I have been an RN for about 3 years (1yr med/surg; 2 yrs cardiac) I just started working ER about 3 weeks ago, and I just have a quick question. Are alot of floor nurses rude and essentially no help what-so-ever when you transfer patients? Tonight I took a patient up to Tele and I had to ask a nurse sitting at the station 3 times if my patient was in the right place and if I had the right room, she just stared at me, rolled her eyes and acted like asking her to give up a kidney or something! I don't ever remember flat out ignoring those who would transport patients from the ER or never helping get the patient into bed. I know it wasn't her patient but at least she could have told me who the secretary was so I could drop off the paper work, or do something!!?!??!!?!
Do you guys run into this alot? Not everyone is rude, but it is has definetly been a trend.
it's a losing battle. everyone is frustrated. the system is what it is and there's really nothing we can do about it. patient's get admitted and we have to find a bed for them. if the floor has an empty bed that mean it's gonna get filled sometime on their shift, so they need to prepare and use their time management wisely. as an er nurse, i do not have the luxury of seeing my bed sit empty for any length of time. most of the time, my bed has a traige patient's name waiting in the wings, or even a squad assigned with an eta of 1-5 minutes, or they stand outside the room glaring at me for not working fast enough, so they too can take a breath before they are called out again. i barely have enough time to get a bed in there and wash the monitor lines down before having to put them on someone else. the waste baskets are full, there's crap everywhere which discusts me but sometimes it can't be helped. unless there is more education to the public about using the ed for minor non-emergent things, or their pcp, we will continue to see this, be abused by the system and in the same sentence, the floor nurses for not understanding the trenches we work in,
How interesting that this older thread is still relevant to us .and sad. We try as hard as we can to expedite employees when they show up as patients in our facility...professional coutesy, ya know. And I know they often expect it, or actually think they have the right to come down and get free advice, scripts, etc, from our docs. I can just just imagine how they would feel if they had to wait hours and hours in our lobby, and partly because the floor nurse wanted us to hold the pt.
I try to be understanding when I know they have just had a code on their floor, or other crisis, but as said before, EMS just can't wait...
One of my colleagues last month told me one of the unit nurses thought we only had 1 pt each........They are only allowed 2 patients, yet with our staffing one RN may have 3 fresh 1:1 pts ......
I loved the comment that we are all just one ED, with all the same problems, makes me feel less alone inthe world
my worst personal experience with an icu nurse was when i tried to call report and the nurse politely said "i am really tied up right now, can you call back in 30 minutes?" even though i was trying to make room for the lobby full of waiting people, since she asked so sweetly, i said "sure." when i called back exactly 30 minutes later, so told me that they were getting ready to do shift change and she could not take report. then she had the house supervisor call my charge nurse to tattle on me for calling report during shift change!#@@!#@$%#!#@!
uuugggghhhh
i feel for you, gator. you have been royally s**t on. but the good thing about that is it won't happen again with that nurse, or, i daresay, with anyone else. that nurse has ruined it for herself and all other nurses you will report to in the future. i am pretty sure you are not the first one she was "sweet" to.
bet you will be scanning the clock from now on. i know, 'cause it happened to me too. it's an old game.
fool me once, shame on you. fool me twice, shame on me!
I just switched to ER nursing about 3 mos ago. When I take patients to the ICU I don't take any crap from the occasional jerk... as I was myself an ICU nurse for 4 yrs and know exactly how to outgame them. It's pretty fun, actually.
I have been an ED nurse for 10 years. My worst experiences are taking patients to ICU, some of the Nurses just don't want to talk or know you. I worked for awhile in after hours management and did my best to educate ward (or floor nurses) as to why it was important to move patients out of ED ASAP. Now in ED I do my best not to send patients close to handover or shift change unless we are really clogged up(which is all too often). During the day we now have what we call the Emergency Department Transfer Coordinator or EDTC. It is his or her job to liaise with the wards in regards not only getting patients out of ED but also getting patients out of the wards to make room. But i think the biggest problem is the lack of understanding between the work load. There is fault on both sides and communication is important here. Oh and if I got offered $10 to keep a patient until after shift change I could probably make an extra $400 per shift....
I cringe sometimes when I hear some of my co-workers - the ones who have never worked on a floor - bad mouth floor nurses and call them everything from "lazy" to "incompetent". I feel bad when I hear floor nurses dismiss ED nurses as inconsiderate jerks who don't care what happens on the floors.
Every time a feud like this erupts, I'm tempted to tell the parties involved to "walk a mile in the other person's shoes before castigating them"... but I shut up before I begin.
Why? Because I think it's a waste of time!
I figure that if you're old enough and a so called "adult" but yet behave like a petulant, pouting child - then no amount of words or wisdom is going to get through to you.
My parents raised me to be considerate towards others. I can't imagine doing some of the things y'all just listed - whatever happened to honesty and basic courtesy?
When I worked the floor, I'd tell ER - "I'm really slammed right now. I promise I'll call back in 15 minutes". Baring any un-forseen predicament (pt. fell, code etc) I kept my word. Now when I work ER, I try to be considerate to the floor. Usually they ask for 10-15 minutes and I oblige. I try not to be overtly pushy unless we're drowning (some weekdays we easily see over 300 patients a day).
The way I see it: Floor nurse or trauma junkie - we both got a job to do. An admission or a transfer is going to throw a money wrench into the works - but it's nobody's "fault". Griping and grousing and stalling don't help - they only make an already hard task that much more harder.
It's a great thing when nurses work together to see these situations from both sides, and I am all for working together. Whenever I have the chance to work with staff from other departments, I get to know other nurses and when I call their floor we can relate to each other. Often they call for help with IVs or such, and if I have questions about floor stuff that I am not familiar with, they are helpful. Codes go smoother because we know each other and I feel like we work together better. They know that I am not a floor nurse and they tell me that they could not work in the ED.
