Taco Bell is hiring

[RoaminHankRN]

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 wanting to take patients. When I call to place patients, oh the attitudes and excuses I hear.

Sure, ER should help out where they can and when they can. But when the waiting room is full and the hall beds are taken, cut 'em some slack. Do floor nurses understand the ER has an "open door policy." How many floor nurses have worked ER? It's a different world down there.

Remember most patients are admitted through the ER and it is their first impression of the hospital. Do you know what the biggest complaint on patient surveys are?

Second... on call staff. Two things to say about that. Save the whining for your spouse and if you don't like on call... Taco Bell is hiring.

Hank

[RoaminHankRN]

I feel the same way about all floor nursing.

How do you do it.. the same type of patients day in and day out.

This I do respect you all for.

[Q.]

Originally posted by RNKitty

:eek: :eek:

No WAY are you getting me into the ER. I do L&D - not qualified for anything else. I really respect what you do, but don't ask me to do it!

I agree! That would be an unsafe alternative just to prove a point. Who suffers? The patients.

Perhaps just losing the attitude and defensiveness would work instead of rotating floors.

[Furball]

Originally posted by pebbles

I know the ER is busy, and I do try to cut them some slack and take admissions when I can. But sometimes it is apparent that consideration does not go both ways all the time.

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).

I co-ordinate with the Nursing Supervisor (who is in cahrge of the whole hospital) as to how busy they are down in ER. If they were NOT busy, and a patient arrives in ER at 2300, there is NO reason WHATSOEVER that this patient *has* to have been moved to the ward at 0700. Get him to me before 0600, or after the next shift has arrived. As a matter of courtesy. ER nurses have been know

to be lazy and avoid work from time to time also...

The article about ER nurses having attitude should NOT be used as an excuse for (un)professional rudeness.

Thank you

[NurseDennie, BSN, RN]

Sheesh! RoaminHankRN, that first post really got up my nose, and didn't get any better with the next couple of posts. Obviously all your problems in the ED are caused by us retarded floor nurses, standing around with our thumbs up our A$$ and we only use our critical thinking skills to think up ways to anger you superior entities.

Or perhaps all of our staff meetings are taken up with discussions of how to slack off. Perhaps someone from the ED should come up and in-service us on how much more important and busy they are? Because if you don't, then I'm going to continue to maliciously allow my patients on the floor to code when you're trying to call report to me.

And wow, that article explaining how *very much* ED nurses do, and how that explains their 'tude isn't even a *little* bit annoying. Guess what? I didn't see anything in that article that was over and above what floor nurses do/have/put up with. And we don't have a problem with "assertive." All nurses have to be assertive. We have a problem with rude, aggressive and obnoxious.

And I have a bit of advice for when the situation comes up like Suzy K's where there isn't personnel at either end for the transfer and the patient waits. Write an incident report. Every single time. I know that just takes more time, but if you don't do that, then the hospital admin can say "What problem? I don't see a problem?"

There is a nursing shortage, RoaminHank, and it's not because there aren't any nurses, it's because the nurses aren't willing to work in hospitals. It sure doesn't sound like you're being part of the solution.

Yeah, this is the place to vent, and I can see where you're coming from, and you were venting. So that was me, venting in response.

Love

Dennie

[PhantomRN]

proud2bme, I think your issue was a problem with management. More specifically the house manager. It is her or his responsibility to make sure pts ar transfered in a timely manner.

I know at my hospital the super comes up to the floors and looks at bed status frequently. So she would have known that nurse was being lazy.

Yah some try to be slick about it. They will write the patients name on the board, like they are already there. All it takes is one question from the nurse in charge or super to find out if the patient has arrived. It dont have to be "did the patient arrive?' The question should be "how is your new admit?" And if she says it isnt here follow thru.

Yes, Hank that is baby sitting and we should not have to babysit adults, but guess what some people will get away with what ever they can.

If you want to end some of the crud going on assume that role.

Question what is going on. You know the floors that are notorious for holding off the ER---go to those floors and literally look in the rooms, question the charge nurse but also call the nurse who is refusing the pt on her behavior.

We had one floor at our place that was very bad about making their floor looking like it was full in the computer---they just would not discharge out of the computer, so the bed would look ocupied. Well, you guessed it--- walk that floor. Give the nurses time limits to get the pt out of the computer. They will do it, just because someone has finally busted them.

By the same token, you worked in the ER. You know which nurses down there have bad attitudes, dump undone tasks, left pts in the hallway etc. If you want respect from the floor nurses you have to show them you are not all for the ER nurses 150% of the time and vice verses.

[Furball]

Hear hear Dennie.

The comment about not having pts in the halls on the floors made me laugh. We DO have pts in the halls waiting for unavailable beds while we rush around transferring pts off and admitting the ER admits all the while we have oiur share of codes, carotid blowouts, PE's, MI's ect ect ect ect ect.. Geesh. I'm certain the double parkings in ER are much worse but I got the distinct feeling that this particular ER nurse thinks we sit around sipping java. They get the drunks, we get the DT's later on on the floor. Both jobs are difficult and I KNOW ED is incredibly stressfull but so is floor nursing. Not attacking ED nurses...I think they are awesome.

