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?
mmmhhmm i second that and i'm a unit nurse. for some reason admits flux in around 630 to 700pm that's why we have instituted a rule not to take er admits between sixthirty and seven thirty, and for some reason they do come, where only responsible for monitoring the patient and not doing the full admit.
Just wanted to toss one thing in real quick.
The docs also work "shifts" and it seems at the end of a shift they're trying to get the work cleared up so they don't pass it on to the next physician.
There are multiple factors invovled in why patients come up the when they do. It's not always the ED nurses sitting on patients until change of shift.
It's too bad you've had that experience...it's been mostly the opposite for me. Here, ER nurses are respected because of the chaotic place we function in so well. When other nurse float to ED, they usually are fairly intimidated; at the very least, they usually speak with true respect for what we do...something they most definitely don't want to do! Even the ICU nurses, who are extremely competent in their speciality, are a little edgy when they come down for a trauma code...like all of us, they have their comfort zone too.
I can only speak for my hospital, but as an ER nurse there are several aspects that contribute to patients being sent to the floor near shift change. The first, as some have stated, is that the doctors do not want to turn patients over to the oncoming physician - I have been told by the doctors that whoever dispositions the pt gets to bill for the patient. So, our doctors change shift at 0600 and therefore, we will suddenly get a box full of admit and discharge orders at 0600. If by some miracle there is an empty bed in the hospital , our charge nurse will come ask why haven't you sent this patient to the floor, you've had a room assignment for 30 minutes! Actual occurrence on Wednesday I had an 81 yo female bilateral AKA admitted for dehydration, hypokalemia. I went to let the family know I had a room assignment, and the patient needed changing. Since we have no techs, I cleaned the patient myself, took about 10 minutes as it was a real mess. Here comes the charge nurse, why is the patient still here. Could have taken her up and let the floor deal with it! I think the majority of ER nurses want to be helpful and not dump on you, we are just getting a lot of pressure to move people out.
The docs also work "shifts" and it seems at the end of a shift they're trying to get the work cleared up so they don't pass it on to the next physician.
There are multiple factors invovled in why patients come up the when they do. It's not always the ED nurses sitting on patients until change of shift.
Just a quick correction here: Bloviate in an above post has not quoted me. I think hrtprncss was quoted, but I can't find the actual post.
I can only speak for my hospital, but as an ER nurse there are several aspects that contribute to patients being sent to the floor near shift change. The first, as some have stated, is that the doctors do not want to turn patients over to the oncoming physician - I have been told by the doctors that whoever dispositions the pt gets to bill for the patient. So, our doctors change shift at 0600 and therefore, we will suddenly get a box full of admit and discharge orders at 0600. If by some miracle there is an empty bed in the hospital , our charge nurse will come ask why haven't you sent this patient to the floor, you've had a room assignment for 30 minutes! Actual occurrence on Wednesday I had an 81 yo female bilateral AKA admitted for dehydration, hypokalemia. I went to let the family know I had a room assignment, and the patient needed changing. Since we have no techs, I cleaned the patient myself, took about 10 minutes as it was a real mess. Here comes the charge nurse, why is the patient still here. Could have taken her up and let the floor deal with it! I think the majority of ER nurses want to be helpful and not dump on you, we are just getting a lot of pressure to move people out.
That's very interesting information, Sanuk! Thanks for sharing. It's increased my understanding of the situation and I appreciate it greatly.
Now I just have to figure out how to come on shift and deal with 6 new patients, and an ER admit and a Unit transfer coming up at 2315, before I've had a chance to assess anyone.
, our charge nurse will come ask why haven't you sent this patient to the floor, you've had a room assignment for 30 minutes! Actual occurrence on Wednesday I had an 81 yo female bilateral AKA admitted for dehydration, hypokalemia. I went to let the family know I had a room assignment, and the patient needed changing. Since we have no techs, I cleaned the patient myself, took about 10 minutes as it was a real mess. Here comes the charge nurse, why is the patient still here. Could have taken her up and let the floor deal with it! I think the majority of ER nurses want to be helpful and not dump on you, we are just getting a lot of pressure to move people out..thumb.jpg.6eeb2c01c27cfd151d706238b7f6d6b7.jpg){kind=small}
bloviate
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