<<One thing that bothers me is that M/S will refuse to take report on one of my ED pts, or ED has to hold their pts. because "M/S is at their max." The ED never closes its doors, we rarely go on divert, so it can be frustrating to hold M/S pts when you have ED pts hanging from the ceiling. Our M/S nurses also expect us to start all the admission paperwork, assessments, care plans
, fall assessments, etc. when we hold them. That bugs me...we're helping them out by holding their pt, but I don't think we should have to do all the paperwork, too.>>
The thing that bothers me is that we turn on each other in things like this rather than realizing it is a systems failure & the fault of the facilitys administration - not the fault of the med-surg RN & also not within her control. Too often we lambast each other for things like this - the ER RN gets angry with the floor RN - the floor RN gets angry with the ER RN - when what we should be doing is getting together to make the administration deal with their problem instead of dumping it on us.
It all stems from inadequate staffing & excessive pt loads. If the floor RN already has more than pts than she can handle safely, or all hell is breaking loose up there, she cant safely take another sick person into the fray until she can give him the attention he needs. She only has 2 hands & professional judgement.
In Minnesota, nurses have the right to temporarily close their units until relief is brought in if they feel they dont have enough staff to safely care for any more pts. Yes that backs up the ER but it doesnt help to move people out of the ER to a place where there is no one to take care of them.
Sometimes the ED doesnt realize that the RN is caring for upwards of 8 people at once. may have just gotten an admission & is tending to that pt, may be in the midst of a procedure, or emergency on the floor, has her hands full - and just cant come to the phone for report at that very second. We pressure each other rather than pressuring the hospital to make the improvements in staffing to alleviate this problem. Maybe because its just easier to fight with each other than to fight with the suits.
I work in ICU & we recently couldnt take report on a new admission because we had 2 codes going on at once & everybody was at those. When we get an admission into ICU, it takes at least 2 RNs, sometimes 4 or more, to handle it initially - depending on the stability of that pt. Theres only 8 of us & we were already divided up between 15 pts - 2 of them crashing at the same time. We could not drop everything to admit another unstable pt right then. We explained to the ER that we'd call back when it settled down. They hung up & 2 seconds later called the supervisor. Funny thing, the supervisor was in our unit helping at one of the codes herself & answered her pager from our nurses station. It was the ER calling to complain about & report us - saying "the ICU RNs refused
to take report on the admission".
The supervisor told them "and rightly so".