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'm appalled at the amount of shade I get whenever I try to call report to the floor. I used to work on the floor so I know what it's like to get that admission, especially when you're behind or when you finally start to get caught up, you're now behind because of this admission. Or my favorite excuse from the unit secretaries are, "the nurse doesn't know about getting that patient yet. Can they call you back?" I work in the ER. I can't stop the patients from coming in. Sometimes I don't even know about a patient that's in one of my rooms, and sometimes they're pretty sick after I had just gotten another sick one down the hall. I just deal with it. If I call the floor and they ask to call back, most of the time I will honor that and wait 10 minutes or so, unless the ER is so busy and we're starving for beds and I have my charge nurse pushing me to get the patient upstairs. But when I have to call back 3-4 times, that gets pretty frustrating. I wish everyone would be mindful on how busy any place could be. Maybe the floor nurses should shadow in the ER for the day and vice versa.
Do you all see how understaffing causes all of this? One department pressured, the next pressured, then we all pressure each other?
Bedside surgery? Nobody gives a rat's patooty about sterile environment?
We do it in my cardiac surgical unit as well...sometimes the patient is too unstable to move, sometimes there are other reasons. Everyone gowns up, everything is draped in sterile fashion. Sometimes it is the best option.
Here's my biggest pet peeve as an ER nurse at my facility. But first of all, I'd just like to give props to all my floor nurses (as well as the ICU, PCU, tele, insert any area here nurse) here on AN and everywhere else! Much respect to you guys and the great work you guys do...HAVING said that.
There's been a few...annoying interactions with some select nurses upstairs at my facility (but most are professional and they go with the flow...I mean, what else are we going to do). So a little background, I work in a large level 1 trauma center, on the 1900-0730 shift. Usually the WR is about 70-100 deep when we start our shift, so needless to say, we rarely ever clear the waiting room by 0730. We have 80 beds in the ED, including 7 trauma bay rooms. So yeah, we're overwhelmed, it's a county hospital, and we're up to our necks. I realize that translates to never...ever having an open bed upstairs, so I realize that our floor nurses are feeling the pressure too.
Most of the times, it takes a while to get a bed upstairs regardless of which area they're getting transferred to, but generally ICU and PCU/SDU beds are the longest waits. So this means I end up having to do admission orders for the majority of my patients - especially the sick ones. But once in a while, I get a ward patient that gets a bed the same time their admission orders drop.
I've had some floor nurses grill me over admission orders I have not completed, and they were ordered less than 15 minutes ago! Our hospital policy only mandates us to carry out admission orders as long as no bed is available. I'm sorry, but as soon as bed control/pt. flow tells me the bed is clean and ready, I'm calling report and shipping the pt. upstairs. What rankles me even more about these complaints is that our inpatient areas have dedicated IV access nurses and phlebotomists. So when I hear,"oh, why didn't you draw that routine CBC/BMP?" all I hear is:"I'm too lazy to pick up the phone to call someone to butterfly my patient."
Our ER used to have a phlebotomist, but we don't anymore, because she has to cover the floor areas now. Forget about IV access nurses, I asked once on a particularly hard stick and they basically said we don't cover ER. So basically when we get an impossible stick, we have to go to our residents for US guided PIVs , EJs, fem sticks, or the dreaded venous cutdowns! I actually have a friend who works on the ward. She basically says that no one on her floor actually starts IVs or does butterflies. They just make a phone call. So please, berate me more for not starting a 2nd line, or not drawing some ridiculous routine labs (I'm sure you're really curious about that protein level, I just don't care). (run-on sentence warning) Never mind that I have an ICU overflow ARDS patient with a brainstem astrocytoma that's completely unstable with a diprivan drip + pressors which is infusing through a PIV b/c wbc/anc complete garbage which according to neurosurg means no central/picc line and also on bag 4 of 8 of k-riders because holy hell K+ of 1.8 but somehow still alive and I'm actually running out of lines (even with 5 PIVs) to infuse all the damn boluses and the 10 ABXs for the massive septic shock for a pt that's been here for over 36 hours in the ED. WHEEEEW.
Anyways, can you guys tell I'm just venting? Not meant to offend anyone. Just don't get why a very select few floor nurses think that ER should carry out all their orders. Just boggles the mind.
BeenThere2012, ASN, RN
863 Posts
Do you all see how understaffing causes all of this? One department pressured, the next pressured, then we all pressure each other?