ER nurses not calling report anymore...

MunoRN, RN · Sep 4, 2013

Interpretations of patient abandonment vary somewhat from state to state, but in general if a patient requires ongoing Nursing care (such a patient being admitted from the ED), the Nurse who has been caring for the patient is legally required to ensure the Nurse taking over care "has received and understood" report on a patient. We tried a written report and got slapped down by our department of health for patient abandonment. Just having the receiving Nurse review the ER charting doesn't include any component of ensuring the receiving Nurse has understood the report, particularly when no report actually exists.

plinytheRN · Sep 4, 2013

I was wondering about that, I will have to look into the laws about it. I am in Louisiana. They even sent one patient up with any IV access! I am starting to wonder what they do down there!

ChristineN, BSN, RN · Sep 4, 2013

I can understand how that change in policy could be frustrating for you, and I am an ER nurse. While the ER may not have to call report, if you are looking in the computer and seeing labs/assessments/etc that raises questions or red flags then you could always take the initiative to call the ER and ask for report.

ChristineN, BSN, RN · Sep 4, 2013

I was wondering about that I will have to look into the laws about it. I am in Louisiana. They even sent one patient up with any IV access! I am starting to wonder what they do down there![/quote']
Not every pt being admitted needs an IV, or sometimes, as good as we are, we still can't get access. Granted this should be communicated to the floor nurses somehow

plinytheRN · Sep 4, 2013

I can understand how that change in policy could be frustrating for you, and I am an ER nurse. While the ER may not have to call report, if you are looking in the computer and seeing labs/assessments/etc that raises questions or red flags then you could always take the initiative to call the ER and ask for report.

I totally agree in taking initiative, the issue is I don't have time to look at the computer and sort through all the details most of the time. I don't know who sent them, therefore who do I call for clarification or report if I need it? The patient shows up, I have little warning and know nothing about them. It's very unsettling to me, especially when I am already swamped in all my other patients.

plinytheRN · Sep 4, 2013

Not every pt being admitted needs an IV, or sometimes, as good as we are, we still can't get access. Granted this should be communicated to the floor nurses somehow

I believe that is true, but we have to have orders to not have any access on the floor at this hospital. I don't know all the details, maybe this pt was not very critical but from my position, I barely have time to get all I need to get done in time and starting IVs take up time. Appreciate your response. My real question is, why this change? what is the rationale behind it? Im ok with a walkie talkie, with no report, but otherwise I don't see it being beneficial to the patient or the nurse.

ChristineN, BSN, RN · Sep 4, 2013

I totally agree in taking initiative, the issue is I don't have time to look at the computer and sort through all the details most of the time. I don't know who sent them, therefore who do I call for clarification or report if I need it? The patient shows up, I have little warning and know nothing about them. It's very unsettling to me, especially when I am already swamped in all my other patients.

I understand your frustration. Perhaps your floor could try having the charge nurse be the one to look over patient information in the computer, which could work well if your charge nurse doesn't have patients. If you are getting patients sent to your floor that are too unstable for your med-surg floor and are soon being transferred to ICU, or the pts require monitoring/drips/etc that is not allowed on your floor you should make sure this is communicated to the ER. Sometimes ER nurses don't know what floor can take what type of pts, so if pt safety is an issue with improper patient floor assignments they need to know.

ChristineN, BSN, RN · Sep 4, 2013

I believe that is true, but we have to have orders to not have any access on the floor at this hospital. I don't know all the details, maybe this pt was not very critical but from my position, I barely have time to get all I need to get done in time and starting IVs take up time. Appreciate your response. My real question is, why this change? what is the rationale behind it? Im ok with a walkie talkie, with no report, but otherwise I don't see it being beneficial to the patient or the nurse.

I do not know the specific reason for the change at your hospital, but if I had to guess, it may be trying to facilitate helping to decompress the ER more quickly. When the ER has every room full and the waiting room is backed up with a several hour wait, it can be frustrating to ER nurses to keep trying to call report only to have to wait on hold for a while, or to be told to call back. I know you guys in med-surg are busy too, but a lot of times there is pressure on us in the ER to get pts upstairs quickly so we can bring another pt back from the waiting room.

My hospital currently uses a written report sheet as well as requiring us to call and answer any questions the floor nurses have. While it can be time consuming, I like being able to verbally communicate with the floor nurse about the pt, even if the pt is fairly cut and dry.

martymoose, BSN, RN · Sep 4, 2013

We get a called report, but 1/2 the time I swear the person calling report hasnt even laid eyes on the pt. Sometimes they even admit that.Had this happen a few weeks ago. person brought up pt. some things left off report:pt is a dialysis pt.soft b/p's , (but pt states this is his norm) Had an mi 1 week ago.Has half their toes amputated. etc. Also brought up right at 1115 pm , right in the middle of report( and room had been available 2 hours prior.Pt rolls over 30 mins later( had been aox3) tech goes in to fix tele- pt coded not more than an hour of getting to floor.ultimately didnt make it. Pt wasnt elderly either.

Does that seem safe to anyone?????

sometimes I wonder why they even go thru er then- just send em on up and hope we can sort it out. :/

not sure why a face is in my text???, but lol.

allnurses Guide · Sep 4, 2013

We get a called report, but 1/2 the time I swear the person calling report hasnt even laid eyes on the pt. Sometimes they even admit that.Had this happen a few weeks ago. person brought up pt. some things left off report:pt is a dialysis pt.soft b/p's , (but pt states this is his norm) Had an mi 1 week ago.Has half their toes amputated. etc. Also brought up right at 1115 pm , right in the middle of report( and room had been available 2 hours prior.Pt rolls over 30 mins later( had been aox3) tech goes in to fix tele- pt coded not more than an hour of getting to floor.ultimately didnt make it. Pt wasnt elderly either.
Does that seem safe to anyone?????
sometimes I wonder why they even go thru er then- just send em on up and hope we can sort it out. :/
not sure why a face is in my text???, but lol.

Lol!

Because you meant to type a colon and then the "p" for pt, but forgot to put in a space between the two.

Type them next to each other and you get

:lol2:

turnforthenurse, MSN, NP · Sep 4, 2013

We get a called report, but 1/2 the time I swear the person calling report hasnt even laid eyes on the pt. Sometimes they even admit that.Had this happen a few weeks ago. person brought up pt. some things left off report:pt is a dialysis pt.soft b/p's , (but pt states this is his norm) Had an mi 1 week ago.Has half their toes amputated. etc. Also brought up right at 1115 pm , right in the middle of report( and room had been available 2 hours prior.Pt rolls over 30 mins later( had been aox3) tech goes in to fix tele- pt coded not more than an hour of getting to floor.ultimately didnt make it. Pt wasnt elderly either.
Does that seem safe to anyone?????
sometimes I wonder why they even go thru er then- just send em on up and hope we can sort it out. :/
not sure why a face is in my text???, but lol.

Sometimes the nurse will only have the patient for a literally a few minutes if there is a change of shift going on. Sometimes we will call report for each other if the primary RN is busy. That is just how it works in the ER. If a patient has a bed available and it is close to shift change, the off going nurse will try and call report. Most of the time the floor nurses don't like this as they are getting report on other patients (and I know this from experience as I used to be a floor nurse) but honestly, I would rather get report from a nurse who has had the patient versus a nurse who is just coming on shift and barely knows the patient.