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!
I used to absolutely hate when the ER nurse calling report would tell me "this isn't my patient, I'm just helping out" and proceed to read from the SBAR. I can do that myself! But after working at a hospital in which the ER does not call report, I appreciate any type of person to person handoff. The charge nurse is supposed to monitor the boards and patient is supposed to be transported a half hour after showing up on the tracker. In theory, this gives the floor nurse time to look up the SBAR and to call for any clarification necessary. I've called for clarification and gotten a snotty attitude. I also had a patient just get rolled up to the floor without any warning. I think it's unsafe.
At the places I work that call report, I'm usually stressed but manage to get the stressed ER nurse to grumble along with me and we sort of blow off some steam together. Once they realized I'm not out to give them a hard time, they usually give a pretty good report. Every now and then, you get somebody difficult that you have to force to give you an acceptable report, asking them questions when you know they're trying to rush you off the phone but they're the exception. We're all stretched too thin way too often and it helps when we can remember that we're in this together.
There is one particular nurse in our PCU who is just miserable all the time when you call her report from the ICU complaining about every little thing that might not have been done or needs clarification. When I just got report on the patient and haven't even seen them yet and am told to call report STAT, I have little to no time to iron out any minor problems for a patient I haven't even seen because a crashing patient is coming from the ER. I just tell her that I'll give her the phone number of the nurse that just left and had the patient all day and didn't follow through with the minor details. I still get a boat load of attitude though. I know the PCU nurse is stressed but I had zero to do with the "perceived" problems she feels aren't her responsibility. I don't have a choice. I have a crashing patient coming and it really doesn't matter if the dulcolax hasn't been reordered or no diet orders have been entered. All minor things the PCU nurse will just have to take care of. Then I get attitude along the lines of,..why does this patient have to be transfered,...you only have 3 patients in the ICU??? She's unaware, of course, that a vented, septic patient on pressors needing a STAT central line, Aline and a temporary dialysis Cath is already on the way to the ICU. Oh and their blood sugar is 1200 and they need an insulin drip and q 1 hour blood sugars and q 2 hour blood work,...and in addition, I have another vented patient, who I haven seen yet. Grrrrrr!!! Oh, and would I be a dear, the on coming nurse is going to be late,...can wait until she gets there and just give her report??? NO,..No I cannot!!! Happens all the time.
I have 2 beefs with taking report from ER, but even so I try not to be surly about it . These are: 1) at change of shift. I'm busy handing off my other patients to the oncoming shift or receiving report from a nurse who wants to finish up and go home. If you have held that patient until shift change to avoid getting a new patient, shame on you. If it just happened to work out this way, I appreciate the sentiment behind wanting to go ahead with report so that a nurse who doesn't really know the patient won't be giving report in a few minutes, but this is really inconvenient.
2) the room isn't clean. I don't know when the room will be cleaned. You promise you won't send the patient until it is, but guess what? I've been burned too many times to trust you.
Unfortunately, I've had the experience of calling a code on a "stable" patient within an hour of arrival on the floor from ER. So if I'm not going to be able to get in the room and lay eyes on that patient pretty quickly, I'm stressed out.
Like I said, I try hard not to let my stress level affect my attitude on the phone. I know we are all stressed.
There is one particular nurse in our PCU who is just miserable all the time when you call her report from the ICU complaining about every little thing that might not have been done or needs clarification. When I just got report on the patient and haven't even seen them yet and am told to call report STAT, I have little to no time to iron out any minor problems for a patient I haven't even seen because a crashing patient is coming from the ER. I just tell her that I'll give her the phone number of the nurse that just left and had the patient all day and didn't follow through with the minor details. I still get a boat load of attitude though. I know the PCU nurse is stressed but I had zero to do with the "perceived" problems she feels aren't her responsibility. I don't have a choice. I have a crashing patient coming and it really doesn't matter if the dulcolax hasn't been reordered or no diet orders have been entered. All minor things the PCU nurse will just have to take care of. Then I get attitude along the lines of,..why does this patient have to be transfered,...you only have 3 patients in the ICU??? She's unaware, of course, that a vented, septic patient on pressors needing a STAT central line, Aline and a temporary dialysis Cath is already on the way to the ICU. Oh and their blood sugar is 1200 and they need an insulin drip and q 1 hour blood sugars and q 2 hour blood work,...and in addition, I have another vented patient, who I haven seen yet. Grrrrrr!!! Oh, and would I be a dear, the on coming nurse is going to be late,...can wait until she gets there and just give her report??? NO,..No I cannot!!! Happens all the time.
We hear a lot of complaints on this site...but your's are completely valid. I'm guessing she simply has no clue ....Sounds like she needs to walk in your shoes for a day.
I'm sure I sometimes sound cranky about getting admits from EOD staff without intending to. A big problem with transfers between units in our hospital is that the EOD staff work a different shift than the rest of the floors, except ICU. While they are trying to transfer patients out before the next shift comes on at 4 PM, we are just getting report on our patients at 3 PM so more often than not our admits occur right at our shift change before we even have a chance to meet our patients and get our feet under us. Again this comes down to administration. If we were all working the same shifts, or at least not having shifts change so close to each other, it would not be such a big issue.
