"I don't want an admit..."

Nurses Relations

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As a charge nurse on a med/surg unit during the 7p shift, I am guaranteed to hear this at least one time each shift.

Yes, it's a busy shift; yes, I know you have another 4-5 patients; yes, I know Mr. Johnson needs his dressing changed and Mrs. Conner needs her PRN Norco...but it's your turn. You're up, everyone else has had an admit.

It's a simple fact on our floor--patient come to hospital; s/he is ill or has a surgical procedure planned; s/he is needing to be admitted; each admission needs a nurse. What is so hard to understand.

I help "my" staff lots with admits. I open and set up the room (if our aides are busy). I get all the stuff ready so you don't have to hunt for it--IV pole there; O2, Flowmeter, Christmas tree ready; tele monitor and leads there; admission kit on table; wound care supplies there if needed; NG tube or oral suction ready and waiting. And I'm gonna be in the room, so if there's something missing, I'll run and get it.

I help get the patient settled in and grab the orders.

I put the chart together, enter the orders, write out the MAR's, fill out the home med sheet and immunization sheet--if I can. The only thing I HAVE to do is put the chart together and enter the orders. The rest I do to help So basically the RN/LVN gets the patient in bed, assesses him, connects any tubes/lines, then take the completed paperwork. If there's any problems, I'll call the doc. I won't leave anybody hanging.

So that admit really wasn't that bad--half your stuff (paperwork) is done, your room was set up appropriately, all your orders are in.

I can't make it easier than that--do the computer assessment and care plan and you're done. (I do the computer stuff too, about 50% of the time).

Why is it such a big deal to get an admit? Why do you have to **** and moan about it? Why are you arguing that "it's not fair" or "it's not my turn"?

Put your big girl panties on, hush your mouth, and take the patient!

Thank you for letting me VENT!!!

Specializes in Med/surg, Quality & Risk.

I hit the like button so hard I broke my touchpad.

It's nice that you do that. But you just need to understand how stressful it is to be taking care of a lot of patients just to get another one when you feel like you can barely make it with the load you have already. It's not just getting the admission itself... it's the continuation of care of that patient (plus the others) throughout the rest of the shift.

Specializes in Med/surg, Quality & Risk.
If I tell you I'm swamped right at this moment and to tell the ED, PACU, etc to hold the patient for at least 5 more minutes to give me time to prepare everything and you tell them that I'm ready and to bring the patient anyway I am going to b**ch and moan.

Yeah here's what I don't understand. As the floor nurse I get notice I'm getting an admit, and I'm just supposed to sit there and wait...and wait..and wait... till it's convenient for THEM to call me report. And God forbid I just go on about my business while waiting for this phone call, which always happens when I'm up to my elbows in it, or starting an IV, or talking to a patient. DON'T YOU DARE ASK TO CALL THEM BACK IN FIVE MINUTES!!!! Because they are VERY BUSY and they need to send this patient off RIGHT NOW! (Oh really. I've been wondering when they will call for 45 minutes, I put my lunch off waiting on your stupid phone call, now it's 3pm and I finally go to lunch and THEN you've decided it's time to send the patient on their way. But it must be RIGHT NOW.)

Why am I at THEIR mercy? Why am I supposed to be at the ready whenever they feel like it?

At one point I was going to start calling the ED as soon as I got notice I was getting a patient and ask for report, and when they told me they were too busy to give report I would say "Oh but I'm ready for report RIGHT NOW and this is when I need to take report." And threaten to turn them in to their manager for not giving me report. Because that's what every admitting dept. in the hospital will do if you dare to not immediately drop everything and take their phone call.

Specializes in neuro/ortho med surge 4.
Admissions. The bane of the charge nurses existence. Everyone loves their charge nurse until there's an admit on the way. I frequently hear the "I don't want an admit" line as well. My response is always "and I don't want to work for a living, but I haven't picked those 6 lucky numbers yet, so here we are." It drives me crazy. Whining, griping, and then of course when that doesn't work the conspiracy theories come out. You always give me the admit because you don't like me or you're jealous of me or whatever other crazy excuse they can think of.

