hardcore nursing. putting my care where my mouth is.

Yesterday was yet another very bad shift. Why bad? Not enough available hospital beds led to an overflow of patients in our emergency department that were waiting to be admitted. This is referred to as access block and it quickly leads to a dangerous overcrowding of our department. Why dangerous? Overcrowding of emergency departments has been shown to result in an increased morbidity and mortality of patients. It also results in an increased likelihood of medical errors, a decreased capacity to manage emergencies, unacceptable waiting times, more incidents of violence, high levels of stress, poor morale, and a pernicious disillusion amongst its staff. Good people become swamped by a bad system. Instead of building quality and greatness into our emergency departments, most of our clinical energy is deflected into crisis management. It becomes a day to day struggle to maintain a flow of patients within the system so that the system itself does not completely collapse and fail them. I have been banging on about this since 2001, and despite a lot of people I really admire, working exceptionally hard to make a positive change, I have seen little, if any, overall improvement. True, we do have days (or even a block of days) where hospital capacity is able to manage our admissions. And at times like this, we get a glimpse of what we could be. But the slightest increase in presentations, or the slightest easing in efforts to maintain flow, and we logjam again. I certainly do not hav...
Source: impactEDnurse - Category: Nurses Authors: Tags: piss and vinegar Source Type: blogs