September 26th, 2016

Honorable

Allan Grayson

5842 South Semoran Boulevard

Orlando, FL 32822

 

RE: H.R.1602 - Nurse Staffing Standards for Patient Safety and Quality Care Act of 2015.

 

Dear Congressman Grayson,

               First, I would like to congratulate you for all you do for Florida, and to thank you in advance for taking time to read this letter. I hope your day is going as smooth as possible. My name is Lilia Landers, EDRN and on behave of emergency medicine, I would like to express my frustrations that affects the profession. The Emergency Room is a very hectic, chaotic place, where patients and family members come in a stage of panic. With that said, my intentions are to bring out concern from a prospective nurse’s point.

               Currently, the nurse to patient ratio is a 4:1 which is honestly doable if all of the patients are stable. However, in the ER we never know what will come through those doors, for we do not pick the patients we want to have. If a bed is available, and the patient need immediate care, we will do what it takes to save lives. That is, having an already critical care patient, and adding another to the assignment plus two other somewhat stable, if lucky, is not only rough but affects the safety of all patients in the group.

               Collaboration between ER nurses is one of a kind, we are like a family. It takes a least three nurses to run a cardiac arrest code. I just want to let you know that those nurses also have an assignment of four patients. During a code, which can last at least twenty minutes, those nurses are away from twelve patients at time. We are talking about stable and non-stable patients. As we love the thrill and enjoy saving lives, we worry about safety.

               To improve safety of our patients, we recommend to have a 3:1 ratio. ER starts the initial care for the patients, we start peripheral access, blood work, first assessment, EKG. All this is followed by the plan of care, IV fluids, antibiotics, catheters and drips. In Intensive care unit, nurse to patient ratio is 2:1. Given the assumption that both patients are unstable (The Lamp, 2013). In the ER situation, we do the initial care for more than that two patient rule in the ICU. Again, patient safety is our only one concern. We want to provide the best care possible in a short amount of time we care for our patients.

               I hope this letter gives you a glance of what an ER nurse feels in a daily basis. The nurse to patient 3:1 works for the safety of all patients, stable and unstable patients. Emergency medicine is an extremely rewarding career; I hope you can help us provide the best care possible.

 

Sincerely,

Lilia Landers, EDRN.

8004 Juniper Rd,

Ocala, FL 34480.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Congress. Gov. (2015). H.R.1602 - Nurse Staffing Standards for Patient Safety and Quality Care Act of 2015. Retrieved from: https://www.congress.gov/bill/114th-congress/house-bill/1602/text?q=%7B%22search%22%3A%5B%22hr+1602%22%5D%7D&resultIndex=1.

Emergency nurses under pressure: minimum nurse-treatment space ratios essential for safe functioning of EDs. (2013, April). The Lamp, 70(3), 16. Retrieved from http://db04.linccweb.org/login?url=http://go.galegroup.com.db04.linccweb.org/ps/i.do?p=AONE&sw=w&u=lincclin_cfcc&v=2.1&it=r&id=GALE%7CA335626925&asid=6fdf2c28bd00080cafc447535ad6abfa.