I Have several questions to ask everyone who's been around a lot longer than myself. I just started my nursing career in a level 1 trauma center in a large teaching hospital and as an ER nurse I find a lot of attitiude coming from everyone.
I have taken many classes at this facility and on several instances have had the instructor say things like, "Oh we have an ER nurse in here I'll have to watch what I say." When I took my PALS class it was taught by the PICU nurses and when I went in for my megacode the instructor said, "OK Mrs. ER nurse lets see how you deal with this one." He made me run the megacode for at least 35-40 minutes and tried everything in his power to stump me, and didn't stop until he did.
My boyfriend is a floor nurse at the same hospital and we often get into discussions about how much the floor nurses complain about us. I try my best to give the best report I can with the focus assessment that I do. I rarely send up a naked patient after a trauma, and always put the patient in bed, get their tele pack on them, and if the patient is soiled, I clean them up before I take them upstairs, or I'll stay to help that nurse clean them if it happened in the elevator (yes it does happen in the elevator and we can't clean it then).
I try the best I can to establish a good repor with nurses from other units, because I believe that communication is key to patient care between departments. I find that I am always courteouse to nurses from other units. We have a 15 minute rule for getting a patient upstairs after report is called. I find that to be very unrealistic and in most cases if I don't need that room right this second, for a major trauma/MI etc I always tell the nurse to just call me when you are ready for them and I'll bring them up. There has been a few times where I had to enforce the 15 minute rule when we had patients in the hallway, and even then I explained the situation and apologized that I would have to bring them up ASAP due to the MI that was lying in the hallway.
I guess what I am asking is, has anyone else encounterd this? I just feel as soon as someone finds out that I am an ER nurse I am automatically disliked and treated differently. We are all nurses and I just wish we could all try and understand each other and work well together. Any tips or suggestions from those of you that have been doing this for a long time on how to keep the peace between departments?
I have walked a mile in the shoes of the ICU nurse and the floor nurse. I now work in the ER and have found that all areas have their own stressors and maybe that is why some of us are better in one area than another. I feel their is a lot of bashing from any unit or area to another and that every nurse should work the best they can for the patient instead of argueing over who does more work or has more resposibility. We all have a choice of where we want to be in our careers. I loved working in critical care and now I have found that I love working in the ER. I also am able to look at the times I complained about what the ER did not do when I worked in the unit and say OK NOW I understand why they were not able to do certain things. I found in the ER that some of things I thought were immediate in the unit are not even as significant in the ER. I apologize if anyone takes this wrong but we all went into nursing to help people when they most needed us and it seems that all we do is complain about what other nurses don't do (me included) If we could all walk a mile in each others shoes we might not like our jobs either
I guess you didn't read all of my message. I DID walk a mile in your shoes, I was a floor nurse before going to the ER. Can you say the same?
Our code team is made up of the ER Doc, ER Nurse, ICU Nurse and RT. Not all hospitals have code teams and those people on the code team are still doing their regular nursing and still have to leave to respond to the code. In all my years I have never seen a floor nurse respond to a code in the ER. We don't call them over head cause we're already there. Each nursing speciality has their own unique way and there is a need for all of us. As I stated eariler. It takes a special person to be a nurse and each nurse in their specialites. Nobody asked anyone to be a doormat, just understand where we're coming from too. Maybe the ER nurses at your hospital stack pt's. I don't know, don't work with you or in your ER. At my hospital we try not to send them all at once and don't call report or take pt's to the floor during shift change. It's called respect, but I can say that there has been times when we have tried to call report and the nurse was busy or the room not cleaned or some other excuse only to find that when taking a walk to that floor all the nurses are in the nurses station gabbing away about nothing. Kinda puts an attitude right out there. So since I'm not on a High Horse, I can't get off. Been there, done that.
