Taco Bell is hiring - page 3

I used to work as an ER nurse and now a house supervisor. Two things about the job that baffles me are the floor nurse and on call staff. What is with the attitude of some floor nurses and not... Read More

  1. by   Brownms46
    Originally posted by pebbles
    [B
    In our ER, they commonly try to "clean house", and get all the admits out of the ED before *their* change of shift. So that means we floor nurses are expected to take admits at OUR change of shift - making us late, etc. Also, sometimes we think it is less safe to admit a patient at change of shift, cuz what if he isn't perfectly stable... So we try to refuse admits within 1/2 hour of change of shift time, as a matter of "unwritten" policy (and some of the ER nurses respect our "rule", out of courtesy).

    The article about ER nurses having attitude should NOT be used as an excuse for (un)professional rudeness. [/B]
    WOOOHOOOOO,

    I'm glad someone else said exactly what I was thinking! I have worked a lot of different areas including ER, and "I" have SEEN "clean house" done up front and in person.

    I have also seen exactly what jimminy has described. I also know for a fact, that working in the ER is a whole different animal.

    But that still doesn't excuse the attitudes I have seen in all too many ER nurses.

    A couple of months ago I and another nurse, transfered a pt back to the ER after having a procedure in the GI specialty area. We ran into the most arrogrant, nastiest nurse ever! All we ask for was some assistance in transferring this person to a bed. And NO...there were was no WWIII going on in the ER. We put on the call light...even though they had received report prior to transfer, and KNEW we were on our way....no one came to assist. Upon going to look for someone...we found several ppl. standing around...who tried to get an attitude also. The non busy ppl had the nerve to ask us what did WE want! Just a little help getting this pt. in bed will do...thank you very much!

    I do agree with jimminy, that everyone should pull a shift in another area, to refresh their memories about the other side of the fence.
  2. by   Katana
    I think we all have had problems with each and every other unit. We get focused in on what we are doing and get really frustrated when the other person can't or won't see that you are dancing as fast as you can.

    It's also not always the fault of another unit for delays in beds.

    One situation I was in.... ER had a patient they wanted to send to me. I work in a very small, 3 bed Advanced Neuro Care Unit. All 3 of my beds were full and ER wanted to send me a patient and were insistant that I take him. There was no way! .... yet....

    I told them that I had one patient who was going to be transfered out to the regular floor but they didn't have any beds yet because the patient mine was going to replace hadn't been picked up by the ambulance yet because they had an emergency and the regular floor had been waiting all day to get the guy over to the rehab hospital but the patient who was supposed to leave there was also late in leaving.... and so the story went.

    Unfortunately, ER got tired of waiting and had patient transport bring the patient up to my unit.... errr..... we don't haved bunk beds... bed is very obviously currently occupied as is the one still out on the floor... so the Fresh hemorrhagic CVA had to stay on the stretcher sitting out in the hall.... along with his huge family getting madder and madder because the bed was still occupied and everyone knows how uncomfortable the ER stretchers are!... me included.

    Yes, I had taken report and had primised to call ER immediately when all the patient movings and bed cleanings had been done so they could send the patient up to me. When I called ER and asked why they sent the patient without my calling, they just said, "It had been so long, we just figured you had forgotten to call us." Needless to say, I wasn't happy, the family was furious, the patient who was supposed to be transfered out offered to sit in a chair while the bed was cleaned for the new patient... the supervisor was royally pissed that she was going to have to straighten out the mess......

    All round, it was a mess and there was no specific person or division at fault. We were full and discharging people and transfering them as fast as possible... and we were all very frustrated.

    I honestly can say that I have worked all areas so I have seen it from both sides... as well as that of being a patient waiting for a bed in ER while being sick as a dog in the waiting room but, on a whole, I have found more ER nurses being rude and trying to be assertive to get their patient up to the floor than the floor nurses being too lazy to accept the patient in a timely manner. Trying to be assertive toward me doesn't work. I admit that it makes me bow my neck but I will never NOT take a patient immediately when I am capable of doing so. The rude nurses just get reported to their supervisor in writing and verbally (face to face), with full documentation about the situation and what was said. The ER nurse might only get a slap on the wrist but their boss as well as mine will know that the incident happened and that I will not back down.

    I also have experienced the ER end of shift clean out. It's not just the nurses but the ER Dr who doesn't want to have to report off on a patient to the oncoming shift.... Heck, it happens in the recovery room, too.

    We all get frustrated but there is no call for the over all and generally rude, assertive attitude I have run into many times from ER nurses. They do a hard job but so do the rest of us. Keep a civil tongue and so will I.

