I walk through the doors of the emergency department and I am greeted by a cacophony of sound and a barrage of fluorescent lighting. I hear the familiar hum of blood pressure cuffs filling with air, the steady blip of cardiac monitors, the low buzz of people talking punctuated every so often by an exclamation. In the waiting area, there are forty people waiting in chairs and five people queued up to see triage or registration. To an outsider this environment might look like chaos but as an emergency room nurse the chaos has become familiar and quotidienne. As I make my way to the nursing station I push past stretchers that line the busy hallway. The patients in the hallway have placed blankets and pillows over their eyes in an effort to block out the harsh fluorescent light. The volume of stretchers in the hallway alerts me to the fact that the emergency department is operating at overcapacity. This is not abnormal. In fact, as one of the busiest EDs in Canada, we operate at overcapacity 11 months of the year. Most of these patients will languish in stretchers for over 72 hours while they wait for a bed to become available. I make my way past the final stretcher and a nurse stops me to ask where the bags of saline are. This is also not unusual. As many of the nurses on shift today are per diem nurses called in to fill gaps in the staffing due …show more content…
Without a doubt, these health policy dilemmas pose challenges when providing emergency medical care. However, they also provide opportunities to create a more efficient and equitable health delivery system. To achieve this goal, emergency medicine must establish a health policy focus that addresses the fragmentation of health care delivery and incorporates patient and nursing
Nurse Jackie is a television series that is set in a hospital environment. Within the hospital there is an interdisciplinary approach which focuses more on the work the nurses perform. Jackie is the main character who we follow and is an emergency department (ED) nurse. Jackie is a hard working nurse who is experiencing severe back pack pain thus causing her to use narcotics to control the pain. That said, this paper will explore how nursing
Pham, J. C., Seth, T. N., Hilton, J., Khare, R. K., Smith, J. P., & Bernstein, S. L. (2011). Interventions to improve patient-centered care during times of emergency department crowding. Academic Emergency Medicine, 18(12), 1289-1294. doi:10.1111/j.1553-2712.2011.01224.x.
Richardson, D. (2006). Increase in patient mortality at 10 days associated with emergency department overcrowding. Medical Journal of Australia, 184, 213−216. Retrieved from https://www.mja.com.au/
First, the increased workload due to staff shortage is putting patient care in jeopardy. Sue need to be aware of facility policies and guidelines about staffing flexibility and accepting an assignment to provide safe care. As stated by Martin (2015),”When nurse staffing is inadequate, the ability to practice ethically is questionable” (p. 4). The Safe Harbor Act protects nurses from the unsafe nurse-patient ratio, but the nurse should be aware when to utilize this resource to protect patient safety and her for liability is compromised due to staff shortage. In this situation, nurse staffing in an ongoing problem and Sue should discuss with the management to employ the policies such as the Nurse Reinvestment Act, the Registered Nurse Safe Staffing Act, and mandated nurse-patient ratio (Martin, 2015). Also, the Guide for the American Nurses Association (ANA) Principles for Nurse Staffing should be utilized in this situation (Cherry & Jacob, 2014). Secondly, Sue’s stress is to provide quality care to indigent patients who are uninsured or underinsured. The uninsured population cannot afford preventative care, and by the time they come to the hospital, the acuity level is high, and treatment is expensive. Many facilities have policies regarding indigent population care. Some facilities have charitable policies to pay medical bills for uninsured or underinsured patients. Sue also needs to be aware of any policy related to lowering
at the orphanage, I was able to help build a sidewalk and a garage for
With patient safety always being the number one priority FTR is the worst case scenario for the hospitalized patient. In an article titled “Failure to Rescue: The Nurse’s Impact” from the Medsurg Nursing Journal author Garvey explains ways FTR can occur “including organizational failure, provider lack of knowledge and failure to realize clinical injury, lack of supervision, and failure to get advice.” Nurses are problem solvers by nature, they heal the sick and help save lives. FTR is a tragic experience for everyone involved. The recent surge in this happening across the country has given FTR cases widespread media coverage. Hospitals are trying to figure out what the root cause is and how they can be prevented. Fortunately, with the advancement of technology and extensive research many hospitals have developed action plans and procedures to help prevent the early warning signs from being
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
I started my Nursing career in India and then I came to the United States and became an RN. I entered Nursing with the thinking that Nursing is a profession that will always allow me to have a job and all my patients will get better. However, from my experiences I understood that Nursing is more than just giving medications, and it requires clinical competence, cultural sensitivity, ethics, caring for others, and life-long learning about others and the evolving field of medicine. Florence Nightingale once said:
Knowledge is power, especially in such a setting where every second makes the difference in life or death situations. Knowing what to do is the first step, but knowing how to perform the task with the most fluidity and with the best practice is the way to improve patient’s outcomes in an emergency department setting. Herbert, Bright, Jhun, & James (2014) explain that:
During, my visit at your facility I had such a great experience and one in particular with Nurse Dianne Cooper. I'm a returning patient to the Piedmont Physician's office and I left a few years ago due to the awful customer service at your other location. Dianne, was not only professional but kind and informative. She was very attentive , patient and just exemplified what someone in the healthcare profession should. I was so impressed with her I asked the front office if there was anyway to leave a patient review for outstanding service.
According to a study done in October of 2002, “...the University of Pennsylvania showed that for the first time, there’s a direct link between the nursing shortage and an increase in patient deaths” (Kohn). Moreover, the problem concerning not all hospitals are equal, especially the level one trauma centers, also affect the patients. These situations are far from the only problems dealing with the cause of patient deaths. However, those two factors play an important role regarding how patients respond to emergencies.
Offering acute care services 24 hours a day, my chosen organization’s hospital affiliate is designated as a Level II Trauma Center, rendering emergency services for injuries and diseases to more than fifty-thousand patients every year ("Emergency and Trauma," 2017). Although not all emergency department (ED) patients does not require hospital admissions, patients who are critically ill with life-threatening conditions typically require inpatient care in either one of the hospital’s two 16-beds intensive care units (ICU) ("Critical Care," 2017). However, the need for ICU services is usually high, that the amount of beds and licensed personnel available is not enough to fulfill the needs of the critical ill patients. Therefore, prioritization
A shiver ran across my frigid spine as I stared across the lifeless room that I was placed in. The whites of my eyes sank into the apathetic walls around me, although I could sense a frenzy in the corners of my eyes. Machinery dressed in all-white coats whirred across the bleached halls to protect the bundles they were rolling. Meanwhile, I, a lifeless soul, became entranced by the stench of disinfectant, staring at the pen and paper in my hands. Without the power to enter the hospital room of my mother, I understood that the body of a four-year-old could not withstand the complexity of the real-world—in my mind I knew. My innocence was dyed in convoluted colors.
Working in the emergency department can be easily described as fast placed and at times hectic. Being aware of resource management and learning to prioritize patients are skills that are required to be learned quickly. Once a basic understanding and knowledge of these skills are acquired, nurses are able to build off of them and adapt them however they see fit.
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they