18-07-2022 ER

This ER is divided up into 3 different units. The main ED is 3 lanes of beds, Lane 1 for critical patients, Lane 2 for other patients, and Lane 3 for psychiatric patients. Then in the back of the main ED they have their "chateau" area which is 6 gurneys in a room that are reserved for demented geriatric patients to be watched by ED Techs. They then have a whole other unit for psychiatric patients on holds that the ED staffs, and they have an ED holding unit that they call "EDX" where they place patients that need to stay overnight for stress tests and such that will be discharged the next day. As a traveler, we staffed main ED and this "EDX" unit. Travelers that were placed in the main ED were always placed in the busiest sections, Lane 1 or Lane 2 and we always got "chateau" patients. The ED had plenty of float nurses to go around and help people but they never came around and asked the travelers if they needed help. I had to usually go searching for a float nurse for help and I usually found them chatting in the corner with other staff nurses. The Clinical Nurse Managers were very passive aggressive and unhelpful if you went to them with a concern. The ED Techs were overworked and stretched because they weren't just techs, they were also transporters and EVS. To get a hold of a doctor was nearly impossible. You always had to text them through the computer or attempt to call them. Through texting the doctors, most of them were sarcastic or rude over because the message center is not apart of the medical record and isn't recorded so they got away with being rude on there. The ED is an older unit so most of the equipment didn't work. Most RNs would go around searching for working equipment and if they found some they would take it to their room and use it. I could go on and on but basically this ED was a tough one. You really had to be an assertive nurse and watch your back here. Travelers helped out other travelers and stuck together. Travelers made up about 70% of the staff when I was there. The ED saw about 300+ patients a day. Very busy and chaotic ED.

S.C., RN ER