....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?
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
I, a coronary care stepdown unit floor nurse, had the pleasure of working on a day that we only had 3 nurses. The ER nurses, please note 'nurses', brought up 4 patients at the same time. Our census was low, that's why there were only 3 nurses, so we had empty rooms. The 4th patient was parked outside of the room where I had just started working on patient #3. The rationale was that there was no one available to accept the patient in the room. So just leave him and his family in the hall??? Really???? If you just cannot keep him in ER until one of us is available, it would be so much nicer to DUMP him in the privacy of a closed door rather than ABANDON him in the hall with the statement "it happens like this sometimes". First time ever that I had witness unprofessionalism to that extreme. 26 years of nursing and I thought it would take a lot to surprise me. Well, that one rendered me speechless! I walked into the hall with my mouth open and in pure shock! I, too, am one of those who would not go to the ER. I know my limitations. But I have encountered quite a few ER nurses who need to recognize the same. There is no shame in admitting that you cannot do a particular job. But to leave a patient in the hall of a floor that has at least 5 empty beds...you have not even learned the concept of fair customer service, let alone 'excellent' customer service. Should you be in the ER? You guys are the first faces that the patients see. Only one chance to make a first impression. Even the deceased are not left in the halls in the morgue. Life as a nurse would be so much better if we all could respect the others' position. This particular ER nurse just blew the patient satisfaction score for his department and ours before WE even had the chance to say "hi, my name is ladside and I'm gonna be your nurse this evening".
Last edit by ladside on Jan 6, '12
: Reason: Typo