But evidently not everyone thinks this way, and the pt suffers on that skinny stretcher mattress while the staff argues. So I think you need to be discerning when it comes to staff members that avoid report. If the bed is not clean, call the house supervisor to see if the stat clean has really been called, and the supervisor will immediately know you are having trouble getting the pt to their assigned bed. Be resourceful and ask to give report to the charge nurse if the staff nurse is unavailable, or if the nurse says "Hey, I didn't know I was getting a patient!" Then you have notified the charge nurse that you are having a problem. Occasionally this has resulted in the immediate availability of the assigned nurse.
(These steps only take a few minutes, and you are already waiting 30 min or more to give your report.)
I know each hospital has different systems and bed control methods; adapt these ideas prn!
My favorite method would be the "fax and take up in 30 minutes" method listed before.
I just switched to ER nursing about 3 mos ago. When I take patients to the ICU I don't take any crap from the occasional jerk... as I was myself an ICU nurse for 4 yrs and know exactly how to outgame them. It's pretty fun, actually.
I know the ICU nurses are exactly the way you described.....just adds fuel to the fire.......
Working at both a level 2 trauma center in a large city (PRN now) and at the only hospital in a very large rural county, it is the same story at both. Fortunately for me, BOTH hospitals have a policy of no-delay report. If the receiving nurse is not available, the lead/charge is expected to take report. Unless there is a crisis on the floor (i.e. respiratory/cardiac arrest), report is taken when the call is made from the ER. No exceptions. Of course, floor nurses are hostile at times but for the most part OK (I'm sure some complaining goes on after the phone call ends, but whatever!).
This policy is expected to be upheld even at shift change when nurses are either (a) giving report or (b) recording report. It's much easier to pause a tape recorder for LITERALLY 1-2 minutes than tell an ambulance to hang out because you don't have a bed for them and their patient that is coding will just have to wait!
I really REALLY don't understand why people on the floors (med-surg OR ICU) get bent out of shape -- report does NOT take 20 minutes, it takes a matter of 1-5 minutes. The same amount of time it takes you to urinate. You wouldn't wait 20-30 minutes to pee if you needed to go RIGHT THEN, so why put off report when it's a short simple process? I have worked med-surg-peds. Going from one to another, I really don't get what the big deal is.
I know the ICU nurses are exactly the way you described.....just adds fuel to the fire.......
Well you know, I'm not talking about all nurses... just ICU at my current facility. First, they don't have to take stepdowns, so when I'm calling_ they only have one other sick patient. Secondly, they have 30 free minutes from the time I fax the SBAR (written report) before I am allowed to call or bring up the pt.
When I was working SICU, the OR called telling me they'd be here in 5 minutes (the bed was already down there) and I had to get ready,accommodate, and maybe get a half orificed report from the CRNA who brought the pt on arrival.
Just last week I sat on a DKA pt on an insulin gtt for 2 hrs before her highness was ready. Well, when I delivered the pt the RN tried to claim that one of her IV's was infiltrated, and then asked me a million questions that she would have known the answers to had she actually read the SBAR... such as about her urinary output, etc. She made a huge deal out of the IV although it wasn't red, swollen, cool but it probably was on it's way out. Well I was pretty peeved about her whining, so I left without my monitor. When I came back 15 minutes later to get my monitor, the IV was still in place, arm not elevated or warm compressed. Now the monitor showed her pressure to be like 70's/40's which I found pretty odd because she had been solid 160s in the ED (now I will say she was at great risk of getting septic because her foot was rotting off... and she was tachy but afebrile). But she was mentating well. Well these girls were all bent calling the intensivist, getting their boluses ready and giving me the evil eye. I then quietly noticed that the NIBP was loose and not properly placed. When I re-took the pressure with the proper fit much to the dismay and protest of chickypooRN, the pt's pressure suddenly perked right back up to the 160's without any bolus or pressor yet. All she could muster was "well she must have perked up". Mwaaahahahahahah!
My charge nurse said I should have invited them over for an inservice on NIBP use but I didn't have the presence at the time!
I just don't get it. When I call the floor, I got out of my way to be friendly, courteous and treat the unit secretary and the receiving RN the way I would want to be treated. When I get to the floor, I greet, smile and ask how their night is going. They still treat me like crap. They barely speak, won't help transfer the patient from the stretcher to bed and won't acknowledge me when I hand the chart off. *** is that all about? You would think they would want to help transfer the patient from the stretcher to the bed...perfect time to assess their skin without having to turn them without help.
I get that we = work but come on, the poor attitude doesn't change the situation at all. It only makes it worse.
TraumaNurseRN
497 Posts
it's a losing battle. everyone is frustrated. the system is what it is and there's really nothing we can do about it. patient's get admitted and we have to find a bed for them. if the floor has an empty bed that mean it's gonna get filled sometime on their shift, so they need to prepare and use their time management wisely. as an er nurse, i do not have the luxury of seeing my bed sit empty for any length of time. most of the time, my bed has a traige patient's name waiting in the wings, or even a squad assigned with an eta of 1-5 minutes, or they stand outside the room glaring at me for not working fast enough, so they too can take a breath before they are called out again. i barely have enough time to get a bed in there and wash the monitor lines down before having to put them on someone else. the waste baskets are full, there's crap everywhere which discusts me but sometimes it can't be helped. unless there is more education to the public about using the ed for minor non-emergent things, or their pcp, we will continue to see this, be abused by the system and in the same sentence, the floor nurses for not understanding the trenches we work in,