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Role of emergency nurse
Importance of charge nurse
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I found your post interesting, having worked in an emergency department during my paramedic years. In my career as a nurse working in a clinic on occasion we must send a patient to the emergency department. I always call to speak with the charge nurse to provide report prior to just sending the patient, often I am on hold for greater than 15 minutes. This often results in the patient arriving at the ER before I can give report. Adding to this the charge nurse on more than one occasion is calling me on another line to ask why the patient it there! However, from past experience I do know how busy the ER can be at any given time.
In researching for my own post, I came across an interesting article regarding the resignation of the ER nurse manger
Monitoring staff levels is an important factor. Also leveling the flow of patients in and out institutions could help to reduce wide fluctuations in occupancy rates and prevent surges in patient visits that lead to overcrowding, poor handoffs, and delays in care. Studies show that overcrowding in areas such as the emergency rooms lead to adverse outcomes, because physicians and nurses having less time to focus on individual patients. One study found that for each additional patient with heart failure, pneumonia, or myocardial infarction assigned to a nurse, the odds of readmission increased between 6 percent and 9 percent (Hostetter and Klein, 2013). All of which costs the hospital money.
Realistically, they very well could be going to someone who has had a persistent cough for 3 weeks and decided tonight was the night that they should be checked out in the emergency room. Unfortunately, the abuse and misuse of the emergency medical system (EMS) is one that exists but can have terrible outcomes and consequences if not changed soon. This problem is not just an issue for the patients waiting on care, but it also affects the hospitals and the emergency workers alike.
Lipley, N. (2001) Whistleblower who wrote to newspaper wins tribunal. Nursing Standard. 16 (12), p. 4.
From the patient’s standpoint, when they push their call button, they are hoping to get a response very quickly and get understandably upset when they are not immediately taken care of. From the staff standpoint, if a nurse or a nurse aide is already busy with something that can’t wait, the other patient is stuck waiting. There is only so much the staff can do. Below shows the unit specific information provided by GSMC on the responsiveness of hospital staff. They are slightly below the target rating for the year to date but are above their threshold achievement percentage (Good Samaritan Medical Center, 2016). With a conscious effort to get to the call lights as fast as possible and not waiting for someone else to do it, those numbers have the potential to
To date there has been limited research on charge nurse competencies, job satisfaction, and development. Additionally, there are no validated instruments to measure these constructs as they relate to charge nurses.
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
Some ambulances are inappropriately used with patients returning to the hospital they were just released from after their 72-hour hold.
This information presented is very good because many patients spend hours waiting to speak directly with a healthcare professional. According to ABC news (2010), patients who spent six or more hours in the emergency department but reported very good communication about delays gave a high satisfaction score. Patients who were in and out of the emergency department in less than an hour but reported poor communication about delays reported a low satisfaction score (ABC news, 2010).
The issue of off load delay is becoming ever more relevant as emergency departments (ED) are filling up and having longer wait times. This isn’t always an issue when there are free paramedic crews in the area but it often results in coverage lapses. The question becomes, should paramedics be leaving their less urgent patients in triage with walk-in patients so that they can get to other people in need? A balance needs to be found between leaving the CTAS 4 and 5 patients in the waiting room and leaving 911 callers at home to wait.
Sayah, A., Rogers, L., Devarajan, K., Kingsley-Rocker, L., & Lobon, L. F. (2014). Minimizing ED Waiting Times and Improving Patient Flow and Experience of Care. Emergency Medicine International, 2014, 1-8. doi:10.1155/2014/981472
First of all as a nurse after going through nursing school we ought to have a better judgement. The utmost goal in the healthcare system is to put the patients’ needs as a priority, which is trying to limit all or most possible adverse effects that are prone to jeopardizing or deteriorating the patients’ health. In this scenario, the charge nurse used a bad judgement of not even considering the importance of listening to reports before making patient assignments for the shifts. The nurse has violated principles of delegation, such as: Right Person and Right Task: The charge nurse did not consider the unlicensed staff’s skills and abilities before delegating tasks to him/her. The charge nurse ought to do a thorough assessment of the individual personnel on her floor to help guide her in making decisions that pertained to patient care. Just randomly assigning tasks to personnel even when they clearly mention that they cannot perform the assigned task due to lack of experience or acquired skills could cause more harm than good for everyone involved. In addition, it was a responsibility for the charge nurse to follow the rules and regulations of her state or agency’s policies when delegating tasks or performing any actions on a patient.
In addition to concerns about the adequacy of the supply of nurses the financial impact of high turnover was startling. According to Jones (2005) Using the updated Nursing Turnover Cost Calculation Methodology, the per RN true cost of nurse turnover is calculated to be 1.2–1.3 times the RN annual salary. That estimate is derived from a retrospective, descriptive study of external RN turnover cost data at an acute care hospital with over 600 beds. The findings indicate that the three highest cost categories were vacancy, orientation and training and newly hired RN productivity. (as cited in Kooker & Kamikawa, C. 2011). For example, At the Queen’s Medical Center, the annual salary of an experienced RN is currently $91,520. Therefore, using the
There has long been an issue with overcrowding issues in emergency departments and fast track units have been used in order to reduce wait times, dissatisfaction of patients, and morbidity. The purpose of this study was to look at the impact a fast track unit has on wait times, length of stay, patients who leave without being seen, and mortality rates. The research question for this study is, can a fast track unit help to improve wait times, length of stay, patients who leave without
The ER staff know whom to see first by checking the patients that are the most critical ill by a clever system called triage, subsequently they check whoever they have arrived first.
Registered Nurse turnover is a continuous problem in the nursing profession. Turnover in this context is simply defined as “someone leaving a job” (Kovner, Brewer, Fatehi, & Jun, 2014). Some aspects of nurse turnover can be viewed as positive, however, most circumstances of turnover are seen negatively and can be referred to as functional versus dysfunctional. The difference between the two is a “functional turnover, a poorly functioning employee leaves, as opposed to a dysfunctional turnover, when well-performing employees leave” (“One in Five nurses leave First job within a year,” 2014). The nursing profession’s recommendation for improvement focuses on dysfunctional turnover of Registered Nurses. Nurses choose to leave their jobs to explore