Best & Worst Excuses for Not Taking Report?

BookwormRN · May 24, 2008

Ok, different take on this thread. I'm the nurse on med/surg having to take report.

The worst possible time to have to take report is when I am just coming onto the floor and having to get report on the other pts I have been assigned. I will then say that I'll call the ER when I am out of report. (Purely out of consideration for the previous shift who have to leave the floor to give us their report, and somehow punch out in a timely manner.)

Now, I know that the ED gets busy, and you have to move Pts out to make room for more, but it is very frustrtaing for the floor nurse to get "attitude" for delaying report at change of shift. In our facility, report ALWAYS happens between 0700-0730; 1500-1530 and 2300-2330. I think that should be taken into consideration....

The only other times I will defer the call is if I am with a Pt (ie: giving meds-especially IV pain meds; or if transferring a Pt and it is unsafe to leave them.) OR I am finally taking a supper break at 8 or 9 p.m.--I am entitled to that break, and if I finally have time to take it, I'll call you when I'm finished eating.

I hope that not all your calls to the floor are handled in the way you described---there really are legit reasons for the floor nurse to have to call you back.

Thanks- just my :twocents:

P.S. If the room isn't ready, we have to wait for housekeeping to do a thorough cleaning---it isn't just a matter of the bed being made. I certainly don't have the time to do it, nor is it in my job description to do so.

nialloh, RN · May 24, 2008

Nurse is in the bathroom, nurse is on lunch, nurse is in with a pt, or last but not least, Hang on and I'll get her......... and then hang up.

nialloh, RN · May 24, 2008

Ok, different take on this thread. I'm the nurse on med/surg having to take report.
The worst possible time to have to take report is when I am just coming onto the floor and having to get report on the other pts I have been assigned. I will then say that I'll call the ER when I am out of report. (Purely out of consideration for the previous shift who have to leave the floor to give us their report, and somehow punch out in a timely manner.)
Now, I know that the ED gets busy, and you have to move Pts out to make room for more, but it is very frustrtaing for the floor nurse to get "attitude" for delaying report at change of shift. In our facility, report ALWAYS happens between 0700-0730; 1500-1530 and 2300-2330. I think that should be taken into consideration....
The only other times I will defer the call is if I am with a Pt (ie: giving meds-especially IV pain meds; or if transferring a Pt and it is unsafe to leave them.) OR I am finally taking a supper break at 8 or 9 p.m.--I am entitled to that break, and if I finally have time to take it, I'll call you when I'm finished eating.
I hope that not all your calls to the floor are handled in the way you described---there really are legit reasons for the floor nurse to have to call you back.
Thanks- just my
P.S. If the room isn't ready, we have to wait for housekeeping to do a thorough cleaning---it isn't just a matter of the bed being made. I certainly don't have the time to do it, nor is it in my job description to do so.

I can understand the change of shift delay, and I try not to do that, but sometimes the other floors make us wait upwards of 4 hours. It is one delay after another.

I am a tele nurse, and we have to guard our empty beds when we are getting full for ER admits, or transfers from other units with abnormal rhythms. We have to downgrade some pt's, and they often make us wait. It's not like they have to admit the pt, and if they were very sick, we would keep them.

We try to be considerate, but we get very little in return.

Dolce, RN · May 24, 2008

Worst: "All the nurses are at lunch." How can they all be at lunch at the same time?

nursebrandie28, BSN, RN · May 24, 2008

I work both the ER and Floors (FLOAT POOL) and floor nurses (in general) will make any excuses not to take report!! Drive me up the wall!! Even when I am working because the ER will keep calling and finally I will just take the report for that nurse.

Best: Ward Clerk: "the nurse is in a code" me: "what? this is a medical floor, they do not do codes on your floor!" Ward clerk:"no, the nurse collapsed and they are getting ready to tube her." me: okay, i will call back!!??!!

p.s.: side note of that story: nurse was sent to the ER, she had a small bleed, got it fixed and is fine now!! :yeah:

Worst: (and the one I HATE): "I am in a patients room, I will call you back." so i wait, then fax the report...when I take the patient up, nurse is sitting

at the desk!!! Drives me nuts!!! :banghead:

AlabamaBelle · May 24, 2008

I work ICU. Was expecting a patient from the floor. The Emergency Response Team had evaluated the patient on the floor and determined that an increased level of care was appropriate. I waited 2 hours on this patient. Called the unit to get some kind of update - the RN was at lunch!

