ER nurses not calling report anymore...

Nurses Safety

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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.

Specializes in ER.
You're right, we really should just get rid of the emergency room altogether because the only nurses that know what they're doing work on the floor anyway. Us ER nurses are just useless!

Ouch...that's a blanket statement. I guess you have worked in every hospital to come up with conclusion?

So since you can handle patients straight from the ambulance. You can sedate patients? Help with central lines? Start ART lines? Assist with chest tubes? Oh and do this while another ambulance rolls in with a patient with O2 sats of 60% or stroke or STEMI. All aspects of nursing is hard. We should be working as a team not acting like preschoolers and playing the blame game. Yes there are bad nurses in all units. If they aren't doing their job WRITE THEM up. But before you make a blanket statement you should walk in their shoes awhile. Remember the patient is the main focus here.

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Specializes in PICU.
Ouch...that's a blanket statement. I guess you have worked in every hospital to come up with conclusion?

So since you can handle patients straight from the ambulance. You can sedate patients? Help with central lines? Start ART lines? Assist with chest tubes? Oh and do this while another ambulance rolls in with a patient with O2 sats of 60% or stroke or STEMI. All aspects of nursing is hard. We should be working as a team not acting like preschoolers and playing the blame game. Yes there are bad nurses in all units. If they aren't doing their job WRITE THEM up. But before you make a blanket statement you should walk in their shoes awhile. Remember the patient is the main focus here.

I believe the person you are responding to (an ER nurse) is being sarcastic in response to the turn this thread has taken of floor nurses vs ER nurses.

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Specializes in ER.
I believe the person you are responding to (an ER nurse) is being sarcastic in response to the turn this thread has taken of floor nurses vs ER nurses.

Gotcha. My misunderstanding. I apologize. Must have read the threads before that wrong. Sometimes sarcasm is lost in text

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Specializes in ER.

I luck out. My facility calls report. There are a few irritating staff on either ends but in majority we work as a team

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Specializes in PCCN.
You're right, we really should just get rid of the emergency room altogether because the only nurses that know what they're doing work on the floor anyway. Us ER nurses are just useless!

I'm sure you don't really think that's what I think of ED Nurses!!

That was not meant to be a dis to the NURSE.It's a dis to the drive thru mass production corporate mentality that we get a patient a bed. ANY bed. And lets close all the local hospitals so we can have all their "customers".

THAT is what I mean. sorry I wasn't specific.

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Specializes in ER.
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.

im in also an ER nurse. I believe that for stable, non-critical patients, the no phone-report thing is okay so long as the receiving nurse knows that there is a pt coming, and the ER nurse is going to be transporting / with the pt to the floor where bedside report can be given . Personally, I call report and 9/10 times also bring the pt up.

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Specializes in Med-Surg, Emergency, CEN.

I've been a floor nurse who is charge trained to tell admitting that we can't POSSIBLY take that pt even though there are only 10 pts on the floor!! The room is dirty, it's blocked, we have an unstable pressure ulcer in progress, there are only 7 nurses....

receiving a pt from the ER? Put them on hold, they'll hang up eventually. Don't worry, they only have 3 admitted pts on the board, just ignore the 60 pts who aren't admitted cuz we can't see them on the admitting board. They are just being lazy....

Unfortunately, this is why we use an evolving system. If the nurse can't take report, the charge has to. When the charge keeps us on hold for too long, we SBARR them up. Most ER nurses have floor nursing experience and know exactly when we are being lied to or run around in circles... And why. So seriously, don't even bother telling me what you think, cuz I used to think the same stuff. Used to.

your pt will be there in 10 minutes.

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Specializes in Med-Surg.

I am a floor nurse and can't imagine not receiving report from the ED. I am grateful that my facility requires the ED to call and give report before sending a patient. Here is how it happens...

