What Works on the Floor, Doesn't Necessarily Work in the ER

Good idea on the floor: 4:1 nurse ratios.  It helps keep the nurses from being overworked.  Result for the ER: management wont even consider the much safer 3:1 ER ratio because "we are just following the law".

Good idea on the floor: printing rhythm strips on monitored patients.  It proves that someone is paying attention.  Result for the ER: Despite the patient's heart rhythm clearly documented on the EKG we just got and their telemetry reading being displayed 2 feet from the doctor's head, I still have to take the time to go print a rhythm strip and sign it.

Good idea on the floor: hourly rounding.  It gets the nurses up out of the piles of mandated paperwork and into the patient rooms.  Result for the ER: I have to leave my crashing patient in 5 to go fluff the pillow of the ingrown toenail pain in 6 to prove that I'm "customer service oriented"

Good idea for the floor: treatment goal posted on the whiteboard.  It gives everybody an idea of what, specifically, that patient is hoping to achieve.  Result for the ER: with patients rotating in and out every hour or two, there is no way to keep up with individual goals.  The end-product: everybody's white board says "goal: to feel better."  Yeah, that's a nice one to have up on the board at the end of a failed code.

Do you have any others?

Centers for Medicare Stupidity

Kevin says it so well.

Schwarzenegger Replaces Most of Nursing Board

This alarms me a little, as I think that based on my experience, most allegations against nurses (at least the ones that I've heard about) are false, or at least overblown.  I am a firm believer in cause and effect, and nurses who are defacing the profession deserve what they get.  I like the idea of cleaning house and getting a fresh start, and I agree that years to investigate wrongdoings is far too long, but I fear that a new nursing board that is put
in place solely because the last board wasn't swift enough to punish
nurses may go overboard (no pun intended)

What do you think?

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

Dissness

I think everybody has been there before, but the answer to being dissed isn't an ER visit, it is a night out on the town with good friends.  Then again, to some of our patients, we are their good friends, and what better way to forget your sorrows than in a good Dilaudid cocktail?

Today's "Reason For Your Visit"

When a patient checks in at our ER, they are asked to fill out a half-sheet of paper with name, phone, SSN, birth date, and "reason for your visit".

Whenever I work triage, I write down the interesting ones and have been building up a list.  Some are funny, some embarrassing, and some just tickle my warped sense of humor.  I try to give the benefit of the doubt.  I know that these people are hurting and just want to be seen, but it still makes me shake my head to see some of the things that patients can come up with.

Thus, my regular (as in whenever I feel like it) series, "Reason For Your Visit."  Please keep in mind that spelling, punctuation, and capitalization are copied directly from the original paper.

So let's get to today's Reason For Your Visit:

sic

[sic]