Er Nurses

[mamason]

Just wanted to say, I thank you for what you do. Even though I think that sometimes you have no idea what I do, I.....in the same sense, don't understand exactly what hurdles you are up against. So, if I ever anger you, or offend you, I don't mean to. It's just I'm frustrated as much as you. Could you please just understand that when you call for report, it's possible that I can't answer that phone call at that given time? I'm in the middle of trying to stablize my pt who won't quit going into V-Tach? Or, I could be in the middle of explaining that all the treatment we are trying to do is not working on this CHF pt to the family? I'm not against you. I'm in this business for the same reasons you are. Because I want to help people. What I do is just as important as what you do. And, I must say, I don't think I could do your job. You are exposed to many things unbecoming that I am not. And for that, I respect you. But, could you please try to understand that I'm not avoiding your phone call? I'm just busy trying to make sure that my pt won't code while I'm trying to take report from you. Thanks for listening.

[Nightcrawler, BSN, RN]

It was too late to edit my last reply- Sorry I misread that you had been asked about the last bm from a floor nurse. I do understand the frustration with nurses that will ask questions until they find one that will stump you just so that they can feel superior.

I once had a nurse ask about the pack year smoking history of a patient two years post double lung transplant. Who the he** cares about how long she smoked with the lungs that we replaced two years ago!

A focused report is fine- but pertinent information needs to be included, and report shouldn't be called before the orders to come to the floor are written

[SDS_RN, RN]

I have been on both sides of the fence and you just don't have an understanding of what the other goes through unless you've done it.

I would have to say in the ED a lot of the times we don't get to take our lunch/supper breaks so when we need to get a pt up to and you tell us not now you're eating that really flames us because we probably won't even get a chance to go the bathroom on hell days.

We don't pick out the AC for our IV's unless it was started by EMS, critical pt, or there is just no other option we don't do it just to peeve you off. We have pt's that keep rolling in the door you have to prioritize and you need to get rooms open for those critical pts that are there. Pts don't wait for change of shift or for you to take a break. I know that you have your own stuff going on but so do we and ours more than likely are going to be more critical no offense.

The room is not clean business is one of my pet peeves. I understand that you need to clean it and I can wait but when I c/b 30min later and it's still not ready then that's when I call and say I'll be up w/ the pt in 5 min.

I don't mind giving phone report and if they need to they can c/b w/ questions but all the info I'm telling you is in the computer or the paperwork I'm handing you. I don't have time to give you a detailed report you get the highlights the most important info and anything less can be looked up.

When I was a floor nurse I never fully grasped what the ER RN's went through but being on the other side I would have to say that the ER does a lot to try to help out the floor nurses by starting the IV's, caths, completing labs, EKG's, rad, CT's ect ect so you don't have to take that time away from your other 5-10 pt's you are caring for.

Floor nurses work hard and have to juggle a lot too and we should all try to collaborate and make the transition as smooth as possible for both depts.

Sorry sooooo long.

[MassED, BSN, RN]

Let's not get carried away here, no where in any of my posts did I say that I wanted to know when the last bm was. However, if the patient came in with chest pain I WOULD like to know what their rhythm is, where the IV is, a set of vitals within the last hour, and maybe whether their pain responded to nitro. I have taken report from nurses that could tell me none of those things. To be truthful, I will usually have looked up the labs and the last H and P myself prior to receiving report so that the ED nurse can just tell me what is going on today. I am capable of asking all of those questions myself- but another nurse is often able to give me cogent answers and I won't look like such an idiot when I ask the patient what brought them to the hospital tonight.

I was giving you an example of what I have been asked by floor nurses - that is truly ridiculous if a ER nurse couldn't provide you with a rhythm, last set of VS, or IV location in report - come on, now - that is not the norm. You must've gotten an idiot for report on that patient, because you know that is not the norm or even close to what ER nurses provide for a report.

[MassED, BSN, RN]

It was too late to edit my last reply- Sorry I misread that you had been asked about the last bm from a floor nurse. I do understand the frustration with nurses that will ask questions until they find one that will stump you just so that they can feel superior.

I once had a nurse ask about the pack year smoking history of a patient two years post double lung transplant. Who the he** cares about how long she smoked with the lungs that we replaced two years ago!

