Help Please!!

nrsang97, BSN, RN · Jan 10, 2009

ER staff brings the pt to the ICU after giving phone report. Questions asked at bedside.

I work the ICU and there is no way I am going to go down to the ER to get report and then bring the pt up. What is being said by the ICU staff in response to this new policy?

ashleyjean3 · Jan 10, 2009

It is called the "pull" system and it is supposed to improve patient flow. The ICU has been receptive so far.

loricatus · Jan 10, 2009

I work the ICU and there is no way I am going to go down to the ER to get report and then bring the pt up. What is being said by the ICU staff in response to this new policy?

I am curious as to why you find this distasteful? I mean no disrespect by this. I have worked both ICU and ER and this policy appears to be promising; so, some negatives regarding it would help me see both sides.

The only drawback I can think of is that the ICU nurse may have to leave an existing patient to come to the ER. If that patient can be covered by a CN, then I think it could work well. It sure beats leaving as many as 8 patients nurseless for an ER nurse to go to the ICU. But, from my vantage point, this is how I see. I would really like to hear more pros and cons.

diane227, LPN, RN · Jan 10, 2009

We did this at a hospital where I work. When the ICU nurse was up there just waiting for the patient, a lot of time they would come on down and get them. When we were holding ICU patients in the ER for extended periods, most often they got an ICU nurse to come down and take care of them until a bed was available.

nrsang97, BSN, RN · Jan 10, 2009

I am curious as to why you find this distasteful? I mean no disrespect by this. I have worked both ICU and ER and this policy appears to be promising; so, some negatives regarding it would help me see both sides.
The only drawback I can think of is that the ICU nurse may have to leave an existing patient to come to the ER. If that patient can be covered by a CN, then I think it could work well. It sure beats leaving as many as 8 patients nurseless for an ER nurse to go to the ICU. But, from my vantage point, this is how I see. I would really like to hear more pros and cons.

We have a assignment as charge nurse. Not the case on other ICU's in our facility, but when charge I have a assignment. Since our patients also need post op CT's and MRI's we also have many travels in the night. We are a neuro ICU and we have staff off the floor at CT or MRI many nights. So if soemone is off the floor to go get their pt from the ER then there isn't enough staff to cover that pod.

My objection is from a staffing point of view not necessarily having to go to the ER to get the pt.

I know you didn't mean any disrespect. However if our unit charge was not having an assignment then I can think I would be more receptive to that idea.

sweetsounds · Jan 10, 2009

VERY INTERESTING! As with everything, there needs to be give and take but, alas, we will never have that because we will have "procedure." Too bad for the pt. that we can't all get along together...

I am soooo happy for the Unit nurse to ask me ?'s Because, guess what, I don't know it all and another perspective can be a good thing! Also, I would like the Unit nurse to see that Out Of The ER is where the pt needs to go.

I completely understand when no one can cover your other pt, hence the "give and take," wouldn't it be great if we all respected each other a little more? I have been fortunate to work in rather small hospitals most of the time where: as long as things are clicking well, it can be between 2 adult/professional people what works best.

Sorry, I digress...

Pepperlady · Jan 10, 2009

Our ICU comes and gets report and picks up the patient ... another support person assists with the transfer unless they are too unstable and then either the ER nurse can go or the Clinical co-ordinator.

It works well as long as the two departments communicate, ER is not shoving patients to ICU when it is unsafe to take them and ICU has learned to be a bit more conscientious of the needs of ER in moving patients out as soon as possible.

nrsang97, BSN, RN · Jan 10, 2009

VERY INTERESTING! As with everything, there needs to be give and take but, alas, we will never have that because we will have "procedure." Too bad for the pt. that we can't all get along together...
I am soooo happy for the Unit nurse to ask me ?'s Because, guess what, I don't know it all and another perspective can be a good thing! Also, I would like the Unit nurse to see that Out Of The ER is where the pt needs to go.
I completely understand when no one can cover your other pt, hence the "give and take," wouldn't it be great if we all respected each other a little more? I have been fortunate to work in rather small hospitals most of the time where: as long as things are clicking well, it can be between 2 adult/professional people what works best.
Sorry, I digress...

Who says we aren't getting along? I gave my point of view. We are a level 1 trauma center so I know patients need to be OUT of the ER. However, I can't leave half the unit unattended, to go get my new patient.

Who said anything about not being like 2 adults? All I said is that I'm not going to leave my pt to go and get another from the ER. This isn't policy where I work. The OP asked about policy where you work. I gave my perspective from the ICU. However like I said before, I may feel differently if our unit charge didn't take an assignment, or we had the staff to accomodate, which we don't. Sometimes we don't have the staff to cover the patients we have adequately.

TraumaNurseRN · Jan 10, 2009

Who says we aren't getting along? I gave my point of view. We are a level 1 trauma center so I know patients need to be OUT of the ER. However, I can't leave half the unit unattended, to go get my new patient.
Who said anything about not being like 2 adults? All I said is that I'm not going to leave my pt to go and get another from the ER. This isn't policy where I work. The OP asked about policy where you work. I gave my perspective from the ICU. However like I said before, I may feel differently if our unit charge didn't take an assignment, or we had the staff to accomodate, which we don't. Sometimes we don't have the staff to cover the patients we have adequately.

That's sad that the charge takes an assignment. High liability risk I would think. We don't have a staffing problem in my hospital.....very nice.

nrsang97, BSN, RN · Jan 10, 2009

We are the only unit that has that issue in my hospital. MICU, CICU, and SICU charge nurses don't take assignments. However charge in my unit is asked by MD's to go to the ER , SICU, and OR to assist with bolt and EVD placements too. Seriously with all that we do including travel, how can we leave to pick up a pt in the ER. I know not all places are like this, but we are trying to change it. We haven't had any luck.

nrsang97, BSN, RN · Jan 10, 2009

sorry double post.