Life After Diversion
Earlier this month, I wondered what it was going to be like in the ER without being able to divert ambulances. Right after I wrote that post, I went to work. It was a Monday. According to the nurse in charge that day, we had the highest acuity and census ever, and we survived.
I walked through the door that day skeptical and concerned. Quickly, I was filled with pride. A Physician's Assistant (PA) was in the waiting room. He was seeing, treating, and discharging patients behind a screen. It seemed, at first, so antiquated to me, but it served a purpose of moving patients through quickly.
The afternoon progressed and in the end we needed to resort to "Code Help." This is our version of a hospital wide response to high census in the ER. So, instead of depending on other hospitals to bail us out, we look into our own facility. Administrators become involved. Beds are forced open and nurses from ICU/Intercare are floated to the ER to care for critical patients that have no beds.
From an ER point of view, "Code Help" is a godsend. Barriers that we had become so used to dealing with have now been obliterated. Floor nurses can no longer refuse report. Beds can no longer be hidden. Other staff from within the hospital will see why ER patients come up to their floor in the state they do. The ER is no longer silently suffering.
The change can even be felt on ‘normal' days. Our patients are moving to their rooms faster than ever before. It doesn't feel like we are holding as many patients, either. I know they are happier; as am I. This change has freed me up to do what I love best: Emergency Nursing.
But, still, it all leads me to wonder what it must be like now on the floors. I was once an inpatient nurse. I remember dreading a patient from the ER and the amount of work that came with it. I remember a time when I never wanted to function in the emergency an environment. And, yet, at times, that is exactly what they, the floor nurses, are going to be forced to do.
The other night, I worked with an Intercare nurse who was floated to the ER. She said she felt useless. She didn't know where we kept supplies, how we got our medications, or even how to go about charting. It was in that moment that I realized a little bit of planning on the administration's side could maybe have softened the blow. If we were going to force nurse's to work in our area, wouldn't it make sense to help them?
I tried my best to make this nurse as comfortable as possible. I wanted her to know that I appreciated her presence. Her knowledge of inpatient care was a relief to me. I did what I could to help ease her anxiety, but I don't think it helped her all that much.
Cautiously, I am breathing a sigh of relief. Maybe the horror of ER overcrowding can be changed. Maybe the answer can be found in the form of a law. And maybe, just maybe, the patients I'm nursing will get the care they deserve. I guess only time will tell.