    Heck, I just heard that night shift at WalMart pays $22/hour!!!! (after about 2 years of working there) Where do I go to sign up????

    Kat
  3. by   horsecrazy
    I really don't mind an admission 20 minutes before my shift is over, how about 5 minutes. I will be told i'm getting an admission at 5 am, no big deal so my patient load is already pass the point of safety. It never fails at 725 am my patient arrives with the er nurse, with her coat on. I don't like patients to wait, it is unfair to them to wait for the oncoming shift, but when my patient tells me they were told there were no beds available and they have been waiting since 5 am to come upstairs it ticks me off.
    I never understand why is it okay for nights to take an admission 15 minutes before 3-11 ends and 7-3 can't take an admission til
    they come out of report. IT's no wonder nightshift has more overtime than any other shift. Didn't mean to offend anybody just an observation.
  4. by   4XNURSE
    Originally posted by Katana
    I think we all have had problems with each and every other unit. We get focused in on what we are doing and get really frustrated when the other person can't or won't see that you are dancing as fast as you can....

    ...All round, it was a mess and there was no specific person or division at fault. We were full and discharging people and transfering them as fast as possible... and we were all very frustrated.....

    I also have experienced the ER end of shift clean out. It's not just the nurses but the ER Dr who doesn't want to have to report off on a patient to the oncoming shift.... Heck, it happens in the recovery room, too.

    We all get frustrated but there is no call for the over all and generally rude, assertive attitude I have run into many times from ER nurses. They do a hard job but so do the rest of us. Keep a civil tongue and so will I.

    Heck, I just heard that night shift at WalMart pays $22/hour!!!! (after about 2 years of working there) Where do I go to sign up????

    Kat
    Kat your problem is that you're more perceptive than the average Joe. (or Suzi or Clyde) You seem to have an excellent handle on the whole scope of the problem.

    Now how do we get the message out?

    ken
  5. by   pebbles
    Hmmm. Kat's post made me think of something.
    Those of you who get angry/outraged family members over things that are not your fault, things that are caused by faults in "the system", or the way other units (including ER) do things: Do you ever encourage the family to complain and tell them where to go with their complaints?

    I'm just thinking management is more likely to listen to their complaints than the word of a nurse - cuz they are the customer in the business, after all.
  6. by   4XNURSE
    Originally posted by pebbles
    Hmmm.....

    tell them where to go with their complaints?......

    LOL ! Tell them to stick it Where ?

    LOL

    ken :chuckle

    PS, I'm trying to be sorry, I couldn't help myself.

    :chuckle :chuckle :chuckle
  7. by   Katana
    horsecrazy, the unit I work in has no secretary. What we try to do for the shift change patient is the off going nurse will do all the orders while the on coming nurse does the admission and assessment. It works well. Yes, the offgoing nurse does a little overtime but the good will is worth it and our nurse manager approves it.

    4xNurse, Thanks. Dunno how we can get the attitude out but it sure would be nice. I've been an RN for 26 years and have worked pretty much everywhere but OR. hehehe I like my patients zipped up, thankyouverymuch.

    Pebbles, we have a Patient Liasion and we refer the family to her. It's her job to find out what happend and to smooth over ruffled feathers. I wouldn't have her job for all the tea in China!!!

    Kat
  8. by   RoaminHankRN
    Floor nurses are bringing up some points. What do ER nurses have to say?

    Floor nurses... what are some remedies you would offer... I sure there a lots of stories to go around. But if I am the patient, I want to know what you (ER, floors, surgery, etc) would do to fix things so I don't wait any longer.

    Another point to remember.. there are two sides two every story..and in our business there is a third...

    Pebbles said...
    "I'm just thinking management is more likely to listen to their complaints than the word of a nurse - cuz they are the customer in the business, after all."

    Because we need the business of the patient.. If one decided to complain.. Who do you think management will side with?
    The ER nurse with her coat on?
    The floor nurse whose shift ended in 5 minutes?
    The patient?
  9. by   SharonH, RN
    Originally posted by RoaminHankRN
    Wendy,


    And you are correct, no one is better than another.

    But there needs to be better teamwork and understanding between the two.



    Well Hank, you know that goes both ways. Why don't you try a little understanding and teamwork? When is the last time you worked the floor? When is the last time you had 9 patients, all of them bad, some of them in restraints(and getting out), docs on the floor writing stat orders, docs doing procedures and another one unstable but there's no bed in the unit just yet and ER calls and demands to give report right now as if you are standing around doing nothing? Oh yeah and where do you think the families go once they hit the floor? Hint: it's not home.


