Shadow an ER Nurse
by: Capella Tucker, October 12, 2007 5:10:00 am
(hospital sound ... door opening)
The shock rooms are busy with trauma patients which is what most people think of when it comes to emergency rooms. But just down the hall is where the constant action is ... the so-called holding room where patients wait for treatments, admission or discharge.
"There's 16 on this side, we probably have at least another 20 on that side over there. When it gets up to, believe it or not we'll take up to 50, based on those numbers before we say we need to go on drive-by."
Ben Taub Clinical Nurse liason R.N. Mark Tamalis explains drive-by means that an emergency room has reached maximum capacity based on staff and space, but that doesn't stop the patients from coming to the emergency room door. On this day, Tamales is training a new nurse to make sense of the activity.
"Let's see if we can get one of the nurses back here to round with us so we can see what's in this room and see how we can help them move some of these people."
Tamalis doesn't want the patients to wait. Then there's the additional pressure that more patients will be coming through the doors. But no nurses are available, so Tamales and the new nurse become emergency room detectives. They find a patient with a nose bleed.
"One of the frustrations of being an ER nurse in this facility when it gets to be overcrowded is the overcrowding actually starts slowing you down on things that should be routine. And every nurse here will tell you that one of the greatest challenges is finding the chart of a patient."
They need the chart to know what to do next.
"So they are relating this to hypertension, the nose bleed. OK. And the on-set looks like it was 45 minutes before arrival and she's been here for about an hour-and-a-half."
Tamalis and the new nurse find another patient to find out if treatments are being applied.
"Hello my name is Mark, I'm one of the nurses here. I'm Angela. Want to check on you. Are you feeling better than you were?"
The patient has a mask on her face and additional equipment around her bed. The patient has been taken care of, but the new nurse, Angela O'Neil, wonders what she would have had to do if the patient was still waiting for the treatments. Tamalis' answer: get creative to get privacy for the patient.
"Relocate her stretcher to, find a spot somewhere, or you might move two beds out and double park them in the middle of the aisle and then move her into a curtained area."
And thus some of the challenges of an overcrowded emergency room. Tamalis says there are more plans in the works for expanding this part of Ben Taub.
"But even with that as you know when you open up a freeway and expand it, within a few years, it's packed again."
Capella Tucker, Houston Public Radio News.