MA ENA member comments

As someone who is currently "inactive" as a provider of emergency nursing care and having a management background, it may be easier for me to see things from other perspectives since I am not on the front lines on a day to day basis. I also look on it from a personal basis and will I get to go where I want to go in an emergency. I would like to think so.  Changes can sometime cause anxieties and worries but this is one we need to try hard to make work.  I don't think it is going away and might actually even be a good thing.  With the trial in the Greater Boston area a few years ago and with this being the norm in other areas of the country, we may find that it is actually better for our patients and us as caregivers.  First - one of the reasons some EDs get behind is when other hospitals go on diversion and we have ended up creating somewhat artificial boluses of patients from "other" hospitals. Many times these patients were very complicated and we needed to start at ground zero in getting the information we needed and then ended up transferring them to the patient's preferred hospital - more work, longer stays.  Secondly we need to trust our colleagues in the pre-hospital environment to help us.  In the distant past before we even had C-Meds, the ambulances services would see how busy one20ED was and they would then ease off and help to redistribute the patients for an hour or two.  I have a feeling that many never knew that this was happening but it did.  And thirdly, we need to remember that in some parts of the state, there is no other hospital to divert to and these hospitals have never had the opportunity to go on diversion so maybe we need to learn from them. 
I have also often thought that we in the ED have been too "macho" and did not work as well as we should with our internal colleagues.  We were not good at asking for help, identifying what we needed, we even made ourselves into martyrs and victims.  But slowly the realization is that this is in deed a entire system problem and not just an ED problem and changes implemented have helped us do our jobs better/easier.  So I advocate that we work together - prehospital, internally - to make this work for everyone - especially the patients.
Kay McClain RN MSN FAEN Beacon Chapter member MA ENA State Council Membership Committee Chair 2009

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