Recently had an elderly female pt who was living at home...she fell out of her w/c and broke her wrist. The ER doc did not feel it safe for her to return home and a SNF admission was arranged for rehab. Our case manager gives me the # for the nurse at the SNF to whom I'm supposed to give report. I call her, she transfers me to someone else, this second person says I should be talking to (insert name of the first nurse) and gives me her number. I tell her that this first nurse had tranferred me to her. She says "Ok then" and hangs up. Frustrating, very busy day, I'm falling way behind.
So I call the first nurse back, she was going to transfer me again until I finally 'convince' her that I need to speak with her to give report. Anyway, this is just the annoying background story.
I'm telling her about the pt, why she is here, what we did for her, etc. I go into the vitals. "On arrival her heart rate was 72, her blood pressure 128/52, her resp..." She cuts me off "52 is her blood pressure? Isn't that really low? Did you notify the doctor about that?" I tell her that is a totally acceptable BP for us, and, yes, the doctor knows about it. Then I go on and finally get to the discharge VS "...and her blood pressure was 99/56." Uh oh, I know what is coming. "And that is her blood pressure?? And she is going to leave there with that?" (actually, thanks to the little phone tag game earlier, medics had just picked up the pt and she was already on her way to the SNF)
I am not try to criticize SNF nurses and I am not angry, per se, with this nurse. She was probably busy too, and perhaps she just had a pt last week whose BP went downhill very quickly and she did not want a repeat performance. It was very frustrating in the course of a busy day to face this line of questions when I was just trying to get things done and get caught up.
Any suggestions on how to make this process a bit smoother?
