Intro

Waiting Room

The flow of the emergency department if often dependent on the volume of patients, disposition of patients. When a patient enters the emergency department (ED), an emergency nurse with specific training triages the patient first. Then, based on their priority, they decide whether the patient has to be seen right away or if they can wait in the waiting area. With many situation of overcrowding many ED departments have standing orders for specif patients so that if there are extended waiting periods they may start some of their basic testing. For example if a patient presents for urinatry tract infection symptoms they may need to wait in the waiting room to be seen by the healthcare provider, however if the department has standing orders the triage nurse may be able to send off a urine sample if there is a standing order. The nurse(s) who are triaging patients are also responsible for the patients in the waiting room. If there are exteded waiting times, the nurse may need to recheck vital signs, or if a patients condition worsens while wating the triage nurse may then need to expedite them to be seen sooner based on the patients clinical signs and symptoms.

Lenght of Stay

The length of a patient's stay varies significantly and is frequently based on their medical condition, any necessary testing, the resources available in the emergency room or healthcare facility, and the number of patients that are currenlty there. A non-urgent patient's stay may last 1-2 hours, however an urgent patient may require several tests before a decision is made and require a longer stay of 3–5 hours. Some critical patients may actually have a shorter lenght of stay in the emergency department as their may need to transfer them to a higher level of care in an intensive care unit (ICU), although their clinical condition may critical their length of stay may require and immediate transfer to another area.

Admission to hospital unit

Depending on their clinical condition, many patients may need to be admitted into the hospital for additional care. There are often a range of different hospital units that a patient may be admitted to depending on their clinical condition. Some patient may be admited to a medical or oncology untion or some patients may need a higher level of care and be admitted to an ICU for close monitoring and care. Transfer to a hospital unit of requires a nursing hand off and report to the nurse who will be caring for the patient in the hospital unit. In addition, the nurse caring for patient that have been admited into the hospital will need to ensure that the patient is safe for the transfer. This includes that they are stable and transfer with the necessary equipment. For example if the patient need cardiac monitoring they may need to be transferred with cardiac monitoring and the nurse may need to accompany the patient so that they can observe the cardiac monitor for any cardiac changes that may occur during the transfer.

Observation unit

In ED a common disposition for patients it to an observations unit. An obseration unit is often within the emergency department and are for patients who require additional monitoring or testing. The nurse caring for these patient will often have to assess thier medical contiion, ensure that the testing that is need is completed in a timely fashion and ensure.

Procedural unit

Some patient may be trasfered to a procedural unit from the emergency department. This happens when the patient's clinical state necessitates an immediate intervention. For example, if a patient presents to the emergency department with chest pain and an EKG reveals cardiac ischemia and an infarction, they may require immediate cardiac catheterization. In the ED, the nurse will make preparations for the cardiac catheterization by making sure the patient has blood drawn, an IV access, and any preprocedural testing done. The will give report to the procedural nurse and the patient will then be transferred to the cath lab to undergo the procedure.

Discharge process

Some patients may be discharge home after they have been seen by the healthcare practitioner in the emergency department and all testing and treatments have been completed. The ED nurse has a responsibility to ensure that the patient is safe to be discharge home and has a means of getting home. If patients have had any pain medication they may not be safe to drive home and will require an additional method for getting home. The ED nurse is also responsible to review any discharge instructions that the patient may have recieved. This may include new medications that they need to start, wound care, or who and when the need to follow up with their healthcare provider.

Assessments and Interventions

Assessment and interventions of patient in the emergency department often focus on addressing the condition or illness the paient presented with. The ED nurse utilized fundamental nursing skills and often employs a focused assessment to determin the appropriate assessment and interventions that will be completed. In addition other essential health inforamtion should be obtained as well, including past medical/surgical/obstetrical history, allergies, current medications, substance use which is essential health information.