I have walked a mile in the shoes of the ICU nurse and the floor nurse. I now work in the ER and have found that all areas have their own stressors and maybe that is why some of us are better in one area than another. I feel their is a lot of bashing from any unit or area to another and that every nurse should work the best they can for the patient instead of argueing over who does more work or has more resposibility. We all have a choice of where we want to be in our careers. I loved working in critical care and now I have found that I love working in the ER. I also am able to look at the times I complained about what the ER did not do when I worked in the unit and say OK NOW I understand why they were not able to do certain things. I found in the ER that some of things I thought were immediate in the unit are not even as significant in the ER. I apologize if anyone takes this wrong but we all went into nursing to help people when they most needed us and it seems that all we do is complain about what other nurses don't do (me included) If we could all walk a mile in each others shoes we might not like our jobs either
You have said that you have been a nurse for 15 years or more, I have been a nurse for 10 years and I can say that I still love my job, you sound bitter or angry with your job. You remind of the saying that that "NURSE'S EAT THEIR YOUNG" I hope you are not one of those nurses because the knowledge you have is invaluable to new nurses and probably would be invaluable to me also
The admitting doctor is the one who decides where the patient goes and usually that is after 3-4 hours of interns and residents hawking over the patient and their history, once that is decided we have to wait to get a room assignment from the nursing supervisor for the hospital not the ER
PS I'm still trying to figure out: who exactly IS the person who decides when a patient goes to the floor? The ER doc? Or the patient's attending? If not the nurse, then would it be the ER Charge?
You have definately hit a nerve. As an ER nurse, i get infuriated when floor nurses state that we can filter our patients into the waiting room. obviously they have never worked in the er before. As someone that has worked on every floor as a tech and student, i can sympathy with all nurses. however, i think a huge problem is disrepect amongst each other. We are all over worked and tired. And instead of fighting management, we are fighting each other. I guess it is easier.
However, as a nurse in a level one truama center, i have had a full trauma bay of 3 traumas- levels one and two, 2 hall way pt's and 3 pt's in rooms, probably on monitors. this assignment is split between 2 nurses!! Anyways, i get so frustrated when an icu nurse wants me to give them time to "set up" before i take my one out of 3 critical pt's up to her/his 1-2 pt ratio. as well as the 5 other pt's floating in the hallway wondering what their nurse is doing. then when you get off the phone with icu, you here that great sound of the hearn going off telling you you have another level 1 trauma on their way in, with no beds open, except the one bed you could empty out if icu would take it.
So my moral is do not judge until you do. i had one ICu nurse complaining about us not catching stuff that quite frankly were not of urgent matters. like socks being off. that nurse had never worked er. go figure.
I Have several questions to ask everyone who's been around a lot longer than myself. I just started my nursing career in a level 1 trauma center in a large teaching hospital and as an ER nurse I find a lot of attitiude coming from everyone.
I have taken many classes at this facility and on several instances have had the instructor say things like, "Oh we have an ER nurse in here I'll have to watch what I say." When I took my PALS class it was taught by the PICU nurses and when I went in for my megacode the instructor said, "OK Mrs. ER nurse lets see how you deal with this one." He made me run the megacode for at least 35-40 minutes and tried everything in his power to stump me, and didn't stop until he did.
My boyfriend is a floor nurse at the same hospital and we often get into discussions about how much the floor nurses complain about us. I try my best to give the best report I can with the focus assessment that I do. I rarely send up a naked patient after a trauma, and always put the patient in bed, get their tele pack on them, and if the patient is soiled, I clean them up before I take them upstairs, or I'll stay to help that nurse clean them if it happened in the elevator (yes it does happen in the elevator and we can't clean it then).
I try the best I can to establish a good repor with nurses from other units, because I believe that communication is key to patient care between departments. I find that I am always courteouse to nurses from other units. We have a 15 minute rule for getting a patient upstairs after report is called. I find that to be very unrealistic and in most cases if I don't need that room right this second, for a major trauma/MI etc I always tell the nurse to just call me when you are ready for them and I'll bring them up. There has been a few times where I had to enforce the 15 minute rule when we had patients in the hallway, and even then I explained the situation and apologized that I would have to bring them up ASAP due to the MI that was lying in the hallway.
I guess what I am asking is, has anyone else encounterd this? I just feel as soon as someone finds out that I am an ER nurse I am automatically disliked and treated differently. We are all nurses and I just wish we could all try and understand each other and work well together. Any tips or suggestions from those of you that have been doing this for a long time on how to keep the peace between departments?
Fighting among ourselves wont convince management to improve our lot. Let's work together! We all take the same license exam, so lets start with that common ground and stick together!
Seen on a t-shirt yesterday, and so appropriate;
"The beatings will continue until morale improves."
Fighting among ourselves wont convince management to improve our lot. Let's work together! We all take the same license exam, so lets start with that common ground and stick together!
