ER nurses not calling report anymore...

[plinytheRN]

Hey all, our hospital started a new policy where the ER nurses don't have to call report on the patients coming to our floor- they can choose if they want to call report. Most don't call report. It is up to us to find this patient and research all about them before they get to the floor, hopefully. Most of the time, they show up before we know they are coming. It is very frustrating and unsafe, we don't know anything about what we are walking into. I work on a medical telemetry unit, with usually 5-6 pts per nurse, it's hectic and busy no time to be clicking through a computer on a new admit. From what I understand this is a trial to test out this new policy, I am hoping it doesn't last. It seems the only one that benefits from this new policy are the ER nurses, it's definitely not ideal or safe for the patients... Anyone experienced this sort of thing? Thoughts? Thanks.

[nrsang97, BSN, RN]

Very rarely have I seen an ER pt go to the floor when they need to be on the unit. Rather it's the floor nurses who don't want to do the work and that's why they ***** and moan and say the pt needs a higher level of care.

Being rapid response I have sent patients to the unit within minutes of coming up from the ER. HR of 150, unresponsive and GCS of 5-6 needing immediate intubation, Hypertensive >200 SBP, pt on stroke protocol should be on monitored bed and on general floor, etc...

So it is up to you as well to make sure the patient is sent to the appropriate unit. If you feel the MD orders aren't appropriate then speak up. We are all on the same team.

It isn't the floor nurses not wanting to work. They work their tails off. I have been there done that. Usually the pt really needs higher level of care than they can provide.

[SionainnRN]

Being rapid response I have sent patients to the unit within minutes of coming up from the ER. HR of 150 unresponsive and GCS of 5-6 needing immediate intubation, Hypertensive >200 SBP, pt on stroke protocol should be on monitored bed and on general floor, etc... So it is up to you as well to make sure the patient is sent to the appropriate unit. If you feel the MD orders aren't appropriate then speak up. We are all on the same team. It isn't the floor nurses not wanting to work. They work their tails off. I have been there done that. Usually the pt really needs higher level of care than they can provide.[/quote']

I've ever had a pt of mine go up and need a RR. Obviously I can only speak for me and my pts. But to act like ER nurses don't give a crap and are irresponsible is annoying and frustrating. I've had too many floor nurses complain about getting an admit, as if I have any control over that. 99% of the floor orders I've seen are completely appropriate and the floor nurse just doesn't want to do the work.

[dudette10, MSN, RN]

But to act like ER nurses don't give a crap and are irresponsible is annoying and frustrating.

I'm just going by your post, in which you said, "We are just following orders," and "It's up to the floor nurse to talk to the admitting doc about a higher level of care." I don't think ER nurses are apathetic or irresponsible, but that is what you said.

I'm also not going to get into and ER vs. floor nurse debate with you, but your attitude toward floor nurses is really out of line.

[nrsang97, BSN, RN]

dudette10 I completely agree with you.

[SionainnRN]

I'm just going by your post in which you said, "We are just following orders," and "It's up to the floor nurse to talk to the admitting doc about a higher level of care." I don't think ER nurses are apathetic or irresponsible, but that is what you said. I'm also not going to get into and ER vs. floor nurse debate with you, but your attitude toward floor nurses is really out of line.[/quote']

Well I'm just going off the attitude in this thread which is pretty rude towards ER nurses. As if we don't care about the pts or what's going on with them. Obviously if the pt is critical the go to the unit, but I've seen too many floor nurses complain about getting any admit and having to do more work. And these are all non critical floor appropriate pts.

[uRNmyway, ASN, RN]

Let's just agree that some floor nurses will whine and complain no matter what because they don't want an admission, and some ER nurses don't care where they send their patient, so long as they get them out of their hair. Ok?

[bebbercorn]

As an ED nurse, I think it is completely unsafe to send a patient up without report. At an old facility where I worked PCU, you had to get verbal report. On the Med/Surg floors, you didn't have to call, just send up written report. No one liked it, not the receiving nurse nor the ED nurse that got yelled at later. At my facility, we send written report if they don't call us back within a reasonable time frame, but usually "I'll have to send the pt with written report" gets the nurse to the phone.

