Emergency Nurses Launch Workplace Violence Toolkit on ADVANCE for Nurses

A recent ENA study found more than half of emergency nurses surveyed reported experiencing such verbal or physical abuse within the previous 7 days. Of more concern, according to ENA, was the finding that in almost half of the cases of physical violence, nurses said no action was taken against the perpetrator; and in three out of four cases, hospitals did not respond to nurses' reports of violence.

"Research has shown hospitals that have policies and plans for addressing workplace violence have lower rates of violence than hospitals that don't," said ENA President Ann Marie Papa, DNP, RN, CEN, NE-BC, FAEN. "Hospitals with policies are far safer for the healthcare professionals working in them and for the patients they care for. We have a responsibility to our colleagues and our patients to make our hospitals - and our emergency departments - as safe as possible. I strongly urge all [ED] managers and hospital administrators to download and use this invaluable, important and free resource." 

via nursing.advanceweb.com

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Most ED patients willing to wait longer to avoid nondoctor care :: Aug. 30, 2010 ... American Medical News

Nurse practitioners and physician assistants account for at least 10% of outpatient visits and increasingly are being used to handle patient care in emergency departments, according to previous research.

But a new survey said 80% of patients expect to see a physician when they come to the ED. Fewer than half would be willing to see an NP or PA for an ankle injury -- they would rather wait two more hours to be cared for by a physician.

• See related content

The survey of 507 ED patients at three teaching hospitals in Pittsburgh and Dallas found that, even for a minor complaint such as a cold symptom, only 57% would agree to see a nurse practitioner and 53% would see a physician assistant, according to the study in the August American Journal of Bioethics. Patients also preferred to see a fully trained physician compared with a medical resident, but not by as wide a margin as their desire to avoid nonphysicians.

Given their strong preferences for care from physicians, patients deserve greater disclosure about who is providing care and what the level of training is, said study lead author Gregory L. Larkin, MD, professor of emergency medicine at Yale University School of Medicine in Connecticut.

via ama-assn.org

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Saving Grace (Emergency Department Nurses)- LA Times Magazine

“I heard a guttural scream,” Rich says, “and a man was handing me his lifeless son.”

“How old?” I ask.

“Nine months. We worked on him for over an hour.”

Rich moves his chair, coughs. It’s freezing in the conference room. [Note: For privacy, nurses are mentioned only by first name.] The muffled din of the emergency room is audible through closed metal doors. It’s 7 a.m., and Rich’s 12-hour shift has just ended. “I flashed to something I heard once about how a casket doesn’t weigh very much—just enough to break a father’s heart,” he says, “and I lost it. I’m standing there, between beds one and two holding that dead baby, and I’m sobbing. I am in charge, and I’m crying.”

As an 11-year volunteer in Cedars-Sinai Medical Center’s emergency room, I’ve seen close up what ER nurses deal with. It takes rare emotional courage not to burn out when you know that every time those doors open—whether you are working triage in front, where a guy may stumble in with a heart attack, or in back, where paramedics may race in with a girl who has been knifed or shot—it’s bad news. Then there’s the physical strength required to survive 12-hour shifts with two half-hour breaks and 45 minutes for lunch. ER nurses never sit. But it’s the children—every ER nurse will tell you—who take the biggest toll

via latimesmagazine.com

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The Long and Winding Road to the Emergency Room - NYTimes.com

He was the first patient of the day, dropped off at the emergency room by the police or a family member — a man in his 50s, unshaved, stumbling, engulfed in the pungent aroma of alcohol.

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Joseph Daniel Fiedler

When he blew into the breathalyzer’s strawlike tube, the readout was 0.18, more than twice the legal limit.

“I get seizures,” he said, referring to the dangerous reaction some people experience when they abruptly stop drinking. Then, as if to prove it, he held out trembling hands. Each bore the nicks and scars of a hard-lived life.

I looked at the beads of sweat on his brow, then down at his vital signs. Heart rate 120; blood pressure pushing 170/90. Despite his high alcohol level he was already in withdrawal. A medical detoxification — with drugs to counteract the sudden absence of alcohol in his system — was the right first step.

“Let’s admit him,” I said to his nurse. Because it was still early, there was a good chance a hospital bed would be available.

