Published May 29, 2002
You are reading page 2 of Are all floor nurses rude to ER nurses?
Amy ER Nurse
I have been told by a floor nurse when I called to give report, "can't you wait 30 min to send them?" This when we had every bed full, 4 sitting in the hall, and 13 in the lobby waiting to get a bed! I told them no of course. She told me, " that is my least bed!" I told her that at least she knew that she would not be getting any more! I sure did not have that luxury~
i think if you can always work as part of the "greater team"
and you can bet that i have asked an ER nurse to hold a patient for about 15 more minutes...........just to allow me to space out the chaos............
but you can also bet that i have said.....oh, yea!!!!!!!!! so bring them on up, cause it sounds like you are havin' he....... down there................
nothing like a lil teamwork .........ya'all know............all for the GENERAL GOOD!!!!!!!!!!!!!!!!
"You guys in ER & L&D are the only one's (I think) that have pt's that walk in off the street. You guys don't really have anywhere to steer your frustration of another new patient. But unfortunately, you get the brunt of it. "
Thank you - not nurses think of this and it is really nice to hear our frustrations verbalized by someone else upstairs - thanks
Our hospital had A LOT of problems between emerg and the floors, mainly stemming from rudeness from one type A personality emerg nurse (who actually called the floor nurse a glorified butt wiper and all hell broke loose!).
The hospital tried to work it out by setting guidelines for patient transfers and it seems to be helping. The floor nurses were having problems with tons of patients being transferred from emerg right at shift change (when they might have been sitting in emergency for 6 hours for no good reason), so the new rule says floor nurses can refuse admits at shift change IF the patient has been in emergency for more than 2 hours and been assessed, which has eliminated that problem completely. Now the emerg nurses either turf their patients in a timely manner or they have to wait.
The other problem was ICU units doing this at the same time, so floor nurses have the right to refuse a transfer right away IF they are in the process of another one, then call emerg or ICU and have the next patient transfered.
The last problem was emergency patients being sent up without any of their treatments or protocols started (one didn't even have an assessment documented!), and now floor nurses have the right to refuse them as well. They seldom do if emerg says they are busy though. But, if we go into the computer and see that emerg has 3 patients and six nurses on, then they are not going to be sending people like this up.
Our emergency room is not the busiest in the world and there are times when nothing is going on down there. I think those are the only times floor nurses resent being dumped on. Fortunately I just float to med-surg, so I've been kept out of the fray, but things seem to be improving. We even had an emergency nurse come up to the floor to help out when things were quiet in emerg!!! You should have seen the jaws drop!!! As nurses in emergency became more aware of the problems on med-surg they became more understanding. That made med-surg nurses more sympathetic to emerg nurses and more willing to go that extra mile for them.
Can ya'll circle the block for about 30 minutes cause I'm really busy now?"
I thought this was pretty funny...:chuckle
I have worked Med-Surg, tele, ER and the units, and have rarely seen the nastyness...except for some ER nurses...who were very rude! Not saying there aren't rude floor nurses though. And I have also received report from very nice and upbeat nurses also, and I felt like I was talking to a friend.. :). It did depend on the hospital I was in.
I also try to be upbeat when the pt arrives. First the person transporting is NOT the enemy...and I believe the pt. needs to be received with a good first impression. They don't need to see a nurse with a long face. Many times they just want to get somewhere that's comfortable....they're hungry...and coming to the hospital maybe the first time for them....and the last thing they need to see is a sour faced nurse greeting them.... I try to get them relaxed...and I use humor many times. I have got good at getting them settled and in bed...in about 30mins or so....unless they come up with a lot of orders. I usually first go and see my other pts...and see if they have any immediate needs...and let them know I have an admission...and will be with them as soon as possible. All most all are very understanding and have no problem with this.
