Quote from Anoetos
Excellent. Just excellent. And so true. How does this happen EVERY DAY?
But to make sure I am hearing the ER RNs correctly: your job is so different and hectic that floor nurses should just suck it up and deal with the fact that you don't have time to do a complete job of charting and reporting?
Now, if there is a completely different ordering, charting, reporting process in the ER than in the units your patients go to such that you're doing it but they cant see it, then the problem goes much deeper than just misunderstanding. It's systemic and needs to be fixed.
I spent 9 years in a cardiac unit prior to the last 6 in the ER. I understand the frustration of getting report from the ER during report to the next shift. I know that in my hospital anyway, the admit database must be completed within 2 hours of the pt hitting the floor. Major pain in the butt! I get that, really I do!
I would never
make the assumption that I somehow work harder or have more work than any other nurse in the hospital! I've been there, done that, and to be honest I can't see myself ever working on a floor again. At least in the ER I have access to 20 other nurses and 6-7 doctors to help me! The big difference is our priorities. We don't get report for our patients, unless the come in via EMS. Then our report consists of 73 yr F, c/o SOB and a set of vitals. No hx, no allergies, no medications etc. In the first 10 minutes I am supposed to get a complete history, start a line, draw labs, do the EKG, place the pt on the monitor, BP, SPO2 etc. We don't have the option of refusing a patient because we just intubated the guy in the next room and the guy next door needs to get to the cath lab asap! We have to prioritize and do those things that keep someone alive first! I don't listen to breath sounds unless it appears necessary, or ask about last bowel movement. It isn't that I think those things aren't important, just not now!
We do send a hard copy of the chart up with the patient. I agree two different software programs that don't communicate with each other is just stupid,...but I didn't make that choice! There was talk about sending a fax report to the floor instead of calling report,..glad that didn't fly!
The frustration of calling report during shift change has always been around. When I transferred to ER it was a huge pain, as we are changing shifts at the same time the rest of the hospital is and that is part of my shift change! If I don't get report called, even if the pt doesn't go up, then a nurse that hasn't seen the pt has to call report! Not good patient hand off!
The name of the game in the ER is to keep people alive long enough to get upstairs and get the specialty care they need. We need to do that quickly to keep the flow moving. The longer a patient is in the ER, the longer a patient is in the waiting room with almost no care!