ER rushing patients to the floor

[freckles23]

So I wanted to run something by everyone. I realize at my hospital, the ER try to push their patients out of their unit and onto the floors. I work on a med surg tele floor. Last night I walked into work and right off the bat had an admission. Well this admission was very unstable and was going into septic shock and my first hour was stuck attending the needs of the patient. This meant I was neglecting all of my other 8 patients. Were they alive? I couldnt even tell you. So a few hours later I transferred the patient to ICU. So yes this patient was my admission but the ER is so quick to rush patients onto the floors that they end up sending unstable patients to the floors and then cause chaos to us because then we need to do the documentation for the assessment and then all the transfer work for a patient we only saw for a few hours. Idk if this is more of a management issue on getting patients up to the floor quickly but it is very unsafe and it is a reoccuring theme at our facility. I understand patients statuses change and stuff happens but it feels like it is getting out of hand. My one co worker walked into work when I did and right off the bat had a patient that passed away on shift change (thats just bad luck I guess). But I really just wanted to know what is the real reason behind this? Last night was too much for me and my stress and anxiety level is thru the roof when I need to go to work. I left work at 10 this morning and am going back at 7 for another 13 hours so I dont know how I am going to manage this night. Just needed to vent! Thanks for listening!

[Wuzzie]

ER nurses have never transported any but vented patients anywhere I"ve worked. Nice try.

Not where I worked. Her point is valid for many of us.

[Newbie_RN17]

ER nurses have never transported any but vented patients anywhere I"ve worked. Nice try.

ER nurses transport any patient requiring telemetry where I work. Just because it doesn't happen for you doesn't mean it doesn't happen.

[Burks21]

We just started something new at our hospital.

Step down patients - They call to say the patient is on the way. No report. Figure it out ourselves now. Often the patients are sent up with patient aides.

ICU patients - Sent up with a nurse, often not the primary. They try to give report to us while moving the patient into the ICU bed, untangling the mess of wires, and fixing their drips (seriously....5mcg of Diprivan and they wonder why the patient is fighting?).

[William2]

You realize that when an ER nurse transports the patient (mandatory for ICU patients in all facilities I've worked and common for all patients, especially on night shifts and weekends), she is also leaving her 3-7+ other, frequently unstable patients for the duration?

That's if they have that many assigned to them or they are all that unstable. If they are all that unstable, truly unstable, then assignments need to shift for that transport to take place

In the ICU its just us we have to make do with the bodies we have even though the acuity is through the roof. That ICU nurse is taking that patient to CT, doing procedures in the room, making phone calls for consent, setting up supplies, and titrating drips in another room taking care of all aspects of that patient such as q2h turns, oral care, hourly urine output, cleaning up BM and managing that family and their phone calls/questions not to mention the new patient ED delivers while assisting their colleagues with whatever they need. It goes both ways. So for ICU staff or any staff on a medical floor going to ER to pickup a patient is a stupid idea. It will not work.

Its a team effort or should be. If your ER lacks this or the lone wolf is encouraged because of personalities in this department in my opinion that job isn't worth holding.

[Horseshoe, BSN, RN]

ER nurses have never transported any but vented patients anywhere I"ve worked. Nice try.

Our ER nurses transported all of their patients. Your experience is clearly not universal.

A "transport nurse" sounds like a wonderful solution. So wonderful, it would probably never be approved by the powers that be.