    I got news for you. There are times that I don't take another patient because I don't think it would be safe for me to do so. I am not going to risk someone else's life (and here's the selfish part) or my conscience and license just because I don't want to rock the boat or be labelled as uncooperative. And it's unfortunate that the patient is suffering(and yes I've been a patient several times myself), but that's not my fault. That is a system fault and I refuse to accept the blame for things out of my control and I refuse to blame my fellow nurses.


    But Hank, heres' the thing. I don't pass judgement on ER when they roll a patient to the floor with 2 pages of orders and who hasn't had a thing done for him since he got to the ER 12 hours before and I don't pass judgement on the units when they roll down a transfer 15 minutes before shift change when they've had the bed assignment for 6 hours. In fact, I am usually working too hard to worry about what the other departments are doing, I just assume they are working as hard as I am, not less.


    What is about nurses that they constantly feel the need to put down each other and assume that the other one is "lazy" or just "incompetent" because he or she isn't ready to do things your way when you want it? Can somebody, anybody answer that one for me?


    If it's so frustrating for you Roamin', then maybe you ought to look into that Taco Bell thing.
  10. by   SharonH, RN
    Originally posted by P_RN
    To admit a patient through ER or from home to the floor required approximately 45 minutes of documentation. That's before you begin any treatment, but any comfort measures are of course done .First there are also the other 13-14 patients calling on you for care too. Sometimes I had a tech for my team, sometimes there was only one for the whole floor.

    If I get two new ones, then there is 90 minutes of paperwork.

    We don't need to gnaw each other. Attitude usually reflect back with the same attitude. Make yours a good one.

    Excellent points!
  11. by   SharonH, RN
    Okay I was a little pissed. I just got off from a really bad day, listening to patient complaints and doctor complaints. No matter how hard I work, it's never enough, I go home many nights with my feet aching and my head hurting and now I hear what's the problem with us floor nurses.........from another nurse? It's a little too much, you know. I didn't mean to be so abrasive.
  12. by   hapeewendy
    I always do try to remember the times I have been a patient in emerg and base my care and warm welcome to my patients upon admission based on the notion that they have been in emerg, being poked n prodded for hours n just want a nice bed to be in and some small amount of "comfort" (if possible in the hospital , which we all know it isnt haha)

    but seriously, the respect thing HAS to go both ways, I understand the stress of workin in EMERG, not first hand mind you but I can be empathetic cant I? We are all nurses, sometimes the tone in which people say "floor nurse" is so condesending it makes me nauseous.

    I watched the ER Nurses save a life when I was down there as a patient, my heart swelled, and I managed to find a few of them later to thank them for going so far for that patient.

    we save lives on the floor too though, and its not appropriate to take an admission when one of your patients has coded recently, or is going downhill steadily. Our unwritten policy is never to make emerg wait for hours for admissions that we know we are getting, we are thoughtful like that, most of us even ask what hasnt yet been done for the patient and tell the emerg RN not to worry about it that we can do it when the pt comes to us.

    consideration works both ways, if I am telling you politely that I have had a patient code , and am not quite done with the family/paperwork etc and that I will call you back ASAP, that should be acceptable, and should not warrant any smartass comments from anyone, its not unreasonable and most of the nurses I work with are not lazy, but like I said, lazy behaviour abounds in all areas of nursing, and every other profession for that matter, we cant judge until we walk a mile in eachothers horrificly tight fitting white nikes!

    I dont judge, so please dont make assumptions about floor nurses based on limited experiences with them.

    for the record - the clean out house thing is notorious and ive heard ER nurses AND MD's talk freely about the plan to get everyone admitted just before they are going off shift, so its not a myth or "coincidence" , the problem is , our ER gets off at 1900 hrs and we dont leave the floor until 1930, so you guessed it, if we get report at
    1900 hrs the pt doesnt show up til exactly 1925-1930, it can be frustrating, I can admit that it annoys me , but the patients never know that I am frustrated and to tell you the truth, neither do any of the nurses.
  13. by   RoaminHankRN
    Sharon.. it's cool..
    Nursing is that way..
    I did leave ER and now work as a house supervisor. My post was not meant to come across as complaining. ( I easily could but then I would dig a bigger hole) I am looking for answers and ways to change (along with sprinkling some of my thoughts... hey we are human)
    I deal with many rude floor nurses. Don't get me started on floor nurses and IV's (hmm I think that might be my next topic to post.. let the gloves come off!)

    Anyway.. sounds like you have some bad apples in the ER that need Taco Bell.
    I found mine in being a house supervisor and would never go back to ER.

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