Anyone fax report?

RNin92 · Nov 10, 2004

We receive fax on my tele unit from the ED but my gripe isn't the incomplete report or the illegible handwritting, but if they bring the patient up and leave without waiting for the nurse to come to the room and I walk in unbeknownst to me to a patient who has been on the unit for who knows how long and may or may not be in distress; to top it all off if I do happen to "catch" them bringing up my admission the nurse is never with them it's always a transporter or a nurse doing the other a favor and they know NOTHING about the patient. I do not like the fax reports, they are short, incomplete, and do not paint an accurate clinical picture, but that is just a gripe, I do think that sending a patient up to a cardiac floor often with only a transporter in attendance and then the patient is not "passed" onto another nurse but may be sitting in a bed unmonitored and possibly without anyone knowing they are even there is ETHICALLY, MORALLY AND LEGALLY NEGLIGENT.Both nurses (ED and receiving nurse) should make an effort to meet for 30 seconds when the patient arrives to see the fax matches the face !

I was glad that you included the last part about BOTH nurses meeting the patient.

In my facility, we still call report. So the floor nurse knows we are on our way. Yet we get to the floor and "magically" everyone disappears from the station. They were there when we rounded the corner...

As far as transporting goes...we do let our medics transport our stable tele patients. I do not see a huge deal here...much of the time 10 minutes after we bring up the patient a VOLUNTEER of about 80 puts the patient in a W/C, takes off the monitor and goes to x-ray! I just don't get it!

It would just be really refreshing if we could just work together for the good of the patient.

I know...and there are winged bovines soaring in the sky!!

RN92 · Nov 10, 2004

I forgot to mention that we fax: MD assessment, admission orders, front sheet with demographics on it. The secretary mostly does this.

ERNurse678 · Nov 18, 2004

We tube report in a tube system that will beep until the tube is removed. We then call the unit and make them aware that the report was sent. We then have to wait 15 minutes to bring up the pt. Now, for the report we actually print a copy of their ER chart and send that. It has their entire assessment, what medicines they were given, vital signs, reassessments, labs that were ordered, PMH, allergies, meds from home and just about anything else you want to know about the pt. If the pt. is going to ICU, CCU or Neuro ICU then the nurse has to take the pt. Otherwise if they are going to telemetry or Med-Surg and the RN in charge of the pt. is comfortable allowing a tech or transporter to transport the pt. then that is who transports. It seems to work really well for us. There was some resistance when we first changed to this system but it has tremendously cut down our average time in department. Also, when we first changed to this system we had a group of ER nurses that went around to every floor and gave them inservices on how to read our charts and where in the chart they could find important information.

mdslabod · Nov 19, 2004

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We are thinking of trying to fax report to the floors. I was wondering if anyone else out there does it and how it's working.
Our sister hospital is starting to do that and it has been quite a struggle for them. Causing a lot of bad feelings all around. We are trying to avoid that.
We want to set up a task force of ED nurses and floor nurses to work on it together.
Any input would be appreciated.
Thanks.

We started faxing report in our ER and I found that we are able to get the patients to the floor faster, which is good. If I need to tell the recieving nurse something, I do it when I take the patient to the floor.

RNin92 · Nov 20, 2004

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We started faxing report in our ER and I found that we are able to get the patients to the floor faster, which is good. If I need to tell the recieving nurse something, I do it when I take the patient to the floor.

Faster is ALWAYS better.

We are going to try!

veetach · Nov 20, 2004

I would love to be able to fax report. As it stands right now, it is a battle just to call report. We wait and wait and wait..... there is always a reason that the receiving nurse cannot take report. Please dont throw things at me, its the truth. One day I was told that "the bed needed cleaned"... I had had that excuse thrown at me one too many times. I went to the computer logged into the forbidden bed census program and found out that the bed was not even occupied in the last 24 hours!! Its not always this way, but more often than not.

I dont like the idea of faxing report on a pt to ccu/Icu though....

I think I like the tube idea better than faxing, it sounds like it works better.

Rena RN 2003, RN · Nov 22, 2004

I mean, how would you ED nurses feel if you had all that to deal with as soon as you walked in the door?

:lol that was funny.

RNin92 · Nov 30, 2004

:lol that was funny.

I know my friend...

Some people just have no clue!!!