I hate being the charge nurse. It was thankless on the med-surg floor I came from and it is even worse now in the ICU. Now we have to re-arrange assignments and stat transfer people out in order to make room for crumping ER patients. Not only do I have to listen to my coworkers complain about the admit, but I have to listen to the floor nurse I am trying to give report to give me 5,000 excuses why they should not have to take that patient while the ER is blowing up my phone wondering when they can bring the patient. Then both the ER RN and floor RN use our internal risk management form to report me. The floor nurse for putting them over ratio or because it was shift change or med pass time and the ER RN for holding up the admission. Joy. So not worth that extra dollar an hour!

I would not be the charge nurse for an extra $10/hr. First off, I have enough to do with my patient assignment. Our charge nurses have a patient assignment and these extra responsibilities. No way is it worth the stress. If I had no other choice but to be forced to be the charge nurse on a prn basis I would find another job ASAP. My sanity is worth more and I would most likely have a nervous breakdown.

Specializes in neuro/ortho med surge 4.
Yeah here's what I don't understand. As the floor nurse I get notice I'm getting an admit, and I'm just supposed to sit there and wait...and wait..and wait... till it's convenient for THEM to call me report. And God forbid I just go on about my business while waiting for this phone call, which always happens when I'm up to my elbows in it, or starting an IV, or talking to a patient. DON'T YOU DARE ASK TO CALL THEM BACK IN FIVE MINUTES!!!! Because they are VERY BUSY and they need to send this patient off RIGHT NOW! (Oh really. I've been wondering when they will call for 45 minutes, I put my lunch off waiting on your stupid phone call, now it's 3pm and I finally go to lunch and THEN you've decided it's time to send the patient on their way. But it must be RIGHT NOW.)

Why am I at THEIR mercy? Why am I supposed to be at the ready whenever they feel like it?

At one point I was going to start calling the ED as soon as I got notice I was getting a patient and ask for report, and when they told me they were too busy to give report I would say "Oh but I'm ready for report RIGHT NOW and this is when I need to take report." And threaten to turn them in to their manager for not giving me report. Because that's what every admitting dept. in the hospital will do if you dare to not immediately drop everything and take their phone call.

I think a lot gets dumped on the floor (med-surge) nurses. More often than not the patients come to the floor and the first thing out of their mouths is I have to pee, I am in pain andor I am starving. The peeing and the pain issue should not happen within the first 60 seconds of the patient arriving to the floor unless they are drug seeking. The not eating I can understand because of the need for the admitting Doc to write orders and make that decision. Sometimes it is known that the patient can eat and that is still not addressed. Sometimes the blood pressure is sky high or I have even had patients needing breathing treatments as soon as they arrive. This is what makes admissions hard and time consuming amongst other things.

Specializes in Med/surg, Quality & Risk.
I think a lot gets dumped on the floor (med-surge) nurses. More often than not the patients come to the floor and the first thing out of their mouths is I have to pee, I am in pain andor I am starving. The peeing and the pain issue should not happen within the first 60 seconds of the patient arriving to the floor unless they are drug seeking. The not eating I can understand because of the need for the admitting Doc to write orders and make that decision. Sometimes it is known that the patient can eat and that is still not addressed. Sometimes the blood pressure is sky high or I have even had patients needing breathing treatments as soon as they arrive. This is what makes admissions hard and time consuming amongst other things.

Yes, they often claim "they told me there would be pain medication WAITING ON ME when I got up to the floor." I usually ask them who said that so that I can write them up, because that would be a blatant lie since I cannot even pull any medication without having their information in my system, and their information doesn't get into my system until after they are already on this floor. "So, who was it, so I know who to write up for lying to a patient?"

Shuts them up every time.

Oh, and "they said I could eat as soon as I got up here." Yes yes, we are the land of manna and honey, and narcotics. These supposed ED nurses should be falling all over themselves to come and work the floor - it's the Garden of Eden up here!

"I'm sorry someone felt the need to misrepresent your situation to you. Your orders to be nothing by mouth are not going to change when you get to the floor, since they were put in place for a reason."

Specializes in neuro/ortho med surge 4.
Yes, they often claim "they told me there would be pain medication WAITING ON ME when I got up to the floor." I usually ask them who said that so that I can write them up, because that would be a blatant lie since I cannot even pull any medication without having their information in my system, and their information doesn't get into my system until after they are already on this floor. "So, who was it, so I know who to write up for lying to a patient?"

Shuts them up every time.

Oh, and "they said I could eat as soon as I got up here." Yes yes, we are the land of manna and honey, and narcotics. These supposed ED nurses should be falling all over themselves to come and work the floor - it's the Garden of Eden up here!