Another nurse and I, while working in the GI special procedures area...went to return a pt. to the ER...from whence she came! Not only did no one come when we arrived, AND put the pt's light on...when they did come...they were rude...and were of no help transferring the pt from the stretcher to the bed. Now they had been given report... knew they were would be receiving this pt back...and that we were on our way. We had to go look for the staff...and found them huddled around the corner drinking coffee!!! Where upon...a bunch of them standing there rudely asked what we wanted...:chuckle. I mean ya gotta luv it...:chuckle!
Whenever I take report from any nurse..about a pt I'm receiving...I try to be calm.....and attentive. I tell them to send them when they're ready...and I immediately go in and get the room ready...unless I'm dealing with something else right then...and then the charge nurse or another nurse takes report...and when I get free...I'm given report by that person.
What I do hate is...recieving a pt from the ER...that has now orders...and they haven't been done. We have 30 mins to do a now order....and I once got a pt with a now Vit K order...that wasn't given. Or a pt. who has been in the ER all day and is a DM...and given no tray..and now it's 7pm and too late to get one! Fortunately the hospital did start having extra tray delivered just because this happens too many times...and most of our pts are DMs. And as for receiving pts from the ER all cleaned up...NOT! There have been many, many times over the years...when this was NOT the case...both in getting pts from ER to the units, and to the floor. I have seen it from all sides...and I know...there are problems with every area....thinking that another area has a problem with them. Or there are those who think they're job is more important then someone elses. I agree with those who said.....let's worked together for the greater good. The P A T I E N T!
Originally posted by jimminy OBHEATHERNurse Thank you - not nurses think of this and it is really nice to hear our frustrations verbalized by someone else upstairs - thanks
Thank you - not nurses think of this and it is really nice to hear our frustrations verbalized by someone else upstairs - thanks
No problem Jimminy! It's unfair of us to assume that just because our unit is busy, that someone else's is not. The anger just filters downward, and stops in ER & L&D.
Can't we all just get along? :chuckle :chuckle
now the emerg nurses either turf their patients in a timely manner or they have to wait.
let me give you some scenarios about patients who wait longer than 2 hrs in the er........our er is chronicly under staffed, no na a third of the time and never after 930pm, a lot of times no transport......now we have a new policy that a cp has to have an ekg within 6 minutes of arrival....guess who does all the ekg's now...yes the nurses......we also are expected to do all the lab draws.....soon they want us to do all of the resp tx too.... and we are using more emt techs now who cannot pass meds or do discharges, we have an lpn who cannot push iv drugs....um let's see.....ok now lets talk about the residents who come to admit these patients and spend an hour doing paper work before they even see the patient then order all kinds of stupid things stat....many has been the time when i've had my pt wiped and diped and ready for transport only to have an unresponsive or chest pain or a code roll thru the er doors and guess what, that is the priority instead of getting a stabe pt to the unit so the floor nurse won't be inconveinced. this is common place in my work environment, l don't always have the luxery of choosing to be 'considerate' of the floor nurse when another pt is going down the tubes. these scenarios are fairly common place where l work. l always hold pts when l can though and do as much as poss. before they come to the unit... i can't even imagine a nurse leaving a pt. in the er for no good reason...all of us are anxious to say 'bye bye' you would have to be a machoistic(spelling?} idiot to leave pt's in the er for no good reason.......anyone who thinks this happens hasn't worked er l guess. l've done floor nursing..longer than er nursing so l know where of l speak....sooooo...walk a mile in my clogs.......it's definatly a different perspective......lr
I understand that lrae, but it isn't the case in our emergency department. We are not a busy trauma referal center. In fact, they are one of the best staffed areas in the hospital (all RN staff, no LPNs or techs or NAs), which is why so many nurses have to wait to get jobs there. I have floated down there, and it just isn't like your emergency department. I never meant to imply that it was.
