Experience with Critical Care Nurse vent - page 3

First of all, ALL critical care nurses please don't flame me, as I'm talking about one situation not all critical care nurses. I've had several experiences with critical care nurses over the... Read More

  1. by   Tweety
    Mattsmom81, wasn't it an ICU nurse that made that statement? But that's definately not true, sometimes we just ship the patient off as quickly as possible without doing anything.

    I have tried very hard not to let this be a us against them thread. I don't think that has happened. Your statements are right on the mark!

    Montroyal, the idea of a float ICU nurse sounds awesome. He/she could have assessed the patient, stablized the patient, or if needed given dopamine until BP stablized. I have in some instances had the charge nurse from the units come over to see if the patient really was critical. But we are so horribly short if ICU nurses and ICU beds, I doubt that they could spare the staff, but if they could it could potentially save some beds.....hmmm....We are finally opening a floor for chronic vents which is going to help as well.

    When I do supervision, Critical Care is always the thorn in my side. I'm not talking about the nurses, I'm just talking the whole critical care bed/nursing shortage, and being the trauma center for the area, the extreme need for critical care beds/nurses...sigh....

    Update: Patient came back to the floor after a couple of hours of triple-digit BPs. About 48 hours laters he's back, this time for a while I believe.
  2. by   l.rae
    Originally posted by 3rdShiftGuy
    I hope I made it clear that I don't feel that way about all critical care nurses. This unit is my sister unit, and we're always there for each other. This nurse is new to this unit, and doesn't know me well. I hope we can get over this riff. But her arrogance was beyond what you described, it was pure arrogance and this is what puts critical care nurses to shame in the eyes of med-surg nurses.

    I realize after many patients are transferred to the unit, ICU nurses roll their eyes, and question the nurses skills and decisions. I float to that unit occasionally and see both sides of the issue. But telling a med-surg nurse she has to manage a patient who once had a palable BP in the 60s, when she/he has a full load is not acceptable. Even if he is cured. It's too nerve wracking when you have seven patients to check a BP every 15 minutes or ever hour, or whatever.

    Again, it was the pure arrogance she displayed that upset me. But since I have to work with that unit, I do hope we can get along. Every time we passed each other she turned her head in obvious anger. We're going to have to talk, as I'm sure I'm taking some of this out of context. She probably was just being herself and if I told her she was acting arrogant she would be appalled.

    Thanks for listening.
    Hey Guy.....you can always take her a tube of lipstick as a peace offering!:roll
    The ER l worked a t prior had pit bulls for ICU nurses and for whatever reason, they did not consider ER nurses real nurses.....needed a whole case of Avon for that crew. The ICU nurses at the facility l am at now are great.....let us know how this ends......LR
    Last edit by l.rae on Dec 18, '02
  3. by   New CCU RN
    I was also a little insulted about the comment that all the work is done once the patient hits the ICU doors.... HELLO...do you think we all sit around on our A**with our one or two patients comparing lipstick colors??????

    While I agree that the individual, one nurse that 3rd shift had to deal with was not so nice....and probably a little out of line... let's not generalize...we all have our jobs to do and that is to get the patient well....we're all working for the same cause, the PATIENT.

    With that being said there is a reason why the patient comes to the ICU....and that is to recieve ICU care... which cannot be done on the floor...and while I have the uttermost respect for floor nurses.....you all work very hard just as ICU nurses do.... let's not get into an argument about floor vs ICU..... and let's not make judgement calls such as all the work is done before the patient even gets there..come on now...why dont we just leave em on the floor then???
    Last edit by New CCU RN on Dec 18, '02
  4. by   OzNurse69
    Originally posted by 3rdShiftGuy
    Montroyal, the idea of a float ICU nurse sounds awesome. He/she could have assessed the patient, stablized the patient, or if needed given dopamine until BP stablized. I have in some instances had the charge nurse from the units come over to see if the patient really was critical. But we are so horribly short if ICU nurses and ICU beds, I doubt that they could spare the staff, but if they could it could potentially save some beds.....hmmm....
    I worked in a hospital once where they employed someone to do this very job...float around, help assess critically ill pts, transport from ED to ICU etc. Great in theory...BUT...in reality every time we paged them to do a transfer (I was working in ED at the time) they had been sent to a ward that was down staff so the hosp didn't have to call in agency - NOT what the original intention of the job was. So we ended up not bothering to page & just doing the tfrs ourselves...don't know what happened to floor nurses who asked for help!!

