Emergency Room Staffing: Nurse Shortage

Published: 26th November 2009
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You rushed a friend at 10:00 in the evening to the nearest hospital due to unbearable chest pain. But at the emergency department, you were greeted with a number for patients waiting to be attended to. It took 30 minutes before your friend was taken care of by the emergency nurses.

You wonder, what is this shortage about emergency nurses? Aren't there enough people who would like to take care of sick people anymore?

According to a study conducted by the researchers from Cambridge Health Alliance as reported in Health Affairs, wait times went up an average of 4.1 percent per year for all patients. Unfortunately for heart attack patients, the wait stretched to 11.2 percent every year. Blacks, Hispanics, women and patients in urban hospitals have longer wait times that others.

So how long exactly are these percentages? For patients diagnosed with heart attacks, the waiting time in 1997 was 8 minutes, but in 2004 it rose to 20 minutes. Patients who needed attention within 15 minutes, according to the nurses who evaluated them, have to wait 10 minutes back in 1997. But in 2004, it went up to 14 minutes. Emergency room wait in urban hospitals was 30 minutes. While non-urban hospital emergency room wait is within 15 minutes.

So why are the numbers increasing?

Emergency visits rose by 78 percent from 1995 to 2003. But the number of the emergency departments to accommodate this rise fell by 12.4 percent from 1995 to 2003. The number of patients rushing in to the emergency department to get medical attention can be attributed to the fact that there is an increase of underinsured and uninsured patients. The aging American population is also a factor.

According to the EMTALA or the Emergency Medical Treatment and Active Labor Act, everyone has the right to be seen and attended to in the emergency department, whether they are able to pay or not. This served as safeguard for the underinsured and uninsured citizens.

There were several accounts of patients dying in the emergency room waiting area because of overdue waits even with critical undiagnosed conditions. Recently, a 19 year old woman died on the Kings County Hospital Center Psychiatric Emergency Department floor. The incident was recorded by the hospital's camera. It took an hour before someone took notice of the woman, but the patient was already dead. The hospital was said to be understaffed.

Different measures are being taken to resolve the crisis in emergency departments and avoid unfortunate events like this. Most resolutions are being directed to the Congress. Some of the proposed means to be taken are:

1. Quickly approving the $50 million in extra funding for hospitals that provide uncompensated care to uninsured patients.

2. Significantly increase a funding for disaster preparedness in hospitals.

3. Establish an agency in the Department of Health and Human Services for emergency and trauma care, and create a demonstration program to promote a coordinated regional approach to emergency care

Dr. Andre Wilson, Chief of Emergency Medicine in William Beaumont Hospital in Royal Oak in Michigan released a study on the effect of the straight back approach in reducing emergency room wait time. On this approach, the patients are immediately moved from the triage to an emergency room treatment area without going through the waiting room. There is need for the patient to go though with the minimal registration procedure and have the patient chart available immediately. With this procedure, the Beaumont Hospital was said to have the satisfaction rating from their patients increased. This also thought to increase the hospital's revenues.

Hospitals are taking measures on reducing the staffing shortages their emergency department are increasing. Emergency room nurses are much in demand nowadays to cope with the increasing number of sick patients requiring medical attention. we could have as many emergency room nurses, but the key issue is how to provide health care for everybody available at all times with minimal amount of wait.

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