I don't know if every time I call I end up catching a nurse whose been a having a bad day or is not feeling well, but of the times I've called every time I have called I've gotten the worst kind of attitude. I almost feel as if, perhaps, it is because the nurses that gave me attitude feel as if I'm ruining their day by adding one more patient.
I get it, it sucks. No one enjoys the current state of staffing ratios. I worked the floor and understand. However just as much as I'm going to be an adult and try my best to not take your displaced frustrations personally, also please try to take me sending you a patient not personal.
If it is is any consolation, by the time I return to my unit - my empty room will be clean already and that means time to prepare it for the next train wreck coming my way. I most likely will not go back and have time to relax. Maybe a quick lunch, as my next train wreck is life flighted to me or your next rapid response ends up here.
Just know we are all in the same business. Never anything personal. If my charge nurse ever calls your unit to expedite a transfer, know she's not doing it to be mean. It's because someone out there really needs that ICU bed. What if it was your mom or dad or friend?
When I worked the floor and was busy as can be, of course I would be a little uneasy when I was getting 5 calls because receiving report was delayed 10 minutes because I was doing wound care etc. So yes I get it. This post was intended as a neither side of the grass is greener kinda post. If I have a floor status patient in the ICU with transfer orders and I know there's no one in need of a room or we have other empty rooms, I will call you report and and ask you "Hey floor nurse, have you had lunch? Go eat and then I'll take you the transfer, ok?" Let's be kind and look out for each other!
In PACU, pts are assigned a level of care which affects billing, based in part on the amt of time spent there (Level 1: 30min with no meds, Level 3: >30 min with meds, etc). If we have a pt roll out from a minor procedure already pretty awake & doesn't need any intervention, there's no reason to hold them a certain length of time, especially when they will go on to another monitored unit. I usually go ahead & discharge them at 25 min to keep them at level 1.
Why does the PACU keep ICU patients? We get them straight from surgery.
Cause our ICU sucks. Not really, but we've been trying to work with them about this. New policy this year is that they get vented pts straight back without a pacu nurse going over to recover, but somehow they are always "short staffed" & want us to come over anyway. Big fiasco for me on my last call...long story.
Bedside surgery? Nobody gives a rat's patooty about sterile environment?
We've had ICU patients that simply can't be moved to OR- all of their equipment won't fit in the elevator, so they've done very basic things like trachs bedside in ICU.
We do trachs, thoracentisis, chest tubes, cranis, all kinds of things bedside. Especially if it's emergent. It's actually better for the patient as well, if they are not stable enough to go to the OR.
Opening shot: Nasty, Overflowing Urban ER. (Anytown U.S.A.) ER nursing staff caring for multiple high acuity ICU caliber patients along with the usual walking dead: MIs, gunshot wounds, traumatic amputations, MVAs, frequent flyers, etc. No ICU beds available for several days: (administration aware)
ER nurse: (phone rings 10-20 times.)
"Hello, my name is Goofster. I have a patient here in the ER. I'd like to give report to the accepting nurse."
Unit secretary: "OK, Let me see if I can locate her."
(5-10 minutes later.)
Accepting nurse: "Hello!"
ER nurse:
"Hello, this is Goofster, the ER nurse taking care of..."
Accepting nurse:
"...look! just bring 'em up, I'm too busy for this! I'll take report when you bring the patient up...OK!!??"
ER nurse: "OK."
ER nurse: ( upon arrival to floor) "Hi, I'm Goofster", the ER nurse, are you the accepting nurse?
Accepting nurse: "What!!! You're the ER nurse!!?... Look! I wasn't expecting this patient. Did you call report first before you brought the patient up? I'm very busy and this is very unprofessional!!! Expect to be written up!!!"
Opening shot: Nasty, Overflowing Urban ER. (Anytown U.S.A.) ER nursing staff caring for multiple high acuity ICU caliber patients along with the usual walking dead: MIs, gunshot wounds, traumatic amputations, MVAs, frequent flyers, etc. No ICU beds available for several days: (administration aware)
ER nurse: (phone rings 10-20 times.)
"Hello, my name is Goofster. I have a patient here in the ER. I'd like to give report to the accepting nurse."
Unit secretary: "OK, Let me see if I can locate her."
(5-10 minutes later.)
Accepting nurse: "Hello!"
ER nurse:
"Hello, this is Goofster, the ER nurse taking care of..."
Accepting nurse:
"...look! just bring 'em up, I'm too busy for this! I'll take report when you bring the patient up...OK!!??"
ER nurse: "OK."
ER nurse: ( upon arrival to floor) "Hi, I'm Goofster", the ER nurse, are you the accepting nurse?
Accepting nurse: "What!!! You're the ER nurse!!?... Look! I wasn't expecting this patient. Did you call report first before you brought the patient up? I'm very busy and this is very unprofessional!!! Expect to be written up!!!"
Been there,done that, ASN, RN
7,241 Posts
Nurses are pushed to the max. Sometimes an admission/ transfer will put them over the edge.
Ignore any attitudes you may run across. I always managed to take a transfer with class.