On the other end, I was transferring a patient out of ICU to the general floor. In the middle of the transfer (literally pushing the patient into the floor room), the PACU RN calls me on my phone leash we must carry. I communicated quite clearly I was transferring a patient, not in my unit and would call her back, 20 minutes tops. Got back to my unit, new patient rolling in as I am returning. This was not an uncomplicated patient, had multiple issues of which I needed to be aware, needed art & CVP setups. I was very unhappy to say the least, especially when she indicated she HAD to leave in 15 minutes.

We try to be ready for ED admits - but when we say we have no bed, that always means we have no beds, literally, even after several calls to the supervisor! Or, we're trying to make room somewhere, somehow. And trying to find that freeze dried RN we keep to take the patient.

nerdtonurse?, BSN, RN · May 24, 2008

On the flip side of the coin, last night we took 8 admissions to a tele / ICU stepdown unit in 1 hour, middle of the big 2100/2200 med passand we only had 4 nurses on a 40 bed unit. We had one bed open, and we're all scrambling to do initial interviews, assessments, get the meds entered manually since the pharmacy goes home at 9 during the week, and ER calls wanting another bed assignment at 2215. We told them, look, we're slammed, you've given us 8 admits in the last hour, and we've only got one bed left. ER sends us a fax which basically has on it the patient's name, doc, admitting diagnosis, and meds given. Keep in mind, we gave no bed assignment, haven't assigned a nurse yet, nothing. We're all racing around, and I notice one of the ER nurses heading out of the unit with an empty wheelchair. I go take a look in 4, and sure enough, they just brought the patient and dumped her off. The pt had alzheimers, and was admitted for SOB/chest pain. Now, what would have happened if she'd wandered off? Coded? We didn't even have her code status and rather than bring the chart to the desk, they just left it on the bed. I entered the whole situation in the risk management software, but it just blew my mind.

BrnEyedGirl, BSN, MSN, RN, APRN · May 24, 2008

I transfered to ER from tele/step down unit about 1 1/2yr ago. This is the number one c/o ER nurses I work with. For some reason they honestly believe that when the floor says the bed is dirty, it really isn't. Or when the sec says the nurse is in a pt room in the middle of a complicated drsg change,.she really is sitting at the nurses station reading a book. I will admit I only know for sure about the specific floor I worked on and the shift I worked (7p-7a),.but when we said we didn't have a clean room, we didn't. I often hear nurses offer to come and clean the room,...wish it were that easy,..first on the floor we weren't even allowed access to cleaning supplies to clean the room and the cleaning process involves a computer entry to bed control so that addmitting can actually assign a pt to that bed.

I remember several times ER bringing a pt to the dirty room,..the pt had to sit in the hallway sometimes for hours before someone arrived to clean the rooom and admitting could assign the pt to the bed. W/o the pt assigned into the computer we did not have access to meds or treatments for this pt,.couldn't order a meal tray, couldn't chart (computer charting) etc. Then when you look at the electronic med records,.it shows this pt dc'd from ER at 1918,.but not admitted to the floor until 2114,..where was the pt that whole time and who was responsible for his/her care?

Another big c/o was from the floor,.when an ER RN would call report and start by saying "this hasn't been my pt but...". The floor would be furrious that the RN giving report hadn't even taken care of the pt. Well guess what,.ER nurses get to go home too,.and our shift change is the same time as yours,....so if I call the floor at 0635 to give report on the pt I've been taking care of, and you are in report (so am I by the way) and no one on your floor can take report until 0710,.then I'm going home,.I'll give report to my ER replacement and you will get report from someone who doesn't know much about my pt.

