The Emergency Department Nurse works in a 123-bed community hospital and Level 3 Trauma Center in Spokane Valley, Washington. The Emergency Department has 21 beds, 8 hallway beds, 5 fast-track beds, and 4–12 outpatient overflow beds used as a secondary fast track. The patient population includes geriatric patients and patients with abdominal pain, chest pain, stroke, psychiatric issues, and respiratory conditions; approximately 15% of cases are pediatric. The nurse-to-patient ratio is 1:4, organized in pods with 8 patients between 3 nurses. The unit has 24/7 support from a charge nurse, receptionist and HUC, respiratory therapy, hospitalists, and phlebotomy services. Technicians with phlebotomy licenses are available for peripheral sticks: 3 on days (7 a.m.–7 p.m.), 3 on nights (7 p.m.–7 a.m.), and 1 on 1-1. Telemetry monitoring is available at the bedside and nursing station. Many ER nurses are trained in ultrasound-guided IVs, and a VAT team is available weekdays from 8 a.m. to 4:30 p.m. New staff receive a comprehensive one-week orientation covering NEO training, EPIC training, skills check-off, and a general site overview, plus 2–3 precepted shifts. Shift schedules are provided during the application process. Weekend rotations occur every other week, and staff are expected to work one holiday per contract. Requests for time off may be approved up to 7 days. The facility has no cardiac catheterization lab; cardiac catheterization patients are transferred to designated facilities. Staff may wear any professional scrub color, and parking is free.
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