[rnkaytee]

We just moved from verbal to faxed report from our ED to Peds. It's worked pretty well, we read the fax and then the nurse calls and we chat briefly. I've found it very helpful to make sure if certain swabs have been done PTA, and ask last-minute questions. I'm just curious how OP's ED gets away with this considering the new "gold standard" is bedside report and they can't even talk for a few minutes?

[AJJKRN]

I've ever had a pt of mine go up and need a RR. Obviously I can only speak for me and my pts. But to act like ER nurses don't give a crap and are irresponsible is annoying and frustrating. I've had too many floor nurses complain about getting an admit, as if I have any control over that. 99% of the floor orders I've seen are completely appropriate and the floor nurse just doesn't want to do the work.

So have you ever worked the "floor" to know what appropriate is? I'm guessing not. My favorite is when multiple admits are coming to the floor with no report or H&P, etc so the ED nurse can go home afterwards and not be reached if there are questions or concerns...wish I could "sit" on my patients until just before shift change so I didn't have to take anymore admits during my shift...come on, walk a mile in someone else's shoes. We've got some great ED nurses that will make sure to give up 2 minutes for Pt safety and then there are the others that just don't think they can spare the time. Same can be said for floor nurses or any nurse for that matter...

Besides that...do you have the time to actually monitor if a code was called after you transferred a Pt or are you one of those nurses that are already in your car and on your way home instead?

[SionainnRN]

So have you ever worked the "floor" to know what appropriate is? I'm guessing not. My favorite is when multiple admits are coming to the floor with no report or H&P etc so the ED nurse can go home afterwards and not be reached if there are questions or concerns...wish I could "sit" on my patients until just before shift change so I didn't have to take anymore admits during my shift...come on, walk a mile in someone else's shoes. We've got some great ED nurses that will make sure to give up 2 minutes for Pt safety and then there are the others that just don't think they can spare the time. Same can be said for floor nurses or any nurse for that matter... Besides that...do you have the time to actually monitor if a code was called after you transferred a Pt or are you one of those nurses that are already in your car and on your way home instead?[/quote']

Wow you're making this personal. Did I hit too close to home with my description of floor nurses? So yes I've worked the floor have you ever worked in they ER? And my hospital we can't call report between 0630-0730 so there goes your conspiracy theory. How in the world do you think ER gets to sit on admits? Guess what, when more pts come in we have to take them no matter what. Doesn't matter how many admits or other pts we have, we don't have the luxury of saying I can't take report or take a pt right now. How about you try walking in our shoes sometimes.

[NICUmiiki, DNP, NP]

So have you ever worked the "floor" to know what appropriate is? I'm guessing not. My favorite is when multiple admits are coming to the floor with no report or H&P etc so the ED nurse can go home afterwards and not be reached if there are questions or concerns...wish I could "sit" on my patients until just before shift change so I didn't have to take anymore admits during my shift...come on, walk a mile in someone else's shoes. We've got some great ED nurses that will make sure to give up 2 minutes for Pt safety and then there are the others that just don't think they can spare the time. Same can be said for floor nurses or any nurse for that matter... Besides that...do you have the time to actually monitor if a code was called after you transferred a Pt or are you one of those nurses that are already in your car and on your way home instead?[/quote']

The nurses in my ER never "sit" on patients. They would get in trouble if they did. They have no control over when they get to call report either. They always try to call report as soon as the patient has a room. Sometimes it happens to be right before shift change. There is always someone waiting for the ER bed.

[martymoose, BSN, RN]

we had someone from ed- a tech , bring up a pt the other day. no one had informed us that the room was even booked. didnt even get a name. so had no idea what their dx was. how safe is that. tech was told by superior to bring pt up. coordinator said no was answering the phones on the floor. we had some critical stuff going on , and all the phones were in use. we dont have call waiting- duh!. so they said send em up anyway.or lately, the room will be booked, but we get a call that pt is already on their way up.doesnt even give us 30 seconds to look up info. so not safe