:rotfl:

Darlene K. · Dec 6, 2004

We just began doing faxed reports this week. After we fax our report we call the unit secretary to make sure they received it. We are supposed to have the patient up to their room within 30 minutes of sending the fax. We have had problems trying to call report, either they can't find the nurse, she is in an isolation room, and so on. Sometimes, they flat out tell you, I'm too busy to take report right now or you have to call back after the shift change. I understand both sides, however, it's very frustrating when you have all of your beds full, patients lying in stretchers in the hall, the waiting area is packed and you can't get anyone to take report.

rncen615 · Dec 20, 2004

We started faxing report about a year ago. We had an admit team made up of ED nurses, floor nurses and house supervisors to try to resolve the constant problem of trying to call report numerous times before the floor nurse could take the call. We started out with a fax report form that was very tedious. Now we use a brief form with the important information contained in it and also fax our nurses note, MD note and labs, CT reports, admit orders, etc. The form has info about patient family, any valuables, meds given, last vital signs and any other info the floor nurse needs. We fax and call the floor to let them know the fax is coming. Then we give them 30 minutes to call with any questions. If we don't get a call in 30 minutes, the patient goes to the floor. It has worked very well. We still have an occasional problem with them not getting report. ( The fax machine is out of paper or some other technical problem) but we have much better results than before. The only stipulation is that no patient can go up during report time which is 6:45 - 7:15 so we try to get report faxed as soon as we can to avoid this delay at shift change.

ERNurse678 · Dec 22, 2004

Yep, you've totally nailed the problems that we have with ER admissions. I don't blame the faxed reports, per se, because I realize that the ED can only do so much for a patient.
Even though our staffing is OK, my particular problem is with coming in at 11 and having an LPN with a full assignment to cover, 6 patients of my own, most of them wanting pain/sleepers. Completing the rest of my assignment, I get a transfer and an ER admit, all at the same time when I first come on duty. Happens a lot. Freaks me out. Is there a solution to that?
I mean, how would you ED nurses feel if you had all that to deal with as soon as you walked in the door?
I realize that's a bit OT, and I don't want you to read it as a complaint, it's not. But it's a problem, and I'm sure there is a solution somewhere, if we just had the time to have a discussion about it without pointing fingers.

Well I am sure nurses on the floor are busy, however in reference to the qoute of "How would you ER nurses feel if you had all that to deal with as soon as you walked in the door?" Well let me ask a return question. How would you feel if you walked in to work and had to take report on 4 pt's of which one is on the ventilator after a cardiac arrest, one is a CVA who continues to be unresponsive, one is in respiratory arrest and is about to be intubated and a traumatic arrest is 2 minutes out? That is what we walk in the door to.

UM Review RN, ASN, RN · Dec 22, 2004

How would you feel if you walked in to work and had to take report on 4 pt's of which one is on the ventilator after a cardiac arrest, one is a CVA who continues to be unresponsive, one is in respiratory arrest and is about to be intubated and a traumatic arrest is 2 minutes out? That is what we walk in the door to.

Look. I'm not about to get into a pi&&ing contest with you about whose job is harder--all nurses have it tough, or there wouldn't be a shortage. I respect you ER nurses because you have to think and move so fast, and also because of the crazy people you have to put up with. I'm sure I wouldn't last a shift.

So I want you to understand that it is with the utmost respect that I remind you that patients really don't give a good ta-hoot about whose department they're in before they have a cardiac arrest, or major hemorrhagic stroke, or respiratory failure. We have to deal with that stuff too.

But--and this is my big point--we on the regular units simply do not have the resources (i.e. docs, transporters, Respiratory Therapists, Radiology) handy enough to help quickly in an emergent situation, and that's why we get nervous and complain. We know that seconds count. Where the ER is situated and designed for efficiency, we're not. Heck, I can't even pull a Nitro gtt or a stat Rocephin from the Pyxis! Can you imagine how much more time we waste dinking around trying to get stuff done that you guys don't have to wait nearly as long for?

This was brought home to me in a very eye-opening way when I floated to a Med-Surg unit and discovered that the first patient I assessed was in the process of having an AMI. There was no EKG monitor on the unit, no one came to help me with the patient, I had to page Respiratory and the doctor myself, I had to leave the patient to go all the way up the hall to get the patient medications, and then the patient was c/o needing to use the bathroom and actually tried to get OOB, attached to the EKG, to go, while the Lab tech was c/o the water that I knocked over in my haste to get the patient back in bed.

Well, at least she wasn't unconscious. :rolleyes:

Anyhow, I think it took about 2 hours start to finish, to get this patient transferred to CCU. On my home unit, it would've taken 20 minutes--most of it waiting for the doc to call back.

And I still had plenty more patients to assess and care for, any or all of whom could've been found in the same situation or worse.

Hope that helps you understand where we're coming from, too.