Lets see. Just recently:
The no water in the ED rule became a no personal property at all in the ED because they were suspicious we might be hiding water in our jackets.
In order to prevent any drinking in the ED they moved the water to the pyxis room, which is locked in a way that physicians cant even enter the room. So not only can WE not get water without a nurse letting us in, but only nurses can get patients water. (to be fair, this occurred a long time ago)
They decided to remove all of the guaiac solution from the ED despite us (6 months ago) going through extensive and annoying color vision checks to prove we were allowed to do guaiac in the ED. So we had no stocks of it. So we went to the back stock room to see if there were any more back there and they CLEARED OUT THE BACK STOCK ROOM stating that if we need any extra equipment or supplies that arent kept in the pyxis room (again, which only nurses can get into) we should send a courrier down to the basement to find it. This obviously goes extremely poorly nearly 100% of the time, so recently we have had to go down ourselves for it (we like to send the administrator themself down when we can to show them how dumb it is).
Lube is now a controlled substance and needs a pyxis order. This includes taking all the lube out of the rescusitation bays, a real pain in the ass for people like me who like to lube their ET tubes.
An ER director at a nearby hospital got fired because they had no ER physicians seeing the psych ER patients despite it being under the ER's umbrella and eventually one with a blatantly obvious medical complaint went back to psych ED and croaked. Now admittedly this was sort of a big deal, but the level of f*** up here wasnt "bad stuff happens" it was "there was no attempt to identify if this guy had any medical complaints and he clearly did". So the response from our ED director was a bit.... heavy handed. We now had to see and fully evaluate, with a full written note, every single psych patient who arrives including medication refills and blatantly obvious "these guys have no medical issues." As we simply did not have a staff to do this without our efficiency grinding to a halt, we asked them to rethink the policy or hire a PA or something to assist with this. Their decision instead was to pull a provider from the regular staffing and place them in a side room where their only job was to watch the intoxicated patients (not joking. Not evaluate them. Not write a note on them. Literally baby sit them) and be available at all times to see every psych patient and they were not allowed to see regular patients during this time, and the lost staffing was not replaced, the main ED just had to bare the load of one less provider than normal during day time hours.
Sunday is a relatively slow day for us as far as ill patients go and nearly all of our patient load is nonsense 4/5 ESIs. Because the ill patient load is low the administration long ago decided to not have the urgent care open that day and just let us bear the brunt. Still the sheer numbr of nonsense 4/5 ESIs is crazy at times, so we got a bit spoiled and asked that it be open so that our sundays can be a breeze. The administration listened (!!) and actually hired an additional PA just so they could flex the PA schedule around and staff the urgent care area on sundays. But the administration did not hire any new nurses nor did they change the nursing assignments so the urgent care center has never had a nurse available. So far 100% of sundays the PA has come in, found no nurse available to work the urgent care area, found nursing management was unwilling to flex a nurse to them, and then the PA went home and the second PA who was to come in later was told not to come in as "the urgent care area is closed today". Collective facepalms have ensued from that lack of thinking through an idea completely. Im sure they will soon complain back to the physician staff how we mislead them and tricked them into hiring a new PA that never gets used.