"I'm sorry someone felt the need to misrepresent your situation to you. Your orders to be nothing by mouth are not going to change when you get to the floor, since they were put in place for a reason."

It is so crazy! I think being a med surge nurse is insane most days, doable some days, and good days are very few and far in between. I can not wait to get out of it. Hands on care of the patient is my favorite part of nursing so it is a shame that the ridiculousness of what is expected of floor nurses/bed side is making me want to get away. It is just not doable in a safe fashion when you have discharges and admissions at the same time- usually change of shift and everyone including the charge nurse is too busy to help. Not to mention your other patients who need attention. I spend most of my shift apologizing as most of my days start out like this. I don't know why I feel the need to apologize as it is the fault of the health care system and not my skills as a nurse. But someone has to say something to appease the patients.

Specializes in ICU.

I have to make a comment about "charge nurses." I usually do charge, and have been chewed up and spit out by administration for doing what they call "aide work," instead of charge nurse duties. I simply offered to do finger- sticks to help everybody out (we have tons of finger-sticks, whether they need them or not). My nurse manager got upset, saying the charge nurse has better things to do, such as look over labs, etc., than finger-sticks. Then I got chewed out for not "helping the LPN's enough." When we are charge, we still have to take a full load of patients, just as many as the other nurses do, but still do charge nurse stuff. So if we don't help out much with admissions, it is because we are swamped, too!

Specializes in Med/Surg, LTACH, LTC, Home Health.

Got an admit and a post-op at the beginning of the shift last night. Got the q1h Dilaudid patient; got the 45-minute chatterbox; what I didn't get was a lunch break. Yet I said nothing. I sucked it up and kept humping. My co-worker mentioned to the house supervisor that I hadn't been able to take a break. Were any changes made? Nope. Charge nurse never said a word; never met my new patient. Couldn't even start an IV for me. And I literally had all sets of orders where half of a narcotic dose was to be given. Every time I so much as looked at the pyxis, I had to get a witness. Ran into one of the ER nurses in the parking lot at the end of the shift. She said they had about 25 people in the ER already with admit orders, just waiting for beds. Wow! My phone rang while I was making the 3+ hour drive home this morning before I was even out of the county. They are desperate for help tonight. Can I help out? Of course I will be glad to help out:yes:.....but not tonight!:cheeky: Passive payback is a ******, ain't it? Rolls around kinda quick sometimes, too.:roflmao:

BUT!!!!! I took the admit without so much as a whimper. And I will see them on the weekend so we can play this game again!:)

Specializes in Med/Surg, LTACH, LTC, Home Health.
I have to make a comment about "charge nurses." I usually do charge, and have been chewed up and spit out by administration for doing what they call "aide work," instead of charge nurse duties. I simply offered to do finger- sticks to help everybody out (we have tons of finger-sticks, whether they need them or not). My nurse manager got upset, saying the charge nurse has better things to do, such as look over labs, etc., than finger-sticks. Then I got chewed out for not "helping the LPN's enough." When we are charge, we still have to take a full load of patients, just as many as the other nurses do, but still do charge nurse stuff. So if we don't help out much with admissions, it is because we are swamped, too!

I believe you. They don't want the charges to do the aide work but expect everybody else BUT the aide to do it, which leaves the floor nurses, who are ultimately responsible when the aide won't do it. (That was another post from recent days).But what the hell. "What else can I do for you? I have the time." (I think that's how the script goes).:sniff: What else can we do to make it better? Might as well break our backs while their cracking.

Specializes in neuro/ortho med surge 4.
I have to make a comment about "charge nurses." I usually do charge, and have been chewed up and spit out by administration for doing what they call "aide work," instead of charge nurse duties. I simply offered to do finger- sticks to help everybody out (we have tons of finger-sticks, whether they need them or not). My nurse manager got upset, saying the charge nurse has better things to do, such as look over labs, etc., than finger-sticks. Then I got chewed out for not "helping the LPN's enough." When we are charge, we still have to take a full load of patients, just as many as the other nurses do, but still do charge nurse stuff. So if we don't help out much with admissions, it is because we are swamped, too!

That is the part of the problem. Charge nurses have an assignment plus charge duties. This is why staff is overwhelmed. No one can help.

I don't think I ever squawked too much about getting an admission; somebody's gotta do it. Some admits are easy, some are complex. I help others when I can; they help me when they can. Some charge nurses are helpful, some less so. Such is life. :smug:

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