This whole debate is a very sore subject for me. I've been on both sides and I so know that sometimes I was so overwhelmed that I couldn't possible take report and another pt at that minute. I also know the frustration of waiting for a bed assignment for hours (not the floors fault I know) and then being told 3 times in an hour and a half that "the nurse is busy, she'll have to call you back",....all while we have 40 people in the waiting room to be seen,.many whom have been there for 4 hrs or more!

The obvious answer here is what we all have been begging for for years,..more staffing,.in the ER,.the floors/units, housekeeping, admitting etc! Until that happens I soooooo wish we could all just play nice together!! :loveya: Healthcare is a 24/7 job period end of sentence. We all have to work together to facilitate the best care for our pts. I see many people who seem to have the idea that they work harder than anyone else in the hospital and that others should somehow go out of their way to help make life easier for them because "they just don't understand how stressful the ER/ICU/NTICU/PICU/Floor etc is." We're all in the same boat here folks,..we are all over worked, understaffed and underpaid. To assume that when a nurse says the room is dirty or for some reason she/he can't take report right now, that the nurse is actually lazy or sitting around reading is not fair and is an attitude that causes unnecessary tension and resentment in the work place. Same goes for the floor/unit who goes on about "that ER nurse that tried to give report when she/he hadn't even seen the pt."

So sorry to have hijacked the thread,....I'll get off my soapbox now:chair:

allnurses Guide · May 24, 2008

On the flip side of the coin, last night we took 8 admissions to a tele / ICU stepdown unit in 1 hour, middle of the big 2100/2200 med passand we only had 4 nurses on a 40 bed unit. We had one bed open, and we're all scrambling to do initial interviews, assessments, get the meds entered manually since the pharmacy goes home at 9 during the week, and ER calls wanting another bed assignment at 2215. We told them, look, we're slammed, you've given us 8 admits in the last hour, and we've only got one bed left. ER sends us a fax which basically has on it the patient's name, doc, admitting diagnosis, and meds given. Keep in mind, we gave no bed assignment, haven't assigned a nurse yet, nothing. We're all racing around, and I notice one of the ER nurses heading out of the unit with an empty wheelchair. I go take a look in 4, and sure enough, they just brought the patient and dumped her off. The pt had alzheimers, and was admitted for SOB/chest pain. Now, what would have happened if she'd wandered off? Coded? We didn't even have her code status and rather than bring the chart to the desk, they just left it on the bed. I entered the whole situation in the risk management software, but it just blew my mind.

Where I worked you could not transfer until a room # was assigned, SBAR faxed and report given to accepting nurse.

That ER nurse would be in big trouble.

I think it works both ways . . . . there are legitimate excuses both ways and illegitimate excuses.

steph

ERbunny · May 24, 2008

Here is what happens in the ED when no one will take report at 0700. Exhausted night nurse has to either give report to day nurse , who really should n't have to bother with a pt she will not be taking care of, she then has to give a report on a pt she barely knows. O r exhausted night nurse has to stay over and wait on floor nurse to get report, get coffee, chat with friends, etc, wants to assess her pts, etc, etc. Exhausted night nurse now wondering if she will be able to stay awake driving home having stayed late to give report. The ED is also now starting to back up, as the drive time trauma is now sucking up resources and the am bus has let off its load in triage.

Bottom line : SOMEBODY on that floor can take report and pass it on.

And yes I have been on the other side, having worked ICU the first 12 years of my 40 year career. We were NEVER allowed to refuse report unless we were personally involved in a code situation.

JoshuaAdamsRN · May 24, 2008

I find it extremely insulting when I'm told the nurse is at lunch and no one else is capable of taking report. I've been in an ER for 3+ years now and I can count the number of uninterrupted lunches I've had on one hand. True, it's where I chose to work because I enjoy the pace and intensity. But for goodness sake, have someone else take report.

My favorite report excuse involved a nurse I knew from school who graduated the year before me. I was told he was in with a patient. So I figure, ok, I'll discharge this patient and call him back. Going out to the driveway, I see this nurse with his cigarette, chatting away into his cell phone. Busted!