The Emergency Department ( Ed )

The implications and effects on patients waiting long hours to be seen in the ED are immense. In a recent study done over five years in Ontario hospitals showed the risk of adverse events and even deaths increased with the length of stay in the ED (Science Daily, 2011). When EDs become overcrowded the quality of care changes and declines; which is extremely dangerous. Authors of the study calculated that if ED length of stay was cut by only an hour that 150 fewer Ontarians would die each year (Science Daily, 2011). Wait times can also negatively affect patients financially, untreated medical conditions can lead to reduced productivity and inability to work leading to increased financial strains (Fraser Institute, 2014). As well as delayed access to care can result in more complex interventions needed. Therefore an initiative is needed to provide patients with timely, efficient care when accessing

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

The role of the emergency department is to diagnose and treat acute and urgent illnesses and injuries. Patients are seen in order of medical urgency. The emergency department bases the patients urgency for treatment based on levels. Level 1 is critical and life-threatening. This is usually related to ABC’s (Airway, Breathing, and Circulation). These patients are top priority and require a lifesaving intervention. Level 2 is also considered high priority and can also be life-threatening. Psychiatric patients are considered level 2, and patients arriving to the ED with chest pain. Level 3 patients require resources such as sutures, x-rays, CAT scans, MRI, etc. Level 3 patients are provided treatment services only after Level 1 and 2 have been addressed. The emergency department at CEMC also has a trauma room and a SANE room. The trauma room is equipped with life-saving medications (such as antidotes for drug overdose) and medical equipment. The SANE (Sexual Assault Nurse Examiner) room consists of equipment used to assess a patient who has been sexually assaulted. The equipment takes pictures of the patient for the SANE nurse to later provide to law enforcement. A SANE nurse is a specialty nurse and CEMC has one on call 24/7.

In the Emergency Response Referral, the RP reported that on 1/27/2017, children Dermarion and Theodore Brown were at a visit with their birth mother Ashley Brown from 3-5pm at CVC. RP reported that when the children returned from their visit the foster mother notice a strange behavior with the boys. RP reported that Jakeisha observed Dermarion and Theodore pulling each other’s hands down, and that Dermarion had an erection. RP reported that Jakeisha stated that the boys were laughing and then she put the boys on a time out.

Kendra Chappell is a clinical shift manager (CSM) in the emergency department at Forsyth Medical Center (FMC). According to their website, Forsyth Medical Center is a 921-bed, not-for-profit, regional medical center in Winston-Salem, North Carolina, that offers a full range of medical, surgical, rehabilitative and behavioral health services (About us, n.d.). FMC has earned magnet designation from the American Nurses Credentialing Center (About us, n.d.). Kendra has twenty years of nursing experience including working as a Practical Nurse before obtaining her Register Nurse degree 15 years ago. She was a staff nurse in the emergency department for ten years before being promoted to CSM. She has earned a bachelor of science in nursing at Appalachian State University and is a Certified Emergency Nurse. She is certified in basic life support, advanced cardiac life support, pediatric advanced life support, trauma nursing core course, and emergency nursing pediatric course, certifications that are required of all emergency nurses at FMC. Kendra oversees the 81 bed FMC emergency department from 7 a.m. to 7 p.m. every Friday, Saturday, and Sunday. She supervises 25 to 30 nurses and 10 to 15 nursing assistants throughout the course of each shift.

A stand-alone emergency department specializes in dealing with psychiatric patients is a proven way to deviate psychiatric boarding in the regular ED. According to a study on the effect of having a dedicated psychiatric emergency service published in Western Journal of Emergency Medicine, “transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus comparable state ED averages” (Zeller, Calma, & Stone, 2014). Not only will the emergency departments benefit from this study, but also inpatient psychiatric

There are Emergency rooms all over the United States that are being utilized as primary care provider., by patients covered by private insurance, Medicaid, Medicare as well as the uninsured.(Baker, August 13, 2008) Some patients call their primary care provider and are told, they cannot be worked in for several days or weeks. The option given is to go to the Emergency room for treatment. Other reasons are people who do not have a primary care provider or insurance. Primary care providers do not want to take new patients without insurance, so their only choice is to go the emergency room for treatment. Another factor driving Emergency Room volume trends are physicians who send

I am a freshman at the University of Wisconsin-Milwaukee. Currently, I am a pre-med student majoring in biology, and my goal is to eventually work as an Emergency Room physician. What initially drew me to work in the medical field is that it would allow me to have a career in science and help people. Service is important to me because my parents instilled in me the importance of helping others. My mother works for the Milwaukee Health Department so I am aware of the health challenges facing many of our citizens. I want to be an Emergency Room physician so that I can improve the health of my community in a way that also allows me to have a career that I enjoy. The College of Letters and Science is helping me achieve my goals by providing me

Well, I've worked in large city emergency departments for 21 years. Working hard, hustling, breaking my back for a non-stop 12-hour shift, it takes a big toll on you, I'm not as young as I use to be I have to admit. But loving what I do still today has given me satisfaction and sense of purpose in my career over the years. I could not imagine having another profession. The patients are sicker, expectations of you, though not unachievable focus not as much on the care we provided, but the patients experience, including family members and how satisfied were they with the care given during their visit also did we meet their expectation. I understand why changes are being mandated as part of our care we provide. I've have held jobs in areas of

Background. This study was done to determine if prolonged wait times in the emergency department (ED) effect overall care and treatment of patients.

The respiratory system is one of the most common systems injured by various types of trauma. Thus, an initial triage evaluation of trauma patients should always include a careful evaluation of respiratory function. The clinician should especially focus on evaluating ventilation issues in the airway, thoracic wall and pleural cavity, and oxygenation issues in the lung parenchyma. In this presentation, I will discuss common respiratory injuries as results of trauma and how to diagnose them at emergency rooms by physical examination, diagnostic images, especially ultrasonography and radiography, and respiratory function test. I will discuss emergency treatment of these patients including oxygen supplementation, management of airways. I will also

To be valued in our society, you have to have a job. Recently I was thinking, what job do I want? I love helping and interacting with people. Then I thought, in the future, I want to become an emergency physician.

During my practicum in the emergency department, I utilised my interpersonal, negotiation and conflict resolution skills to de-escalate a situation during a busy shift. When asking the patient how I could help her, the patient became verbally aggressive. Expressing displeasure with her nursing care, a lack of communication, the long wait time for medical treatment and not being offered food and drink.

6:00 a.m. — Alarm rings. Time to prepare for a potentially long day and night. 8:30 a.m. — At the clinic, routine gynecologic cases, such as annual exams and infections are seen 10:00 a.m. — pager goes off needing assistance to the emergency room to see a 30-year-old woman, who is 30 weeks pregnant. 10:15 a.m. — race from the clinic to the hospital, and discuss the modes of delivery she may need. 12:00 p.m. — A scheduled C-section on a 26-year-old. who has requested tubal sterilization. 2:00 p.m. — A calls comes for a 20-year-old, who, at 41 weeks, needs labor induction. 4:00 p.m. — Rounds on the maternity ward. 7:00 p.m. make it home to catch dinner with my family. 10:00 p.m. call from the clinic 's labor and delivery unit about

Patient wait times in the emergency department have significantly decreased as a result of stand-alone EDs. From 2013 to 2016 the average wait time in hospital EDs went from 28 minutes to 22 minutes. This shows an improvement from the decade before which averaged a growth in wait time due to populaiton growth, reduced primary care access, and less ED facilities.