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| No. 10 | 
May 07, 2009, 12:25 PM
 Re: ED Admissions
I'd rather ICU stay out of my dept...you stay in your corner and we'll stay in ours except to transfer of course. My fear would be for the ED length of stay to increase because the ICU nurse wants to implement an admit med or intervention that could be done up in ICU.
You guys up in ICU get to take your lunch, give your meds, finish your bedbaths etc before we can even think about bringing the patient up and then you have the nerve to complain when we think we are ready to bring them and something comes up to delay transfer...sheesh...must be nice! Try telling an ambulance you have to take lunch before you can take their patient...lol!
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May 07, 2009, 07:50 PM
Re: ED Admissions Originally Posted by Larry77  I'd rather ICU stay out of my dept...you stay in your corner and we'll stay in ours except to transfer of course. My fear would be for the ED length of stay to increase because the ICU nurse wants to implement an admit med or intervention that could be done up in ICU.
You guys up in ICU get to take your lunch, give your meds, finish your bedbaths etc before we can even think about bringing the patient up and then you have the nerve to complain when we think we are ready to bring them and something comes up to delay transfer...sheesh...must be nice! Try telling an ambulance you have to take lunch before you can take their patient...lol!
Having been in both positions, (ED and ICU) I found that I often missed lunch in the ICU and I often miss lunch in the ED. It is interesting how one area thinks another "has it made".... I used to tell my co-workers that we would need to "walk a mile in their shoes" before knowing how easy their job is.... That should mean that the nursing home RNs would have the easiest job on the planet, right, don't their patients just "sit there"? ( I do NOT feel that way, I imagine that to be among the most difficult nursing positions out there, I couldn't do it, and I am so glad that there are people who can!).... Each area of nursing has it's own difficulties, and I hope that someday we can all appreciate what the other one does. Kinda like the day shift vs. night shift thing, each one thinks the other has it easier.... Peace!
| | No. 13 |
May 07, 2009, 07:55 PM
Re: ED Admissions Originally Posted by ashleyjean3 At my ED we are trying to implement a new policy where the ICU nurse comes to the ED to transport their patients to floor and recieve bedside report. Our tech aids in transport. I am currious to the process at your hospital for getting patients to the ICU For the most part, in every ED I have worked in, it was the ED Nurse’s responsibility to transport the patient to the ICU. In my last ED, the only exception was for patients going to CT before going to the ICU. The ICU nurse would bring the bed to CT and receive the patient there. However, this was for patient convenience and to better facilitate patient transfer, not for nursing convenience. Originally Posted by stressgal I too cannot imagine leaving the ICU, and any patient I have to transport a patient up to the unit. At my facility it is a combination of RN and medics that bring the patient to the unit. Originally Posted by TraumaNurseRN Yes, I see your point....please see mine. I do not like leaving my 3 ESI/2 patient(s) to transport a now stable patient to ICU, but it's part of our protocol and we do it. It can get quite scarey sometimes....Luckily you speak of only one patient whereas, I have 3 or more.....We all work hard don't we. ....my new saying is....come on down to the front door of the hospital.....It's the ER! Not all patients in the ICU are high acuity patients requiring constant nursing care. Just as every patient in the ICU is not a high acuity patient, not all patients in the ED (even those classified ESI 2) are high acuity patients. If one of your patient’s requires transport off unit for a procedure someone is going to cover your patients while you are gone. Transferring a patient to the ICU or going to the ED to retrieve a patient is no different. Again, it’s just a matter of the two nurses talking to each other to see who is best able to facilitate the transfer. Originally Posted by Larry77 I'd rather ICU stay out of my dept...you stay in your corner and we'll stay in ours except to transfer of course. My fear would be for the ED length of stay to increase because the ICU nurse wants to implement an admit med or intervention that could be done up in ICU. If I come to the ED to transfer a patient, I am not going to implement any ICU medications or interventions, I can do this much better in ICU where I know where everything I need is located. If the patient has an airway and can be ventilated, and their circulatory status is relatively stable, I’m out of there. Originally Posted by Larry77 You guys up in ICU get to take your lunch, give your meds, finish your bedbaths etc before we can even think about bringing the patient up and then you have the nerve to complain when we think we are ready to bring them and something comes up to delay transfer...sheesh...must be nice! Try telling an ambulance you have to take lunch before you can take their patient...lol! When the room is clean and ready, I am going to call you for report. My expectation is when we hang up the phone, you are on the way. I can give meds and whatever else I have to do for my other patient after I receive the patient from you and get them situated. I would appreciate a call from you if you are not immediately on the way so I can take care of my other patient. We all work hard to provide the best care possible for our patients. It’s easy to see that in our unit, but sometimes not so easy to see or believe about the other units. Unfortunately many ICU nurses have never worked ED, and many ED nurses have never worked ICU. As a result we often lack appreciation for what these nurses do. Who transfers the patient should not be graven in stone. Personally I think that the ED nurse is probably the best person to transport the patient the majority of the time. However, as I mentioned earlier, this doesn’t mean that as the ICU nurse I should never be expected to help with the patient transfer. All it takes is a little communication between the nurses, and never forgetting what’s best for the patient. | | No. 14 |
May 07, 2009, 11:07 PM
Re: ED Admissions
the only time we would leave the unit to come get a er patient is if you have no pt's assigned to you and your assistance is not needed at that time and if a super major trauma (plane crash) has just been called. the attending er nurse and a er tech brings the pt to the unit. they would have a very hard time trying to start a policy like that at my hospital and at the part time position i have in their unit i think the unit director would have a stroke if they tried to implement that.