    Another one of those "great in theory, doesn't actually work in practice" things.
  5. by   hapeewendy
    the insults and bad feelings, unfortunately go both ways, in my opinion its like apples and oranges, no one is better than the other, they are just different... everyone chooses the area in which they work for a reason - doesnt make anyone superior at all!
    I hate the whole floor vs ICU or vs Emerg thing ,I'm getting better at ignoring it all and not participating because it always ends up with bad feelings involved. everyone in the health care team is important and the things that connect us all are the fact that we are nurses (which means a heck of a lot!) , that we all work to improve the lives of our patients and that we provide a valuable and vital role in the health care team..
    lets not regress to making assumptions and generalizations.....
    as for the comment about all the work being done before the patient hits the ICU - it seems like that was meant as a compliment in reference to a particular individuals experience, to compliment and counteract that I would like to say that on our unit when a patient goes sour or in a code situation our ICU nurses have taught me a heck of a lot and have been the first ones to step up and tell me what a good job I did , regardless of the outcome... on one particular night shift we had a nurse just lose it , long long story there but basically she just lost it and hightailed it out of there leaving us with 3 on the floor - her patient had coded and was going to the ICU- let me tell you the ICU nurses just took control of her, we didnt have to go and give report or anything they got her meds n chart n brought her up to the unit and one of the ICU nurses came back down just to see if there was anything she could do to help
    THAT is what nursing is all about !
  6. by   Tweety
    Originally posted by OzNurse69
    I worked in a hospital once where they employed someone to do this very job...float around, help assess critically ill pts, transport from ED to ICU etc. Great in theory...BUT...in reality every time we paged them to do a transfer (I was working in ED at the time) they had been sent to a ward that was down staff so the hosp didn't have to call in agency - NOT what the original intention of the job was. So we ended up not bothering to page & just doing the tfrs ourselves...don't know what happened to floor nurses who asked for help!!

    Another one of those "great in theory, doesn't actually work in practice" things.
    We actually had an "Admit Team" which was a nurse and a CNA to go to the ER and admit patients, start the paper work, take vitals, bring the patient to the floor and settle them in the room. That lasted a few weeks before, when they were short nurses on the floor and started using them essentially as part of the float team. Another of those "great in theory, doesn't actually work in practice things". sigh...
  7. by   montroyal
    Originally posted by OzNurse69
    I worked in a hospital once where they employed someone to do this very job...float around, help assess critically ill pts, transport from ED to ICU etc. Great in theory...BUT...in reality every time we paged them to do a transfer (I was working in ED at the time) they had been sent to a ward that was down staff so the hosp didn't have to call in agency - NOT what the original intention of the job was. So we ended up not bothering to page & just doing the tfrs ourselves...don't know what happened to floor nurses who asked for help!!

    Another one of those "great in theory, doesn't actually work in practice" things.

    Its unfortunate this has happened at your facility. I have worked at facilities were it has worked. I guess my question is why did it not work? The float nurse should of had a copy of their job description. Being forced to take an assignment on a short floor cannot be included in that description. If a float nurses is told to do an assignment, they should politely refuse and explain that an assignment would prohibit them from caring for the patients the were hired to care for. Hospitals have a bad habit of looking at short term only. A true critical care float nurse could help ensure appropriate care is given to patients while helping with the shortage of critical care beds and helping the hospitals bottom line. Transport should only be done by the critical care nurse if they have provided the stabilization care. That way they can give an accurate report to the nurse assuming the patients care.
  8. by   mattsmom81
    The idea of a free floating charge nurse to do these types of things is a good one I've seen utilized...but as mentioned, inevitably he/she ends up with a full assignment and the idea gets defeated.

    I loved being free to troubleshoot, teach, supervise, etc.. and go out to the floors and help out if needed...and it's great for unit morale and relationships between units. Too bad we never get staffed to do it too much anymore.

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