It doesn't happen often that we have insulin drips, mostly because we are primarily an oncology floor, but I have had a patient with an insulin drip with 3-4 other patients who also might be getting blood or on a heparin drip.
I won't do the sandwich but I will administer PRN meds if I have them because I know that it may be awhile before the floor nurses get to it.
I'm not sure what you mean by we "also get to triage."
Yes, we have an MD but once the patient becomes an admit, I have no more access to an MD than do you because the ED doc is no longer the patient's attending physician.
By "get to triage", I just mean that the guy with the toe infection can be kept waiting when the ambulance with the MI rolls in. Once they get to the floor, they're on more of a schedule.
Luckily, our ER docs will give a few "courtesy" orders here and there even after a patient has been admitted ...sometimes even after they get to the floor.
Please reconsider the sandwich ....but I'll take the ativan by itself if that's all I can get.
By "get to triage", I just mean that the guy with the toe infection can be kept waiting when the ambulance with the MI rolls in. Once they get to the floor, they're on more of a schedule.
The collective 'we' gets to triage but that doesn't change the fact that we're under pressure to fill rooms as fast as we can... and the triage nurse doesn't much care about how hard the bedside nurses are working or whether they're getting slammed. {By 'not care' I simply mean that it's not part of the thought process... we all fill all the roles and we certainly are empathetic toward each other.}
The triage nurse is also in the unenviable position of having to sit out in the lobby and bear the brunt of the angry patients who aren't being seen quickly enough for their liking.
When it's going off, we're rolling our patients out as fast as we can and aren't all that concerned about detailed reports and tying up all the loose ends. It's just not too high on the prioritization list.
Admittedly, some ED nurses are famous for dumping on the floors just as some of the floor nurses are infamous for always being hard to reach and nasty. Both are wrong.
Luckily, our ER docs will give a few "courtesy" orders here and there even after a patient has been admitted ...sometimes even after they get to the floor.
Our docs will only do so in critical situations.
Please reconsider the sandwich
Sorry, but those things are like gold on the night shift where we're usually down to crackers and water by the wee hours. If the patient is a diabetic with a dropping sugar, ok, otherwise, they can be hungry.
....but I'll take the ativan by itself if that's all I can get.
Hey, I was a floor nurse once, too, and I still work per diem in the units... anxiolytics and pain meds are important to keep up on; the emergent colace I generally defer for y'all.
I used to absolutely hate when the ER nurse calling report would tell me "this isn't my patient, I'm just helping out" and proceed to read from the SBAR. I can do that myself!
Right... which is why voice-to-voice is unnecessary unless you've got urgent questions in which case you can call.
But after working at a hospital in which the ER does not call report, I appreciate any type of person to person handoff.
My last gig was one of those... it sure seemed to work ok. In my current job, it's rare that report conveys information not readily apparent in the EMR.
I've called for clarification and gotten a snotty attitude.
Totally inappropriate on their part!
At the places I work that call report, I'm usually stressed but manage to get the stressed ER nurse to grumble along with me and we sort of blow off some steam together. Once they realized I'm not out to give them a hard time, they usually give a pretty good report. Every now and then, you get somebody difficult that you have to force to give you an acceptable report, asking them questions when you know they're trying to rush you off the phone but they're the exception.
By the same token, there are the floor nurses who clearly refuse to look at the chart and are expecting to be spoon-fed by me all the details for them to fill out on some silly piece of paper.
I had one nurse who was all bent out of shape because I couldn't tell her where was the functional IV. I finally quipped, "start at the bag of maintenance fluids and follow the tubing... at the end you will find the IV site." Not my proudest moment, to be sure, but at some point it gets tiring trying to rehash needless details which are documented in the chart.
yep and tamponade too. We have to "crack" the chest back open and the surgeon digs out all of the clots around the heart while I'm prepping them for emergency surgery. Beating heart exposed and all.
Yup, one time I had a fresh trauma patient. Just arrived from OR. No BP, Tachy. Trauma surgeon at bedside. Double concentrated Levo AND double concentrated Neo and fluids running 999 on the pumps. Had to open the abdomen in the room to try and stop the bleeding. Rapid infuser with so many units of blood I had to count the empty bags to keep track. Not a good night. And no,....I wasn't able to have this as a 1:1 patient. Ugh!!!
Rexie
108 Posts
I used to absolutely hate when the ER nurse calling report would tell me "this isn't my patient, I'm just helping out" and proceed to read from the SBAR. I can do that myself! But after working at a hospital in which the ER does not call report, I appreciate any type of person to person handoff. The charge nurse is supposed to monitor the boards and patient is supposed to be transported a half hour after showing up on the tracker. In theory, this gives the floor nurse time to look up the SBAR and to call for any clarification necessary. I've called for clarification and gotten a snotty attitude. I also had a patient just get rolled up to the floor without any warning. I think it's unsafe.
At the places I work that call report, I'm usually stressed but manage to get the stressed ER nurse to grumble along with me and we sort of blow off some steam together. Once they realized I'm not out to give them a hard time, they usually give a pretty good report. Every now and then, you get somebody difficult that you have to force to give you an acceptable report, asking them questions when you know they're trying to rush you off the phone but they're the exception. We're all stretched too thin way too often and it helps when we can remember that we're in this together.