[carachel2]

without even asking me ! I *totally* don't mind and totally appreciate the help when someone pokes their head in to a curtain where I am working and says hey "your guy in 9 is up for discharge, can I do that for you ?"

But I HATE it when I come out of a room and look for the chart on the guy in room 9 because I want to go discharge him and POOF it's gone, he's gone, chart has been taken apart,etc. There are two nurses specifically who do this to me ALL the freaking time. This last weekend I had a lady I specifically wanted to watch for 30 minutes before I sent her on her way. I came out of a room and find another nurse (who had not even seen this patient before and who incidentally, had her own four patients to take care of) discharging this little old lady and her daughter. I had specific things I wanted to teach her and her daughter and a plan for how I wanted to do it and most importantly, I had NOT asked for help. I later asked the family if they had gone looking for help (as in asking if someone could help get them going) and they said no.

Like I said, I love the team player aspect of our ER and I love that we all help each other out. I love digging in and helping everyone get it done but I ALWAYS go ask that nurse before I touch her patients.

Do I just need to talk to these people individually or is this an aspect of the ER that I must get used to ?

[canoehead]

I think its part of the deal. If I want something done, or someone to wait I put a sticky on the chart so anyone that looks at it knows.

[carachel2]

I like the sticky note idea ! So do you just indicate that you are aware of the order,etc ?

[missnurse01]

i don't know...i can see both sides of your coin there, but we would drown if we didn't get help from eachother in my er. if there are specific things i want done before someone d/c's my pt, then i usually write a few words note and stick it to the top of the chart so while it is in the rack it will be obvious what needs to be done before they can go. this eliminates the prob of running after each other and asking what else we can do, it is all on the sticky. we put things like rechecking s/s or vs, or specific d/c instruc they need, etc. this helps the flow i think...if there is something i want to do myself i either tell the other nurses or write it on the chart, leave for ___. there is a lot of letting go of controlling every little aspect of what is going on for a pt, we tend to think of it as OUR pts, rather than yours or mine, at least we try that!! it works for us, but i could see where it wouldn't...i'm sure others will chime in with what works for them, so u should get more ideas! good luck to u.

[carachel2]

Definitely bring on the tips ! Like I said, I am pretty much green at this. Maybe because everyone knows I'm the new kid on the block ? But really it is just these two. I don't know if they think I'm not keeping up or if they are just genuinely doing what they would always do. I *am* probably a bit slower than someone who has been doing this for years, but I don't think I'm slow enough that there is an all out alert for helping me.

I totally love our ER and the fact that everyone is helpful, I just want them to let me know !

[Nurse Ratched]

I didn't really understand this is how it worked in the ER - I know it's not unusual to have someone from ED call report on a pt being admitted and not know anything about the pt other than what they can easily glance at on the sheet - kinda makes it hard to get the story sometimes. I am a control freak - wouldn't last there lol.

[PennyLane]

In my ER most people will ask you if you want something done first. I've had co-workers discharge my patients, but usually after they've asked me first. Very rarely, when I've been totally in the weeds, has someone sent a pt of mine home without asking me. For one thing, once someone is sent on their way, the room is then open and you will get a new patient. I find it common courtesy to ask first.

Now, if someone wants to put my little old lady on the bedpan for me, well, I don't mind at all!!

[Spidey's mom]

This doesn't only happen in ER . . . . it happens when I work acute too. While I do appreciate help, please don't note my orders and stick the chart back in the cart. Or discharge my patient unless I ask.

I'm a control freak too . .

steph

[canoehead]

We generally share the walkie-talkies but divide up the sicker patients informally. If someone needs a med hung, or a bedpan we'll do it and let them know. We only have two nurses on so if one lands in triage the other needs to be able to pick up easily, so charting as you go and keeping your partner up to date is essential.

I think knowing each other is important. I know I get all balled up if someone starts doing one thing with the patient while I'm doing another, I can't think and listen at the same time. Once I expressed that people would make necessary phone calls, help with paperwork questions, or let me give them a task instead of jumping in.

Now that I think about it we generally check in with each other before discharging anyone that required a lot of interventions. Usually that means just saying "I'm gonna discharge room 8, OK?"

[LeahJet]

I think it's a matter of the whole "ER type personality". I believe either you have it or you don't. Not saying that someone can't adapt but it really has to do with our basic personalities. I, and most of my co-workers, have kind of a laid back...but know when NOT to be laid back...personality. We know real emergency situations vs. the small stuff. I worked about 2 years, off and on, in an ICU....and discovered I am not really an ICU nurse. I am not focused on control and total order. I really respect the nurses that are but that's just not me. Thank God that nursing can be so diverse.
As far as the sticky notes on the chart idea....I've always been a fan of that. i.e- "pt. can be d/c'ed at 2130 d/t rocephin IM" We all help each other out because it is good for the flow of the ER. It's kind of not fair for one nurse to be turning over her group of pt's fast and getting more in her rooms while another putters along. When I see a chart sitting there, ready to be d/c'ed....I let it sit there a few minutes and if the nurse taking care of that pt. doesn't get it done, I am on it.(IF it's a simple d/c) I want those people that have been sitting in the waiting room for 2 hours to get back before they become even more hostile....
NurseRatched, lol, I know that it drives the nurses "upstairs" crazy when someone else calls report and I can see your point. In our ER, we really do try to limit that practice. The other night, I was calling report because my co-worker was absolutely swamped and we needed the room for an MVC coming in....so after I asked her if I could help...and she asked me to call report.... I could hear the disgruntled tone of the nurse taking report. It made me cringe but it had to be done.
I am sure the OP is a great nurse and probably would put me to shame with the teaching aspect.... but it may be beneficial to try to curb the control thing while in the ER. I'm afraid that might lead to burn out.