nobody comes to our unit to get patients that we transfer out. we have to push them out ourselves. heck...the way i see it is if you want them out of your unit then you find a way to get them where they need to go.
| | No. 15 |
May 09, 2009, 11:49 PM
Re: ED Admissions
Hmmm, that's interesting to hear. I can understand the benefits of recieving report from a nurse in-person. However, leaving your own unit to recieve another patient makes little sense to me since you will likely have other acute patients to tend to. I work at a Level 1 Trauma hosp. and we recieve all ED admits by an ACLS RN (Maybe 2 if needed) and ED tech. Respiratory meets us in the unit room, programming and setting up the vent. Honestly, I've never seen any of the nurses complain about NOT recieving report face to face with the ED nurse.
| | No. 17 |
May 16, 2009, 02:20 AM
Updated
May 16, 2009 at 02:30 AM by dorie43rn
Re: ED Admissions
Our staff in the ICU would laugh that suggestion of an ICU nurse coming to the ER to get the patient. The ER tried a thing with us that they use for the floors. Send a SAR, then bring the patient to the floor. NOT! The ER has to call report to us, then wait till we tell them we are ready. I cross train in the ER, and I know they are busy most times, but with a 4 p
| | No. 18 |
May 16, 2009, 02:24 AM
Re: ED Admissions
Our staff in the ICU would laugh that suggestion of an ICU nurse coming to the ER to get the patient. The ER tried a thing with us that they use for the floors. Send a SAR, then bring the patient to the floor. NOT! The ER has to call report to us, then wait till we tell them we are ready. I cross train in the ER, and I know they are busy most times, but with a 4 patient load, THEY can have someone watch their patient while the nurse and tech bring them up one floor to the ICU. We already have to take our patients on road trips, go on codes and rrt's and are downstaffed to minimal nurses, no aides and no clerks, ARE YOU KIDDING??? Do the ICU nurses a big favor, and throw you suggestions right out the window.
| | No. 19 |
May 16, 2009, 08:32 AM
Re: ED Admissions Originally Posted by TraumaNurseRN I was invited to check out the responses to "ED admissions" by nrsang97 who recently visited the ER nursing site and voiced her opinion about a new policy her hospital instituted..... (having the ICU nurses come to get their patient from the ED). I must say, I thought there would have been much more discussion on this issue on this CCN site other than 2 responses before me. nrsang97 made it sound like there was actual debate and conversation going on. Frankly, she was rude and insulting on the ER thread. I got the impression she needed the ole 3 vacation days with a mimosa in hand somewhere on the shoreline.
I see now....there really isn't a debate.....
I think we all work hard, and in general overworked....I think it's a managment issue myself and feel it wrong that there now seems to be a ERRN vs ICURN issue here.
I know from my own experience.....I'm never afforded the luxury of an empty room less that 3 minutes, the amount of time it takes for me to wipe the bed down, and prepare for my waiting EMS stroke/MI/MVC/Resp Fail/Full Arrest....etc.....let alone the bogus drug seeker, the drunk the police brought in, the hang nail from triage....constipated for 2 weeks (ick...manual dissempaction in my future) Vaginal bleed, omg and the list goes on. ...sometimes not even 3 minutes.
She was actually quite rude and insulting....
We all work hard......we all deserve a break....and as I said in the ER nursing forum....It shouldn't be ER vs ICU RN....it's managment who doesn't care. If she is forced to be in charge, take a load, and pick up patients for admission or other transport.....it's not the ERs fault....it's the hospitals management.
Yes...but...ICU nurses are still cooler than ER nurses.
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