Floor nurse, please forgive me....

  1. 25
    ....when I send you a patient whose chest tube connections are not taped and banded. Really, I am not an idiot, believe me. You see, the pulmonologist swooped in and switched from the heimlich valve placed by the ED doc to a pleurevac *right* when I was packing up the patient to go upstairs, and we had a trauma arriving who needed the bed. The trauma patient could not wait in the hallway while I taped and banded the chest tube! And no, I didn't even have time to call you and warn you, because the second I sent the patient your way, I was already being pulled into a Stroke Alert.

    ...when my patient arrives to you cold, hungry, and grumpy as hell. I don't make a practice of ignoring my patients' comfort, and I'm usually pretty good at smoothing things over when we're really busy and people don't get the attention they expect. Many times I've warned them of what to expect when they get to you (that a meal tray won't be waiting for them, that it will take time for them to get tucked in, that lab draws will no longer be pulled from their peripheral IV, that it will take some time for their meds to be ready, etc.) in order to help make things easier for everyone. This time, I just couldn't. I had critical patient after critical patient, and so my stable ones didn't get much attention.

    ...if my charting stinks. Most of the time my documentation is decent. Not outstanding, but decent (we chart in narrative form on paper documents). But today, I chose bedside care over documentation, and I really hope it doesn't come back to bite me in the butt. Please, if you have any questions, feel free to call me. That's why my phone number is on the piece of paper we fax to the floor for every admit. I really don't mind if you call me. I might be in a hurry to answer your questions as quickly as possible and get off the phone so I can do the other five gazillion things I need to do STAT, but don't take it personally.

    This is not satire. I really do feel badly about these things. Does anyone else have any guilty confessions, or is it just me?
    ybq2008, JulieL, Skeletor, and 22 others like this.
  2. 51 Comments so far...

  3. 1
    Chuckle, yeah, I thought it was just me!
    MADDOG70 likes this.
  4. 23
    Dear ED nurse,

    ICU nurse here, and I understand. I believe you when you say the patient pooped on the elevator ride up. (No, really, I do. $&%* happens, and it is bound to be after you have the patient all settled, pretty, and ready to go. Ask me how I know. )

    I notice and appreciate what you have done to make my life a little easier, whether it is hanging that antibiotic, starting a second line, whatever. I notice the things that aren't done, but ya know what? I chalk it up to the mad, mad world that is the ED. I don't really expect a super-comprehensive assessment, but a good, focused one. I'll figure out the rest.

    And good Lord, if the patient has an iffy BP, and you go ahead and start dopamine down there before you bring 'em up, I might kiss you. On the face. Without apology.

    I'd be lost if they made me go "down there" (ED). So I guess what I'm trying to say is....thanks! Carry on!
    Last edit by Always_Learning on Jan 6, '12 : Reason: Typo
    bjaeram, MADDOG70, mybrowneyedgirl, and 20 others like this.
  5. 3
    I always feel bad giving the floor nurses those mean, cold, old ladies that are miserable for the sake of being miserable. I try to feed, gown, wipe and hydrate them with their choice of beverage, not to mention the 30 blankets and pillows.

    Oh, also pts with really bad skin. I truly feel bad about this. I don't always have the time to take a picture and document all of them, nor the time to dress every single one, and I apologize, but sometimes I am tied up. Sorry.
    GrnTea, flyladynurse, and ~*Stargazer*~ like this.
  6. 20
    Quote from Always_Learning
    Dear ED nurse,

    ICU nurse here, and I understand. I believe you when you say the patient pooped on the elevator ride up. (No, really, I do. $&%* happens, and it is bound to be after you have the patient all settled, pretty, and ready to go. Ask me how I know. )

    I notice and appreciate what you have done to make my life a little easier, whether it is hanging that antibiotic, starting a second line, whatever. I notice the things that aren't done, but ya know what? I chalk it up to the mad, mad world that is the ED. I don't really expect a super-comprehensive assessment, but a good, focused one. I'll figure out the rest.

    And good Lord, if the patient has an iffy BP, and you go ahead and start dopamine down there before you bring 'em up, I might kiss you. On the face. Without apology.

    I'd be lost if they made me go "down there" (ED). So I guess what I'm trying to say is....thanks! Carry on!
    Dear ICU Nurse

    thank you so much for your understanding.

    I also understand too. When I call report up and speak to you on the phone, Sometimes I wait on hold for 10 minutes while someone fetches you because you are at a bedside with another patient. When you come, I'm never irritated (we've all been there)

    When I hear the exhaustion in your voice at the end of a very cordial report when you ask
    "How long do you think before you bring the patient up?"

    If the rest of my patients are stable, and census is stable, I reply

    "well, I have to hook them up for transport, find a second nurse it might take me 30-45 minutes..is that okay?"

    I always hear relief on the other end of the phone...because we both know I could have the patient on the floor in 5 minutes.

    IF only ICU and ER could be friends all the time...
    ChristineN, ybq2008, NickiLaughs, and 17 others like this.
  7. 9


    I feel the love.
    TinyRNgrl, MADDOG70, Nascar nurse, and 6 others like this.
  8. 12
    Aww what a wonderful thread.

    From an ICU nurse...

    Thank you ER for all that you do
  9. 0
    I have a question for you, have you ever been a floor nurse? I have a lot to say, however i'd like to know your reply first.
  10. 1
    Quote from cardiacrocks
    I have a question for you, have you ever been a floor nurse? I have a lot to say, however i'd like to know your reply first.
    Yes, I spent two years on a busy cardiac interventional and medical overflow inpatient unit.
    Esme12 likes this.
  11. 1
    No, stargazer, I have those guilty feelings too at times when there is no way I can 'prep' my patient like I would like to prior to transfer to the floor.

    When I'm lucky enough to have only the set ratio of patients (we can easily go over that during crazy times, as you know) and they are all stable, I'll do a good skin assessment on my nursing home patients, make sure they are clean and wearing a fresh brief. I try to reconcile the med list if I can because I know that is one less thing the floor nurse has to do when they enter the endless admit charting upon the patient's entry to the floor. Anything else I can do to help, I'll do.

    However, the times where I get critical patients all at once, the best I can do is stabilize and hot bed them out - with a yelling charge nurse to send them up, triaging the 3 ambulances that arrive at the same time as to which one I think will die first if I don't see them now, I can't do what I would like to do. I'm not happy about it, but sometimes it's beyond my control.

    In my experience, there has been less floor vs ER lately and I always explain if there is something that needs attention right away and why I couldn't get to it. Normally there's understanding with the few exceptions.
    fiveofpeep likes this.


Top