We started the day two nurses short and with two ICU holds so that took one nurse for them, two nurses and the charge nurse to run the rest of the ER. It wasn't long until we all had 4 patients including the charge nurse and the nurse with the two ICU holds which put us way out of ratio. We told the nursing supervisor and her response was 'ok.' The other hospital went on diversion so we started getting all the ambulances plus the doctors were accepting patients from outlying facilities. Pretty soon we all had six patients including the two ICU holds, 3 step-down holds and 3 medical floor holds. there were 18 patients in the lobby with complaints of chest pain, weakness, pneumonia and there was nothing we could do about it. Fast track was doing work ups. The nursing supervisors response? "Do the best you can, we know it is bad down there."

WTF? You know it's bad down here? Get down here and help us for God's sake.

Our charge nurse blew her top. It was pretty impressive as she is the most even tempered, easy going person I have ever know. She never even raises her voice. She said to the supervisor "I am declaring an internal disaster" and hung up before there was any response. She overhead paged "Internal Disaster, ER now."

Surprisingly, when all the directors get called in there are bed assignments. Funny how that happens. The cath lab crew was called in to work in the ER, they threw a big hissy fit at that but were told they had to come in. The president of nursing told the nursing supervisor to put on scrubs and get down to help us, which she did - wonder how long it has been since she has done any real nursing?

I got out of work 9 hours after my shift was over, which means I worked 21 hours. I am whipped. Last I heard there was going to be a big pow wow this morning with all of admin to figure out a solution to the problem we've been having the last few months. Let me help you, get some nurse in here now!

Sheesh.