There is seldom a reason for a patient to be our emerg for five or six hours when a bed is available on a medical floor, which was routinely happening on nights no matter what the census. Patients have been left in emergency because someone went on a break or "didn't feel like entering it into the computer" or doesn't want to go to the trouble of bringing them up when on nights when we don't have any porters. I'll never understand that one. The nurses on days just have to call the porter to come get them and take them up, right about 730. There is ABSOLUTELY no reason to have 5 admits at 730 like I have seen, when the census and acuity in emerg was low (we can check these via our unit's computer).
I think the fact that we basically never get a rush of patients at shift change since instituting that policy would prove the fact that they don't all need to be transfered then!
Fergus, it's true all ER's are not the same......ours is not a level 1 either but is is tremendoulsy busy.....that 2 hour thing just blows me away though.....cause l've spent longer than that in an Urgent Care, l can't fathom expecting to get labs, x-rays, returned md consult calls and admit orders in 2 hrs...it has happened, but seldom.......ln fact when a fast track patient complains about having to wait 2 hrs, we tell them about the routine 5-6 hr wait at the level 1 just up the road. lreally had a bad night last night, had a 6ft, 275#+ elderly pt..SOB..kept sliding out of the cart, couldn't get comfortable etc......well finally got his orders, got him cleaned up and ready....started to do a couple of the now orders and here comes a squad with a 30 something guy who had been hit by a car and drug several feet in a parking lot.....head inj, mental status chng. Ofcourse it is the weekend so we are more than usual short staffed.....we have to help each other it's just pure survival where l work. Well, by the time we get this guy stable and l go back to my admit, the old fella is half way off the bottom of the cart, moaning "l can't stand this much longer." lt has now been an hour since i was originally going to take him to the floor. l put the cart i trendellenburg pos. (nice for a breather) and heft him up by the sheets, and roll him on over to the unit...l considered finishing the now orders, but hmmm...something else catastrophic could roll thru the door any minute and here we go again.....off to the floor we go....... l help transfer the guy to the bed, his depend has a yellow river in it, l get diry looks.....but sometimes your best just isn't good enough, ya know? My back hurts, my bladder is full and l havn't had lunch again...l'm too tired to really care too much.......however, about an hour later l was able to make the time to go to the unit to do a difficult IV stick. But l'm with you on holding pt's in the ED just because you don't want to transport or put in computor.....can't fathom that one either.....sounds like this ER has some unusual issues........in the end i'm glad things have worked out.....There is no excuse for rude nurses regardless of where they work......."Glorified butt wipe!??" That nurse would most likely have been fired where l work.....unexcusable!!!! Thanks for listenin'.............LR
PS: l would never defend rude nurses no matter where they work...the ER l worked at before had the meanest rudest nurses l have ever met in my entire life!! l hope you don't work there!!
Definitely with you there lrae! I should clarify the 2 hours is 2 hours after their orders have been entered into the computer, not 2 hours from the time they come in. That would definitely be pushing it! Most of the emerg staff are really great, it was one nurse in particular who would hold all her patients until day shift came on because days has porters (the same one who called the floor nurse a glorified butt wiper). Most of them are very nice, even to a floater like me who won't take a patient assignment!
Got it Fergus! you gotta promise me if she ever comes in this direction you post a warning! hee hee:chuckle: Reminds me of a situation... Recently had a kid in the ER...drunk.....real bad scene eventually had to put him on a vent to get controle.....he's a young teenager, had F*&% the Police tattooed right on his abd in big bold.....ya know....l jokingly asked one of the officer's the other day if they had heard from FTP (his nick name due to tattoo). She said no, he escaped and is probably in Ca and we have no real desire to look too hard...you know, Ohio's loss, California's nightmare...LOL! Well l suspect if your lovely ER nurse ever defects no one will go after her huh? Maybe she has F*^& the Floor Nurse tattooed on her butt and she wants you to wipe it! :rotfl: l've just seen toooooooo much of this type in my 22 yrs...............you have my sympathy.........LR
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