A focused report is fine- but pertinent information needs to be included, and report shouldn't be called before the orders to come to the floor are written

I wouldn't think most would call report without admission orders in hand - what about "now" orders that could be written... we can't call report without orders in hand, just an FYI

[DanFNP]

I've worked both. Both departments get a bit irritated at assumed weaknesses/laziness of the other. It's the name of the game. But overall, we're all in this together. Breathe. Relax. Smile. It will all be over soon.

[Nightcrawler, BSN, RN]

I was giving you an example of what I have been asked by floor nurses - that is truly ridiculous if a ER nurse couldn't provide you with a rhythm, last set of VS, or IV location in report - come on, now - that is not the norm. You must've gotten an idiot for report on that patient, because you know that is not the norm or even close to what ER nurses provide for a report.

This happens all of the time at my hospital- usually when someone other than the nurse that is taking care of the patient is calling report. This is why I would like to get report myself from someone who has actually seen the patient. If you are just going to read the computer- then I could do that more efficiently myself- I want to know what is happening for the patient, and what I can expect when they hit the floor.

obviously we all have the things that drive us crazy, and probably all of our complaints are valid. We have to remember that we all work in different hospitals, with different ED policies, number of beds, average number of people in the waiting room etc...

[MassED, BSN, RN]

This happens all of the time at my hospital- usually when someone other than the nurse that is taking care of the patient is calling report. This is why I would like to get report myself from someone who has actually seen the patient. If you are just going to read the computer- then I could do that more efficiently myself- I want to know what is happening for the patient, and what I can expect when they hit the floor.

obviously we all have the things that drive us crazy, and probably all of our complaints are valid. We have to remember that we all work in different hospitals, with different ED policies, number of beds, average number of people in the waiting room etc...

true - if the ER nurse hasn't provided what you need (IV location, fluids, how much infused, u/o, meds provided) than just ask - and if all that ER nurse has is computerized documentation to provide to you because she walked in the door and it was dumped onto him (or her) than you have to just roll with it. It happens. The floor RN CAN say, how about an IV? Any meds? not too hard.... and if many of you are experiencing ER nurses who can't provide you that, than I question where you work! I've only worked in two, but it is standard to provide those interventions in report....

[Nightcrawler, BSN, RN]

I wouldn't think most would call report without admission orders in hand - what about "now" orders that could be written... we can't call report without orders in hand, just an FYI

You may not be able to call report without orders- but it happens at my hospital all of the time. The ED doc decides to admit, the ED asks for the bed and pages the resident to write orders. Often the ED will call admit as soon as the bed is assigned, but before the resident has even arrived. I have received patients as much as 4 hours after report was called because the residents were backed up- this will happen to someone on my floor at least once a week. In the two years that I have been at this hospital I have only received an updated report on one of these patients once.

[BrnEyedGirl, BSN, MSN, RN, APRN]

Residents are kind of a pain in the ER. Only because they are slow and being fast is the name of the game in ER. It is very frustrating to have report called, chart copied, monitor off,.ready to roll and the resident shows up "let me take a quick look at Mr Jones before you go",.he/she spends 10 min with the pt,..45 min with the chart in hand trying to talk to the ER doc,.another hour, chart in hand, on the phone with his/her cohorts and then spends 45min writing orders,..aarrggghhhhhh,.in the meantime the floor nurse has unecessarily delayed her lunch/complicated drsg change/assessment of isolation pt etc because I told her we'd be right up!!:smackingf

[PeachyERNurse, BSN, RN]

Residents are kind of a pain in the ER. Only because they are slow and being fast is the name of the game in ER. It is very frustrating to have report called, chart copied, monitor off,.ready to roll and the resident shows up "let me take a quick look at Mr Jones before you go",.he/she spends 10 min with the pt,..45 min with the chart in hand trying to talk to the ER doc,.another hour, chart in hand, on the phone with his/her cohorts and then spends 45min writing orders,..aarrggghhhhhh,.in the meantime the floor nurse has unecessarily delayed her lunch/complicated drsg change/assessment of isolation pt etc because I told her we'd be right up!!:smackingf

Same here! Just had an intern that came down to see my patient after I'd already faxed report with temp orders written by the ED doc. I was like "nope, she's about to go up." And she did. The intern took forever to come see the patient, so now he can go to the floor and see the pt. We need our beds for people out in the waiting room!