Her reply was apologetic but resigned: “He’s out of network.” I winced at my own naïveté. “Out of network,” a euphemism for “insurance will not pay,” was a roadblock I should have anticipated. A nuisance for many patients and would-be providers, it is ubiquitous in the second-class world of substance-abuse treatment, where insurance companies contract with selected hospitals and doctors to deliver care at bargain rates.

We called the few in-network hospitals within a broad radius. One had a bed. But before accepting my patient, the receiving doctor wanted a battery of tests, including an electrocardiogram and laboratory work, to rule out other medical concerns. It would be a day or so before the tests came back.

But the patient was already in withdrawal, I told the doctor. He couldn’t wait a day.

“Sorry,” he said flatly. “He

via nytimes.com

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24 Hours in an ER - Boston Magazine - Trauma Pics - Graphic

With more than 132,000 patient visits last year, Boston Medical Center’s level-one trauma center is the busiest in New England. Granted nearly full access to the facility, photographer Christopher Churchill documented the scenes that play out here day after day.

Originally published in Boston magazine, December 2010

via bostonmagazine.com

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Tough To Say No To CT Scans In Emergency Rooms : Shots - Health News Blog : NPR

A trip to the emergency room today is likely to trigger a round of routine diagnostic tests from blood work to an electrocardiogram to a urine sample. And increasingly, there's one more on that list: the CT scan. A new study shows that CT, or computerized tomography, has increased in ERs nearly six-fold since 1995 and shows no sign of tapering off.

Andrew Ciscel via Wikimedia Commons

A CT scan of the brain shows the cerebellum, a small portion of each temporal lobe, and the sinuses.

CT, a radiology tool that once took nine days to finish, was used 16.2 million times in 2007 to diagnose headaches, stomach aches, back pain, chest pain and the like. That was a huge increase from 1995 when it was used 2.7 million times, according to the paper published online in the journal Radiology.

via npr.org

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Violence in the ER-Emergency Department Nursing

A Maryland man made headlines last week when he shot and wounded a doctor at Johns Hopkins Hospital in Baltimore. But unfortunately, his story is no longer a rarity. Hospital violence is increasing in frequency — and ER nurses bear the brunt of the hostility.

According to the International Association for Healthcare Security and Safety and the Emergency Nurses Association, more than half of all emergency room nurses have been spit on, pushed, scratched and/or verbally assaulted on the job. Almost a quarter of ER nurses say they’ve been assaulted more than 20 times in the past three years.

ER nurses are particularly at risk because they often deal with intoxicated, confused or violent patients. Add to that increasing frustration over ER wait times and the healthcare system, and it’s easy to see why nurses are vulnerable.

While some hospitals are installing metal detectors in an effort in improve safety, many experts say that proper training is key to decreasing ER-based violence. All staff working in the ER should know:

• Warning signs — If a patient is pacing with clenched fists, watch out. Also pay attention to patients’ speech patterns, history (have had they problems with authority in the past?) and diagnoses. Patients with psychiatric disorders and those under the influence of drugs or alcohol are more likely to lash out.
• How to get help — Call for help as soon as you sense a threat.
• De-escalation techniques — ER staff should be trained in special techniques designed to diffuse a potentially volatile situation.
• What to do if violence occurs — Safety, of course, is number one. But after violent incident, report it! Hospital administration needs to know about each and every incident so that steps can be taken to create a culture of safety.

Have you ever been assaulted at work? Do you feel adequately trained to meet the threat of violence?

Tags: News, Workplace Safety, Workplace Violence

via scrubsmag.com

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Being an ER nurse is ‘like living on the edge - Little Falls, NY - The Times

Being an ER nurse is ‘like living on the edge - Little Falls, NY - The Times:"Being an ER nurse is ‘like living on the edge:"Countless number of patients pass through the emergency room doors every year and fall under the care of its nurses, doctors and staff. “I enjoy participating with my local hospital because it’s a way of giving back to the community,” said Heather Swartz, a registered nurse in Little Falls Hospital’s emergency room."
http://www.littlefallstimes.com/news/x123460206/Being-an-ER-nurse-is-like-living-on-the-edge#

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