The charge nurse gets paged when a bed is assigned and either they or the unit secretary will notify the RN of the assignment. We are told the name, admitting physician, and admitting diagnosis. If I have time I will look at the patients chart before receiving report. Usually I am not able to do this since most admissions arrive right at the beginning of shift change (19:00) or shortly after. ED will call usually within 30-60 minutes of the page, sometimes sooner. If the relieving RN on the floor is busy then the charge nurse is expected to take report. It may take the patient anywhere from 15 minutes to over an hour to get to the floor, depending on transport services.

I have never had a problem receiving report from the ED. Occasionally I get a very brief report but I almost always am told everything that I need to know during report. I don't ask many questions either because I know I am going to asses the patient and call the physician once they get to the floor anyway (that is, if the admitting physician hasn't already seen them in the ED).

I am very easy going about report. The only thing that bugs me is when we get a patient in the middle of shift change. I realize the ED has little to no control over this. It's more of an assignment/transport issue.

I feel lucky that my perception of the relationship between the ED and my floor is a good one.

The only thing I can say that has happened to coworkers (but not me) is that we have had a few patients code within ten minutes of arrival to the floor. I don't know the circumstances on any of them. Then the ED sent a patient who arrived dead. Patient was a DNR. Never got to hear more than that. I am sure if I were privy to the entire situation that there were multiple factors going on in those situations.

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When I was on the floor I never got report from the ED unless the patient was getting blood, actively suicidal, or getting a drip. I was fine with that I read the SBAR. When I moved to the ER I try to make the transition as painless as possible. Every single time I call to the floor the nurses are asking for report. Our new computer system automatically fills up the SBAR. I will call the floor when the patient is a trainwreck, getting drips, and if I actually have to come up with the patient. I still work on the floors sometimes so I know if the nurses there are pulling my leg when they are dragging on report. The hospital's policy I work at when it comes to ER transfers we are only obligated to give nurse report to: Facility to Facility Transfers ICU Transfers ER Observation transfers (this report is basically here for this, we did this, they need this to leave) Psych/Crisis Unit OR Patients What I do not like is the hospital I work will transfer patients at change of shift without regard.

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Specializes in Emergency & Trauma/Adult ICU.
I've been a floor nurse who is charge trained to tell admitting that we can't POSSIBLY take that pt even though there are only 10 pts on the floor!! The room is dirty, it's blocked, we have an unstable pressure ulcer in progress, there are only 7 nurses....

receiving a pt from the ER? Put them on hold, they'll hang up eventually. Don't worry, they only have 3 admitted pts on the board, just ignore the 60 pts who aren't admitted cuz we can't see them on the admitting board. They are just being lazy....

Unfortunately, this is why we use an evolving system. If the nurse can't take report, the charge has to. When the charge keeps us on hold for too long, we SBARR them up. Most ER nurses have floor nursing experience and know exactly when we are being lied to or run around in circles... And why. So seriously, don't even bother telling me what you think, cuz I used to think the same stuff. Used to.

your pt will be there in 10 minutes.

I regret that I can only *like* this post once.

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Specializes in Critical Care.

Maybe it's because I work a mix of ER, ICU, and the floors but I can't really imagine not talking to the nurse I'm giving a patient to in any of these settings. It's generally considered compulsory to talk to the nurse you're giving a patient to on the floors, so why would it when I'm in the ER giving a patient to the floor? It seems to be based on the premise that I don't do anything for patients in the ER worth properly communicating. An SBAR is a good starting point for report, but it's a minor part, it's the conversation, questions, etc that is the "meat" of report. If we can cut that out of ER reports then why not everywhere else?

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ED nurses not giving report on patients seems inexcusable to me. I'm so tired of ED nurses who think that they're too busy saving lives to do small tasks, like phoning report, when the truth is that unless you work in a big city trauma center, you're dealing with sprained ankles and rashes a majority of the time. So pick up the phone & give report!

if all the ER is dealing with is rashes and sprained ankles then where do all the patients we are transferring to the floor come from?

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