TRANSITIONING FROM CLOSED TO OPEN SYSTEMS 1 NURS 6053: Interprofessional Organizational & Systems Leadership Week 2 Discussion Transitioning From Closed to Open Systems INITIAL POST I work in a small rural facility that contains an emergency department, intensive care unit, surgery, medical-surgical floors, and a psychiatric ward that provides care for adolescents to geriatrics. However, we lack a pediatric unit and obstetrics. Our emergency department is comprised of thirty beds containing one seclusion room, one negative pressure room, and two trauma bays that are rarely utilized because we recently lost out trauma certification. Although management seems fit to staff us with one clinical nurse manager, five registered nurses, a ward clerk, one certified nursing assistant, one physician, and one midlevel provider; we still find ourselves barely keeping our heads above water when caring for our patients. We often find ourselves with returning patients, increased patient acuity, and even holding critically ill patients in the emergency department for days. Per Barish, McGauly, & Arnold (2012) the crowding in