The lack of control of Emergency medicine

[Birdstrike]

I've just stopped worrying about COVID. Let the admins deal with the disaster stuff. I put on my surgical mask, see the patients, end my shift and go home. I've realized that overcrowding and lobby medicine aren't things I can control at this point so don't waste my time worrying about it.

I wasn't talking about COVID necessarily, more about stress in general. But I hear, ya. I've over it, too.

 

[Birdstrike]

I'm an admin (associate medical director, chair of ED PIC committee, EMS medical director). I also have to improve things in the ER to keep an EMS unit available for 911 calls because of extended wall times. It's hard to not get overwhelmed when your average hospital ER in metro Atlanta is consistently running with an NEDOCS score >400 on a daily basis.

We're implementing multiple plans to help. Some docs have excellent ideas, and I always welcome input from them.

You're much more to the front of the front lines, with a lot more spinning plates in the air than me right now. So, I doubt I have any excellent ideas that haven't already occurred to you. But what's the biggest problem you're having? The obvious, like ED overcrowding, holds, no beds to admit to, short employees due to quarantining? Something else, less obvious?

 

[GeneralVeers]

The biggest issue right now is a shortage of nursing, and unwillingness of administration to fix the problem. Yesterday it was 4.5 hours just to draw labs on our waiting room patients because the nurses were doing a work slowdown. No amount of begging on my part could make them work faster. My medical directors are sympathetic, but because it's a CMG there is very little they can do to help with any of the clinical issues.

 

[southerndoc]

The biggest issue right now is a shortage of nursing, and unwillingness of administration to fix the problem. Yesterday it was 4.5 hours just to draw labs on our waiting room patients because the nurses were doing a work slowdown. No amount of begging on my part could make them work faster. My medical directors are sympathetic, but because it's a CMG there is very little they can do to help with any of the clinical issues.

I can tell you administration at my shop doesn't have an unwillingness to fix the problem. The problem is the shortage of nurses, probably exacerbated by the nurses who have become nurse practitioners. Nurse administrators are being put in clinical roles at my hospital.

 

[namethatsmell]

The biggest issue right now is a shortage of nursing, and unwillingness of administration to fix the problem. Yesterday it was 4.5 hours just to draw labs on our waiting room patients because the nurses were doing a work slowdown. No amount of begging on my part could make them work faster. My medical directors are sympathetic, but because it's a CMG there is very little they can do to help with any of the clinical issues.

Having lived through this reality as well, I just chalk it up to reason #13,749,825 why our health system is maddening.

 

[Cinclus]

I can tell you administration at my shop doesn't have an unwillingness to fix the problem. The problem is the shortage of nurses, probably exacerbated by the nurses of nurses who have become nurse practitioners. Nurse administrators are being put in clinical roles at my hospital.

I swear that at least a quarter of my nurses have left to become travel nurses, leaving us needing more travel nurses...

 

[turkeyjerky]

I swear that at least a quarter of my nurses have left to become travel nurses, leaving us needing more travel nurses...

Can you blame them? Many were getting laid off or furloughed in the spring. Loyalty's a two way street.

 

[bravotwozero]

Yeah unlike us, RNs are in a bargaining position like never before, and are now realizing it. Some hospitals have had entire floors of RNs walk off the job because they didn't like what admin was doing. Nurses can kick the C Suite's @ss all day long if they wanted to.

 

[GassYous]

I swear that at least a quarter of my nurses have left to become travel nurses, leaving us needing more travel nurses...

I would too when the hospitals are paying travel nurses 4x more for the same job except with less bs

 

[Dr Mantis Toboggan]

I would too when the hospitals are paying travel nurses 4x more for the same job except with less bs

I’d argue associates in nursing is probably the most bang for the buck of any degree right at the moment. assuming you are not a super skilled tradesman etc

 

[namethatsmell]

Can you blame them? Many were getting laid off or furloughed in the spring. Loyalty's a two way street.

When interviewing at gigs I've been asking how many docs/staff were laid off or slapped with disproportionate pay cuts 2/2 covid. Figure it's a quick way to screen for a decent workplace culture, supportive admin environment, and a financially solid organization.

 

[Siggy]

I can tell you administration at my shop doesn't have an unwillingness to fix the problem. The problem is the shortage of nurses, probably exacerbated by the nurses who have become nurse practitioners. Nurse administrators are being put in clinical roles at my hospital.

I'm sure if they offered enough money they can score some travelers and agency nurses.