
I don't know how you guys do it. I want my patients to have all their body parts sewed on before I see them. ER doctors and nurses are amazing people.