Over this past year and a half, this team has risen to the occasion of continuing to serve our patients, not only for known and familiar emergencies, but for those that are attributed to the COVID-19 pandemic. At the beginning of the pandemic, the ambulance bay, now referred to as Forward Triage Area or FTA, was converted into 12 extra hospital bays, with negative air pressure, from one Friday night to the following Monday. For many months, these rooms allowed for a designated area to treat ambulatory emergent patients experiencing COVID-19 signs and symptoms. As our ambulatory COVID-19 patient population has dwindled over time, this area continues to serve many of the lower acuity patients presenting to the Emergency Department (ED), expanding our treatment rooms from 43 to 55. According to many of the patients our emergency room treats, many referred to us as the “destination” emergency room and hospital, not only for those concerned with COVID-19, but for health care in general. Working as the “destination” providers, our Emergency Department serves over 60,000 patients annually, and are “prepared to treat any injury or condition, from common to rare, minor to life-threatening, at any [given] time.” The difference this team makes is witnessed by their determination, grit, and resilience to be their best, do their best, for the best; our patients, both in the Emergency Department and throughout the health system.

ED staff serves the health system by dispatching to various areas of the hospital to assist with placing Ultrasound Guided Peripheral Intravenous Vascular (USGPIVs). Several emergency nurses are trained in USGPIV access and bridge gaps overnight, during instances where IV therapy staff is limited or unavailable. Similarly, our emergency department techs and UAPs respond to STAT EKGs pages overnight, fulfilling a need that would otherwise remain unavailable. Another gap noted by our nurse manager, within our department, was the amount of time between a patient checking-in to starting the triage process. To reduce the amount of time patients waited until triage is started, our manager introduced the idea of “Triage Ten,” an Voalte message notifying staff that five patients are waiting to be triaged or at least one patient has been waiting more than 15 minutes for triage. By activating “Triage Ten,” one, two, or more staff members present to triage at once and proceed to triage 2-3 patients during the next ten minutes. Upon completion, staff then returns to their assignment. Because we have seen up to 25 patients check in over the course of one hour, this allows the team to pull multiple resources for a short duration, but has a significant impact for identifying emergencies, allowing staff to provide better care, and continue to build trusting relationships both among co-workers (by responding to the “Triage Ten”) and patients with staff, by decreasing their wait time from check in to starting the triage process.

Looking back at patient references to The University of Kansas Hospital being the “destination” place for health care is only further supported by the health system’s ranking as the facility in the Kansas City area, according to U.S. News and World Report. This is the reason the ED encounters many of their patients requiring emergency services because they receive a majority of, if not all, their health care with the system. But once here, our team makes the difference, because unlike most other teams, we are jacks of all trades–masters of all. The Emergency Department demonstrates clinical expertise in their bedside care, continuing education, and ability to perform under high pressure situations. Emergency staff fulfill requirements of the accreditation process for multiple designations including, Level 1 Trauma Center by the American College of Surgeons, Advanced Comprehensive Stroke Center by the Joint Commission in collaboration with the American Heart Association and American Stroke Association, and the Comprehensive Cardiac Center by the Joint Commission.

The University of Kansas Hospital’s Emergency Department received the Emergency Nursing Association Lantern Award 2019 (valid for 3 years). Nursing team members are also Trauma Nursing Core Course (TNCC) certified, VAD (Ventricular Assist Device) Aware, and a handful are Advanced Burn Life Support (ABLS) certified. Not to mention, approximately 30% of our nursing staff holds at least one certification and seven nurses holding two or more certifications. The team’s work is not only recognized from governing bodies and through awards, but also from our patients and peers. Several of our nurses have received DAISY Award nominations and accolades via Patient Relations. Nurses and techs/UAPs often recognize their peers through Shift Shout Outs daily and supervisors through their daily End-of-Shift reports. Many peers also recognize each other through the annual Nursing Excellence Awards (22 nominations for 2021) and Donor Supported Awards (5 nominations, 2 winners for Angela Buisch Award 2021), many of whom are also recipients.

Our forensic program coordinator has been nominated for the International Association of Forensic Nurses Frontline Nurse of the Year Award 2021 by nurses within and outside of the health system. And seeing that a team is made more than just the nurses, it is also important to note that two of our physicians have been awarded Attending of the Year (only three given/year since 2019), and several more also received nominations. While these examples highlight the competency of the Emergency Department team, it fails to embody their compassion and empathy. So how does staff put this into practice?

Following a pediatric resuscitation, a nurse obtained permission from the coroner’s office to cut a lock of hair for the parents. Staff continuing to resuscitate a patient until a priest arrived to fulfill family’s wishes of final prayers (last rites). Another nurse recognizing a patient being groomed for sex trafficking and calling our forensic program coordinator to visit with the patient, identify necessary resources, and developing a safety plan. Though these are but a few examples, they all required staff to build trusting relationships and display compassionate care both with patients and their families within a short time span. Like the daily functions of the emergency department, we hope this brief encounter with who we are, what we do, and how we serve as a team, is reflected in this nomination. As with any unit, staff often rely heavily on one another to make a day successful, and this team’s ability to perform at these demanding, high levels of competency and expertise, remain compassionate and trustworthy, all while providing extraordinary service, continues to be made possible because of their strong teamwork.