Okay, why do ER nurses think they're so cool?

[gayle_the_RN]

I get it, we on the floor don't see what you see- gunshots, knife cuts, fights, rape victims. But you chose that. Nursing is a wide, varied profession and ER is just a piece of it. So you work with firefighters, paramedics, police. Okay. But you're not a firefighter, paramedic or a police officer. You're a nurse. When you call the floor for report and we say we're too busy right now, we'll call you back, please don't call your boss, or the House Supervisor, and tell them we refused report. Again, I get it. Nobody is as busy as you. But we may have had our hands deep in poop, or in the middle of a dressing change, or with a doctor, or administering chemotherapy. Or we may be already getting report from the offgoing shift. And yes, another nurse is just as busy and can't take the report I would rather get first hand anyway. When we get report from you for a hip fracture patient and you say the BP is 191/92 and she has a history of hypertension, please don't get offended if I ask if you've covered the blood pressure. I know she's being admitted with a hip fracture and not for hypertension. But hypertension is something we're aware of, because it is also bad. If you send the patient up without covering the BP, by the time she's moved from gurney to bed that BP has spiked to over 200 and I have a possible stroke to add to that fracture. Will it kill you to walk over to your MD, the one with whom you enjoy a closer relationship, and ask for some Vasotec? And while you're at it, could you not forget some pain meds before you send the patient to the floor? You see, I have to call the admitting MD, that very MD your doctor just spoke with to admit the patient, and wait until he calls back, before I can give any medications. That can and does take hours. Meanwhile I have an increasingly uncomfortable, unstable patient and a family who is getting very concerned that this new nurse can't help their mother.

I'm sorry for the long post, but I just read another Megalomaniac ER blog slamming floor nurses as stupid and lazy, refusing report, fighting with ER because they're uncomfortable taking unstable patients ER wants to move because they need the beds. There is more than just you, ER.

[Annisme]

Gayle,

I'm sorry you've had a terrible experience with ER nurses. I have worked Med/Surg and now ER so I see both sides. Have you ever worked in the ER? I have invited several floor nurses to work a day with us and, so far, none have taken the offer. The usual response I get is :eek:"No Way!!" I'll let you in on a little secret...

The hip fx patient you just got that is hypertensive; While you are on the phone with her physician getting Vasotec, the ER nurse that sent him/her up may have an ICU patient they are holding because the ICU is full, 2 peds patients, one waiting for transfer to a Children's hospital and a 40 year old with a STEMI they just put in the room vacated by your new patient. I'm sorry you didn't get the report and the orders you want prior to the patient arriving. Your new patient had a room assignment prior to the admissions orders being written and the doctor that wrote them put them on the chart and left. I understand that you don't have time to take report. We don't have time to call with it, but we have to find the time.

If you haven't already, please walk the proverbial mile (really more like 10 miles) in our shoes. I think we should do the same.

[leslie :-D]

I always asked her how is it soooo hard to be a triage nurse? The only thing hard was breaking up her clucking hen party.

bs (the name, not the expletive)...seriously, is this for real???

anyways, i can see that name-calling and disdain, isn't ltd. to er nurses.

thank you for making my point.:)

leslie

[GilaRRT]

My advice is not to read blogs you find offensive and stay away from making sweeping generalisations about a group of people. This very well may be a vent; however, are you not creating a similar situation as said blogger by making this thread?

[tokmom, BSN, RN]

Our ED nurses are the golden children of the facility. They call the shots how our floor is run. They send us pts with no report. One pt came up with pacer pads on. We had no idea why. Needless to say, she landed in ICU within 30 min of arrival. The problem are a the alpha nurses who run the place and run over the managers. Very frustrating. Right now, we are having meetings and trying to meet in the middle.

I think it can be done. But first we have to start respecting each other.

[LegzRN]

ER nurses think they're cool because they wear sunglasses at night, because the sun never sets on a bad@ss

[GilaRRT]

ER nurses think they're cool because they wear sunglasses at night, because the sun never sets on a bad@ss

Okay?

[LegzRN]

Okay?

kidding, friend

[FancypantsRN]

Why does it have to be floor nurses vs. er nurses? I don't get it. We all went to nursing school and we all passed the NCLEX. Some of us were floor nurses prior to being er nurses. Geez.

I guess that's like asking why does it have to be dayshift vs. nightshift.

[GilaRRT]

kidding, friend

I was thinking it was humour, but I can be a little dense sometimes.

[studentgolfer]

gayle, i get your frustration...definitely.

the only comment i have about er nurses needing to give report, is if they didn't...

couldn't the er become backed up?

imagine if all floor nurses said, "can i get back to you"?

it's the makings of something potentially catastrophic.

It seems to be a general consensus that ED is the only Dept. that is busy. A nurse has every professional right to refuse report/refuse to care for a patient if they feel the pt. is out of their limitations. Can you imagine a world where Charge nurses didn't know what type of patients they are set up to take? We'd be admitting MI's left and right to our med/surg floor instead of the cathlab.

And yes MD's DO try to send dumber diagnoses than that up to us on a MED/SURG NON ICU floor. (Oh, they were having chest pain in the ED but I gave them a percocet and they rated that it went from a 10 to a 9, you can take him now right?)

And should we DROP WHAT WE ARE DOING in a patients room to go take call for you so your night runs smoother? Rushing through patient care is a bigger concern to patient safety than them having to wait an extra 5 minutes for report. :redbeathe:twocents:

The world would function more smoothly if others took the time to realize that someone else MIGHT just be as busy as they themselves are.

[DLS_PMHNP, MSN, RN, NP]

We all put on our pants the same way. Period.

Nothing wrong with thinking you are "cool", unless you do it someone else's expense.

[hiddencatRN, BSN, RN]

Okay?

I think that was meant to be a joke.

I spent some time on the med surg floor as part of my orientation in to the ED. It was very valuable time spent and I appreciated the experience. Once in a blue moon an ER nurse will need to be pulled to a med-surg floor in my facility: I'd honestly be happy to go for a change of pace. Usually it's MS nurses being pulled down to the ER.

I find I'm a little more patient if a nurse I'm calling report to takes a long time calling me back. I DO feel bad when a room is suddenly ready....5 minutes before shift change but I still have to call to give report anyway. I try to be thorough in report and call report on my own patients instead of letting someone else do it for me who is not familiar with the patients. If I'm taking the patient up I make sure they are set up in bed with whatever monitoring they need on and if they need a weight I'll get that if the scale is already in the room too.

But it really is frustrating when someone I'm trying to call report to plays hard-to-get, or acts like I'm personally trying to ruin their day by calling report. I want to get my patients up to their rooms because we have X patients waiting in the waiting room, the patient I'm moving upstairs has been in their room for hours, and I know they will get better care and be more comfortable up on the floor. There's a chance that after the patient goes upstairs I'm cleaning the room too to speed turnover because housekeeping has their hands full as well. Also, sometimes the communication breakdowns come from somewhere else- I've been told a room is ready, only to call up to the floor and be told that it's still being cleaned, or I get told a room is ready but the unit hasn't been told they're getting an admission: it happens, and it's really best if we both handle the situation with grace.

I think a week or two of cross training would go a long way to help floor/ER relations. One shift really isn't enough, because you could always happen to get a slow shift that doesn't really represent the norm.