Seen on a t-shirt yesterday, and so appropriate;
"The beatings will continue until morale improves."
great response!! yes we definately need to bond together and i am all for that. i know from my own "grass roots" efforts, despite my own frustration, i try to see the other persons side and help out.
why do we nurses get on each others neck?you never see any other professions get out there problems out in the open like nurses do.Infact in med school first year students are called drs by there professors while in nursing we were told half will make it through the programme if not Nclex? lawyers get the same prestige.where is nursing headed?Yes Im CCRN and i get the same treatment.Infact working on telemetry is my biggest nightmare.I have masters and the adn nurses think im telling rather showing them to be nurses.really it all depends being masters prepared in critical care doesnt mean im the super nurse but this poses challenge to the adn nurses who have practiced for long time and for me being 25 with 3 years experience is unacceptable for me to tell them anything and especially when we have emergencies like a code. surely i have worked in schock trauma for the 3 year and the only times i float is with registry and i believe some cases im better prepared in terms of crtical thinking and trying to stabilise a patient.so im back again in school this time for doctorates.I dont intend to be patient care nurse of course but i miss just working in schock trauma and saving lives.Its time also Nursing become like other professionals and learn to keep it problems to ourselves
okay, it's obvious here that the main issue is that everyone thinks their problems are more important than everyone else's. the truth is, the patients are the priority here. nurses need to stop making transports into a "personal" thing. i work on L&D and find that there is resistance from postpartum at times because they're busy and feel like we're slamming them with admissions. well, it's important to think of our unit. (and i've worked on both units) we are also slammed, and it's more of a priority that a laboring or bleeding or delivering woman get into a room and get evaluated in L/D, than a postpartum pt getting VS on time in the unit. floor's have different acuity levels. er is a top priority, these pt's are coming in off the street and need to be evaluated, thus pt's taking up rooms unnecessarily should be shipped out as soon as possible.
i think it's important also to keep each other in mind. i have no problem as charge nurse keeping a pt on the unit if pp is slammed and we have the staff and the room for it. HOWEVER, i do not feel comfortable keeping her here past my shift, because staffing ratios change and it may not be as convenient for the next shift. but, i make that clear with the pp floor, "yes we can hold this pt for a few hours, but if our census changes suddenly, or before shift change she WILL be transferred." it's only fair.
"I have the hallway, the waiting room, as well as the ambulances that keep on rolling in. I know that it is and can be an inconvenience, but I cannot just say I'll take the intubated trauma comming in 30 minutes when they have a 10 minute ETA." ( quote from jen2)
this was beautifully said by jen2, and especially when they are not intubated, after a few attempts and need to be.........and are calling report at the back door.
It really differs at each hospital I find. Some hospitals track time from bed given to time to floor. ( and if it's longer than 30 mins, it's looked down upon in the ER) Other hospitals don't even let the primary nurse know, they let house sup know, then er charge know then primary................
anyways....i just wanted to say that was a nice quote from jen2, and as a new nurse, she obviously knows whats going on.
come on girls, if you were doing your very best as a nurse and had a good working relationship with your patients, where is all the rest coming from??? We have absolutely NO control over who comes into ED, how long they will be there and where they will be sent - honestly I find ED nurses less bitchy as we are all too busy to go there and work together well as team members in BOTH New Zealand and Australia - the only "edge" I keep as a nurse is when the next patient comes under my care - and that to me is a necessary prerequisite of being a nurse - especially and ED nurse
FYI; I am not a "girl" I am a woman. Also using the term bitchy is sexist. I can't imagine how, from the ERA rally I went to @ age 18 1979 that woman have manged to infantize themselves, call one another girls et al & give their daughters Barbies dolls.This is why we are not taken seriously. Judging from my society it truly saddens me that I actually fought for feminism as a teenager. this reply is from Diana. Twin #2 My father actually wanted me to follow in his footsteps & join the LAPD. I wish I ha.
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critical nurse
5 Posts
I have walked a mile in the shoes of the ICU nurse and the floor nurse. I now work in the ER and have found that all areas have their own stressors and maybe that is why some of us are better in one area than another. I feel their is a lot of bashing from any unit or area to another and that every nurse should work the best they can for the patient instead of argueing over who does more work or has more resposibility. We all have a choice of where we want to be in our careers. I loved working in critical care and now I have found that I love working in the ER. I also am able to look at the times I complained about what the ER did not do when I worked in the unit and say OK NOW I understand why they were not able to do certain things. I found in the ER that some of things I thought were immediate in the unit are not even as significant in the ER. I apologize if anyone takes this wrong but we all went into nursing to help people when they most needed us and it seems that all we do is complain about what other nurses don't do (me included) If we could all walk a mile in each others shoes we might not like our jobs either