Taco Bell is hiring - page 8
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
Dec 4, '02deathnurse, did you get your name by going around digging up old threads? What's up with that? I've counted at least 4 so far.
Dec 4, '02Yes, ED does get sufficient staffing round the clock - for a regular no. of pts. Unfortunately, some days (read most) are NOT regular. When we have pts lying down here for 24 hrs because no facility in the city has a bed to admit them into, we can't put up a sign out the front saying "Department Closed". However if all the ward beds are full, THERE ARE NO MORE ADMITS TO THAT WARD!! Not under any circumstances!! Bypass means absolutely stuff all if every other ED in the area is also on bypass - the ambos are going to come whether you tell them to or not - and even when bypass is actually effective, the ED still gets the same amount of walk-ins as any other day. We CAN'T close beds, we CAN'T cancel elective OT cases to make room, WE JUST HAVE TO COPE!!! (Can you tell I've had this discussion several times in the last few weeks, & I'm sick of it?)
Dec 4, '02[QUOTE]Originally posted by deathnurse
[B]Yes, ER also gets patients at 10 minutes before change of shift. But ER is USUALLY the first to get sufficient staffing around the clock.
Someone needs to let my ER know about this! ...Yeah, l tell the ambulances..."hey, take a few more trips around the block, will ya?....l'm not ready to take another pt right now.".......LR
Dec 5, '02One of the nice things about moving from a Level I trauma center to a rural ER is that it's usually very easy to get beds - I was used to up to (and sometimes exceeding) a 24 hour wait period. Which is a blessing, because patients think that they will get that floor bed immediately upon being told they're being admitted and then ask you every two minutes if they bed is ready.
I've witnessed lots of game playing when it comes to beds. And it includes ER nurses, floor nurses, nursing supervisors and even the bed control folks. I agree with everyone who says we really need to work on the teamwork here.
However, it is annoying to get admit orders between maybe 6:30 and 7:30 (we all work 6:45 - 7:15 here). It is absolutely impossible to get a bed then, I call it the Bemuda Triangle of Nursing. Also, don't rag on me if I haven't done the floor orders - check and you'll see that I have started the IV and given all stat medications.
Thanks for your understanding.
Dec 5, '02Next time the ambulance arrives at your ER, kindly tell them you're in the middle of shift change report and could they please come later, or tell them your maxed out and can't take patients right now. LOL
Stressed out floor nurses, with many patients and no help can't stand getting admissions. We have a policy that the floor nurse has no power to obstruct an ER transfer, if the ER insists they can even fax report if they've tried to call report and have gotten no respone in 30 minutes.
Usually however, the ER is good about working with the floors. I have a reputation for cooperating with the ER, so when I say I can't take a patient, they believe me, because nine out of ten times I take the patient, no whining or complaining.
When I've done house supervision, getting some floors to go the extra mile and cooperate with the ER is like pulling teeth.
It'd be nice if there was mutual understanding, but a lot of people are in their own stressed out little worlds.
I see both sides of the fence when I do supervision. Cooperation is the key.
Dec 15, '02As a floor nurse, I don't try to stop ER admits unless we need a few minutes to actually clean the room from the last pt. I value ER and get along fine with the ER nurses. But I really don't understand why a good 90% of the ER admits take place within an hour of change of shift. Happened again tonight; got all 3 at change of shift. I actually just had the oncoming shift, who were still in report, take the ER report on the third (why repeat?) but then I had to settle the pt. in until they got out. I don't believe the ambulances all show up at the same time, so why is everyone shipped up to us at the same time, and it's always when things are so confused anyway as we try to pass on or gather information about who's on the floor and what's going on. I've always been just really curious about this.
Dec 15, '02Hi guys,
I'm browsing through various threads, looking for people who feel disturbed by some of what they have found working as nurses.
I find a lot of people saying the same things - in different places. I think it might help if we started saying these things in the same place. What things? For me they are: I love nursing, I am a good nurse, I can't find an employer that wants to hire or keep a good nurse. Too often, I find myself fighting fellow nurses.
For those who feel similarly, I have tried to start a single thread with a poll, "Have you considered taking a sabbatical?" I invite everyone to vote. I also invite everyone to participate in a debate: is there something wrong? if so, what is it? is there a way to fix it?
I started the thread and added one "rule": a healthy debate is welcome; disagreements that lead to bickering, scolding, excusing is not. I ask that others opinions be respected - i.e. no one is wrong for having an opinion, no opinion is stupid (or if it is, don't say it). It is OK to say what your opinion is, why and how it is different from someone elses.
Of course, I can not enforce this rule. I do not have the authority. I merely ask that it be followed.
Sometimes I am so emotionally involved with something, I can't disagree without blaming. I am learning to stay quiet until I can say something without blaming. I sometimes make mistakes. When I do, I welcome corrections, I don't like being scolded though.
If you feel you cannot participate, please vote.
Thank you all.
Dec 15, '02Addendum:
I am hoping the thread I started will turn into a debate about solutions. I really want to work as a nurse, I'd like to solve my own problem.
The thread, in general nursing discussions, is also a poll, "Have you considered a sabbatical".
I would appreciate a vote from all - my own curiosity. I would love solutions.
Dec 16, '02Originally posted by dawngloves
Try this shoe on:
Spend half the day trying to get tele monitors DC'd because ER is full with R/O MIs. Super tells you you have an admission, you wait and wait for ER to call report. You are ready to take VS on your 6 pts. so you call them. RN can't come to the phone. OK, tell them to call when they're ready.
Do your VS, nothing. Set up for the admission, go into computer and get admissions lab results, still no report. Call super to make sure pt didn't expire. Nope, still coming.
Well, 1830 rolls around and guess who's calling report and quess what else, the pt is on the way with transport on a monitor!!! No RN! Hello!
Why is this? Because the ER is busy? I don't doubt it. Just remember that, because it gets busy in the floor too.
This happened to me almost every weekend I was on. And then I got over it.
Dec 16, '02I guess it is an assumption that the others have it better. I wouldn't be mad at ER nurses my hat is off to them because of strange things that walk in there and scary public one have to deal with. I couldn't stand our floor because we had to take up to 10 patients so in that reasoning I would be irritated. The poor ER nurse can have up to 20 patients in all with being admitted and/or sent home with meds or something. Either way nursing dealing with patients can be very difficult at times. Taco bell doesn't pay enough to make my ends meet anyhow even though some of us feel we are making chump change as it is!!!!!!!!
Dec 18, '02Speaking of Taco Bell, in our TN town, Taco Bell employees make almost as much an hour as a first year LPN.