I thought my life was complete when I started a new job at a new ED which I thought was my dream hospital to work. Everyone is so nice but there is no teamwork! At my previous job, we had amazing teamwork. Every time we get new patients, we always help each other out whether it be doing an EKG, putting the patient on the monitor, checking a blood sugar, starting an IV, sending labs, giving meds etc. It was the definition of team work. I feel like at this new job, the culture is totally different. Everyone minds their own business and they have the "that's not my patient mentality." Where I worked before, we would always say, "that's not my patient but what can I help you with?" What attracted me to the ED was the teamwork. I love helping my fellow coworkers and I do offer help when I have the time but nobody is returning the favor! I feel like I'm drowning most of the time, and nobody cares that I am running around while they are all talking about how their personal lives are doing. They are great nurses but I I just feel like I do not belong here. I feel burnt out already and I don't know what to do. Just ranting I guess.
Nov 22, '13
I have days like that. The ER could be like the flood gates of hell and it's not bad because of the team work.
Then there's other days.. I want to splash some flushes in coworkers faces.
I find I need to be the needy nurse when that happens.. Except when they refuse to help. Then I wanna spike some flushes.
Nov 22, '13
Have you thought about talking to the clinical manager and see if they can do a trail of "team nursing" in your station. And it also depends at my hospital who the charge nurse is. If I have a crappy charge then I do pretty much all my own ****. Good luck
Nov 22, '13
Even at my ER, there's no team work from the other nurses as far as the things you mentioned. In most cases, your floor tech is your team when it comes to stuff like EKG's and and blood sugars. I rarely get reinforcement from other nurses unless my patient is critical. They really expect you to be able to carry your own weight. If we have a float nurse who's available to help us with whatever we need than that is a luxury.
Usually I have to ask another nurse for help if I need assistance. In most cases they won't just offer. Which is fine for me. I understand that everyone has their own load to carry and can't always be worried about my load.
And yes I know what it is like to be running around while other nurses are chit chatting. But keep in mind that this is the nature of ER, fast paced running environment, especially if your ER doc is fast. I think your going to have to either adjust to being independent or look for a different ED job.
Nov 22, '13
I have the opposite problem. With the exception of trauma activations, I'm used to being alone with busy patients doing everything myself, so it's still a little strange to have another nurse come in and start an IV while I'm putting the patient on the monitor, etc. I really don't know how to act.
Nov 23, '13
I"m actually curious to know if you and i work at the same place. :Two shifts ago, I had two patients who I knew were going to be ICU, hgb 5.5, and an ETOH requiring IVP valium every time I could get in there because of DTs. My other two patients, were somewhat stable sorta, I could ignore them, except they ended up needing ICU too for closer neuro monitoring. Bleh... No one could help me because we had two super sick traumas roll in. A few people helped a bit, enough to keep me afloat. But it does get frustrating.
In my case, I just kept reminding them, "hey i've got 4 ICU patients over here, and I am unable to adequately and safely care for these patients." I got my help oddly enough when it was my turn for lunch and my lunch relief came because who wants to care for 4 ICU patients alone?
I'm sorry about the lack of teamwork. It's hard to find a balance, especially if it's a super big Trauma I ER. Keep your chin up, hopefully it will get better, and if it doesn't, there's always other places.
Nov 24, '13
Unlike the ED I work in, the team work is great. Sometimes I feel like, ****, I can't do anything for my patient who's getting tubed b/c I have a nurse on each limb getting IVs, one has the RSI, one tech has EKG , foley, RT is bagging, etc.... And all I can do is document and put orders for the doctor during intubation I'm sorry that it's like that for you all at your ED
Nov 26, '13
it's weird, but I feel like the "teamwork" in the ED has fell to the wayside in the last few years.
Nov 27, '13
I think it really depends on the team. I noticed that you said your previous job had a great team but this one is terrible.
When I work with my usual crew (our weekends "on" people) it's like clockwork. I know that my tech will already be getting the ekg, that my aide/transporter is getting the pt undressed and on the monitors, another RN will come in and ask if i want to take report or to put in the IV and get bloodwork, and that a provider has seen the pt at the door and is already starting to get orders put in. Everything is done efficiently.
When I do an extra shift, or overlap with the other weekend crew, it's the opposite. I'm doing it all on my own and taking report while doing it and looking for a provider to pick up the pt for any extra orders. Takes much longer and I worry about my other patients, but it gets done.
Nov 27, '13
I definitely think it has to do with your place, and what the crews are like. I have not seen a reduction in teamwork. My ED has really good crews where like NurseOnAMotorcycle describes, the crew works with almost not even needing assigned tasks, to crews that are more independent, but they will ask and help out if you need it.
I think there are several factors that have fostered the teamwork we have.
1. We bring in a fair number of new grads each year, or fairly inexperienced nurses who need several months of preceptorship. Because of that, they get accustomed to asking for help when they need it, and we get accustomed to looking out for each other and helping when it's needed.
2. We have a really good management team that emphasizes the importance of teams.
3. As nurses almost all of us have been in that position when an extra hand saved our bacon and made what could have been a hell shift into one that we were able to survive and even get a pee break in during.... Because of this, we tend to help out another nurse in a "pay it forward" kind of concept.
Nov 27, '13
My 'crews' vary. But I find it's the shift.
Nobody wants to work (generalized, myself included) but most work together and help each other out.
When 1 is charting and the other is tasking, the pt is set up.
Nothing gets me going much like drowning because I have 4 pts that are difficult sticks, can't ambulate, need the full work up, know they are going to be admitted and I step out my door and see 3 nurses sitting around.
Tonight, I had a nurse start a squad, knew everything that was going on.. A family kept calling on the telephone and I had things going on. Instead of talking to the family, they said I'd call them later.
I had drowning day today and not much back up. If I had a critical, they would have helped. I was so glad to run out of there today.
Nov 28, '13
Is staffing and acuity different in your new job? Perhaps it's unreasonable to assume people are going to help you with routine tasks, but hopefully when the poop hits the fan in your assignment and someone else is less slammed with acuity, they will step in. The ED where I work has a layout which is not conducive to team nursing, but somewhat isolates nurses with their assignments. You really rely on your ancillary staff. With an average patient assignment of 6 in a busy level one trauma center people don't always have time to help on a routine level, but they are great at stepping in when acuity strikes, i.e. intubation, STEMI, code, etc. I've always believed you have to promote a culture of teamwork. I try to offer people help whenever I can in hopes that what goes around comes around.
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