Welcome to the NJENA Blog!!
We are going to be posting questions to the members here to share best practice, innovative ideas, legislation, upcoming events, practice and management questions. Please let us know if there are burning questions you would like to see posted and answered by your New Jersey Emergency Nursing Peers.
Gayle Walker-Cillo RN, MSN/Ed, CEN, CPEN
NJENA President
Comments
ED Management Structure
I was wondering if someone could tell me their management structure for a 80,000 - 100,000 pt visit per year ED that separates pediatric patients from adult patients. For example, do you have a manager for each unit (peds vs adult) and then a Director of the ED?
Peritoneal Dialsysis
I am wondering if peritoneal dialysis is being done in any of the ED's you work in. If so, is there a procedure or protocol specific to your ED?
initial ambulatory entrance receptionist
Would like to know who the 1st person in your ED ambulatory entrance is to speak to the patient.
What is your process for input ? Is demographic info initially taken ? How much & by whom?
What is your triage process afterward?
Ambulatory entrance reception
We are a Level II Trauma Center in central NJ. The first person to meet the patient is the Security Guard, acting as Visitor Control. He or she has the pt fill out a brief form with Name, date and time of arrival, reason for visit, date of birth, M vs F, and yes or no to "have you ever been here before." This is a 2 part form, the copy is given to registration w/a copy of the patient's ID if they have any. The original is dropped through a "mail slot" into the Triage booth.
Registration does a "mini-reg" which collects name and BD and merges the old records to the new account number. The name automatically transfers to the ED information management screen (We use EDIM). This gives us the new account number so we can begin labs/radiology/ECG etc.
Once the patient is brought back, the registration is completed. That is when the insurance info is collected and the rest of the demographics is confirmed as correct.
Kathy
Face Book
We have this Blog site and a NJ ENA Facebook page as well. These are both great ways for members to share ideas and information and ask questions of other members. Please feel free to use it.
Critical Care in the ED
I am interested in the ever expanding skills and competencies that ED nurses must maintain. How do you remain comfortable and proficient in the low volume high risk procedures; i.e. ventriculostomies, CVP readings, A-line, ScVO2 monitoring and transvenous pacemaker placement?
Do you think the "annual skills day" format works?
Do you just have to "see one, do one"?
Would Nursing Grand Rounds - case discussion of a real patient who needed this treatment. work?
What works for you in your environment? Share your best ideas.
Gayle Walker-Cillo RN, MSN/Ed, CEN, CPEN
NJENA President
expending skills and compatency
Nursing grandrounds case presentation of real patient works.
Ones a month we have a staff nurse to present a "problem" case to the ED staff.
It's educational and very informative. The nurse involved in the problem case takes full responsibility of the "problem" and present's the corrective action.
Our purpose to educate the staff . I feel that staff present to the staff is very effective and take responsibility for ones mistake in a professiona setting is prodactive.
In the ED we created a no blame envirinment. We disscuss all "mistakes" and learn from it.
Pediatric Issues in The Emergency Dept
I have only worked in the MMH Pediatric emergency dept for 4 yrs ,on the night shift ,but have noticed a great team interaction with peds and adult nurses.I have been a pediatric nurse for over 38yrs--so I am comfortable with this population.
What I have noticed is the adult nurses reluctance to take care of pediatric pts. It would be helpful for case discussions with peds nurses and adult nurses together. The adult nurses have taught us much in caring for adults and we should return the favor.
Pediatric Issues in The Emergency Dept.
That's wonderful that you have a great team interaction with the adult nurses. I think the adult nurse reluctance to take care of a pediatric pt is due in part that they are out of their comfort zone. The adult nurses are used to "big bodies" to take care of and when presented with a "little one" that is 12 months old for example, well, that can be extremely stressful. I'm sure there are other feelings about this topic however that is my opinion.
I would welcome the challenge to take care of a pediatric pt, but with no pediatric er nursing experience, that won't happen anytime soon. Your idea of a case discussion between the peds nurses and adult nurses sounds like a positive step in the right direction. Good Luck.