[NurseDennie, BSN, RN]

Furball -

I think they are, too. But I don't think they are necessarily *that much* more awesome than everybody else. Maybe I am just a little piqued that what little glamour image and respect there is for nurses, seems to be tilted to the ED nurses. They seem to do so much less "scut" work and the paperwork seems less intrusive, they have all the equipment and support, and they get all this glory. So my remarks probably came from a part of me that I'm not all that proud of.

But still......

A friend of mine was floated to the ED when she had a back injury - it was less strenuous than the floor she came from.

And floor nursing is NOT the same patients all the time. No, it's not dull.

Love

Dennie

[hoolahan, ASN, RN]

Hank, I like the way Dennie put it best, your post really got up my nose too.

Seems like your background as an ER nurse has made you see things a little one-sided?? When the floor nurses give you "attitude", do you go up to the floor to see why? I am sure you are busy too, but maybe if you checked it out, and I apologize if you have already, you would see for yourself what is going on.

I did PACU, and we would get the runaround sometimes. There were times I would be pi$$ed at having to wait for 7pm on OT until the next shift agreed to take a pt. I'd go take a walk and find out for myself if the bed was empty. Sometimes it was, and I would find it was usually the same nurse who tried to BS me, other times I would bring a pt, even when they said I could, and I had one nurse who was so overwhelmed with her assignment, that she burst into tears as I gave her report! I could see she was stressed, and had too many pt's wo were acutely ill, transfusions she was supposed to be monitoring q 15 minutes, and 2 more post-ops waiting for beds. Her co-workers were just as busy, no one was sitting around filing their nails or had hands filled with coffee cups.

Maybe next time the flloor could use your hands to help them accept a pt. Maybe you could comfort the family of the pt who just died so the nurses can clean the bed since housekeeping can't be found, so they can take the admit sooner.

I'm sorry to say this, but in your original post and a few that followed, it seems that your attitude is one that promotes division among the staff. If there are certain offenders, you need to deal with them on an individual basis, rather than lumping all "floor nurses" into one category!! I find it very disturbing when managers do not address individuals, but rather post memos to everyone. I suggest you investigate the causes of why floor nurses are not taking admits in a timely fashion. Maybe there is really only 1 or 2 people you need to manage.

[hapeewendy]

hank, what makes you think i was talking about you judging?

was my post reffered to you directly?

it wasnt, for the record.

and as for your quote about me "hearing" about the clean house thing being notorious

it was followed directly by "I've also seen it"

I am not judging anything, I'm speaking of my experience, and one of the reasons I am starting to dislike posting here is the way some people seem to dissect everything that is said and take it too personally, I am not here to ruffle any feathers I am here to share what I have been through , and offer my opinion , which is what I thought was the entire point of this.......

and we did report to the supervisor about the times when the code happened and she agreed that although in poor taste there is no policy regarding when ER Nurses call the floor to give report though she was going to work on the not calling during/just post code situation.

and its hard at times to go to a supervisor that you may not have complete faith in, but thats another issue.

[RoaminHankRN]

It's good to get under certain people's skin. That is the whole point.. to bring up some dialogue about what can be done. There are obvious issues or people would not get so upset:) Sure my first posting was out of frustration having worked ER. I love how people read one post and assume that is my position. If you read my subsequent postings after listening to the other sides, I have agreed and disagreed but have also asked for suggestions.

(I will not quote them... go back and read for yourself)

Hoolahan.. sure I check on the floors. There are times the floor are short nurses... have critical patients.. I always offer my assistance. But you should know that there is only so much I can do. I can't get tied up in patient care but can offer starting IV's (which is another story, maybe not for you but here it is) or take care of the paperwork with a death. Majority of the floor nurses are great. Same for the charge nurses. But there are enough bad apples that have to and need addressing. I have had several one on one chats with some. Maybe my postings say otherwise, but I am comfortable in the job that I do. And you will find staff that like me and hate me. Is not that true for everyone. You are not going to please every staff member.

If I ruffle feathers, get up your nose or tick you off then I have done my job.

If you do your job correctly, you should have nothing to be upset about as my comments are not directed at you. Not ALL floor nurses are lazy. Yes there are ER nurses who are rude.

I will say this.. for those that give the impression that you are above all this...

Please come work here. We could use some good nurses like yourself:)

[RoaminHankRN]

Originally posted by deespoohbear

Our ER is notorious for holding patients for 3 or 4 hours, and then bring them up for admission at shift change. Usually in our small hospital there is not a wait for a med/surg or tele bed so that excuse is blown. I truly believe that our ER does the "clean the unit out" routine before their next shift starts. Another thing that gripes me is when the patient comes up from the ER on a monitor and no IV access!! Somebody is asking for trouble. I don't usually deny to take an admit at any time, but there are times I sure get frustrated!

What is your policy for bringing patients from ER that are monitored?

Does a RN need to be present, IV started, etc.?

Are you writing incidents down for your director if ER is not doing something they should?

[RoaminHankRN]

Originally posted by hapeewendy

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.

Then you replied later..

"and as for your quote about me "hearing" about the clean house thing being notorious

it was followed directly by "I've also seen it"

I don't see that:)

Hmm.. I'm sure I'll upset you with that:)

About the limited experience.. I am guessing that I should not refer to everyone based on one or two experiences? Yes that is correct.

But I am referring to those who don't do there job based on experiences over the years.