Frustrating

srercg6 · Mar 4, 2017

we had that quite a few times, but it was because the patient just came in close to shift change or at shift change, and or after shift change and the oncoming nurse was calling report.

Tneo8385, BSN, RN · Mar 6, 2017

Well what question did you ask to make him give that response? Just like srecg6 said, most times it happens during/after shift change, I usually prefer for the nurse leaving to call report since they actually assessed the pt and then I would take them to where they have to go. That way if there are any questions the nurse that did the assessment can answer them.

Wuzzie · Mar 6, 2017

Yes, you're being picky. When I was in the ED we frequently gave report on each other's patients because sometimes the original nurse was in the middle of something (you know, like a code) and couldn't do it in a timely fashion. By the frequent posts here regarding admits from the ED it appears there is absolutely nothing that the ED can do right. The floor doesn't like the timing, doesn't like getting report from someone other than the original nurse, doesn't like not getting report, doesn't like faxed report, doesn't like not being told exactly where and what size the IV is, doesn't like that a full skin survey wasn't done...I could go on and on. It seems the only common denominator is the floor doesn't like getting admissions. We get that. It's a lot of work. The thing is, I rarely see posts where ED nurses are complaining about how the floor nurses dodge taking report/admissions. We know it happens all the time but for the most part ED nurses just let it roll of their backs, go about their own business and get back to it when the admitting nurse is ready. You had no right to cop an attitude with him when he was just being honest with you. What would I do? I'd find that nurse and apologize to him for being snotty and maybe buy him a cup of coffee.

Wuzzie · Mar 6, 2017

Yes, you're being picky. When I was in the ED we frequently gave report on each other's patients because sometimes the original nurse was in the middle of something (you know, like a code) and couldn't do it in a timely fashion. By the frequent posts here regarding admits from the ED it appears there is absolutely nothing that the ED can do right. The floor doesn't like the timing, doesn't like getting report from someone other than the original nurse, doesn't like not getting report, doesn't like faxed report, doesn't like not being told exactly where and what size the IV is, doesn't like that a full skin survey wasn't done...I could go on and on. It seems the only common denominator is the floor doesn't like getting admissions. We get that. It's a lot of work. The thing is, I rarely see posts where ED nurses are complaining about how the floor nurses dodge taking report/admissions. We know it happens all the time but for the most part ED nurses just let it roll of their backs, go about their own business and get back to it when the admitting nurse is ready. You had no right to cop an attitude with him when he was just being honest with you. In a previous post you admonished people to be kind to one another because nursing is a hard job. You went on to say we should encourage each other. Perhaps you need to take a page out of your own book. What would I do? I'd find that nurse and apologize to him for being snotty and maybe buy him a cup of coffee. You might make a friend and gain a better understanding of how things work outside of your own world and the same for him.

nursebeth77, ASN · Mar 8, 2017

I got this pt at 2100 (9pm), so he had been there for 2 hrs without seeing his pt. And if you read my original post, I said I have worked in the ER, and I never once passed on a pt without seeing them. I was just asking basic questions that he should know when he offered up the fact that he didn't know because he had not seen the pt. And the bit about the floor does not like getting admissions is sometimes true but not with me, I really don't mind getting them. Oh and we have codes on the floor also... On our floor we have 6 pts to a nurse, total care pts, no cna's, sometimes I have pediatric pts as well.

I support all nurses and I do have understanding of bad days but not seeing a pt does not sit with me.

Wuzzie · Mar 8, 2017

Then your experience is not the norm because it happens very frequently due to the nature of the ED. There is no malintent. People are just doing the best they can in whatever situation they are in at the moment. You have no idea what that nurse had done in those two hours (if in fact he actually had been there for two hours as most EDs have multiple shifts. I worked 9a-9p for instance) perhaps he was busy with other sicker patients and had another nurse lay eyeballs on this particular patient. You are implying that he neglected that patient without any evidence that he had. So what if it didn't "sit well" with you. You got report on a stable patient and had no right to cop an attitude with him. That's the bottom line.

**canoehead, BSN, RN** · Mar 13, 2017

I am more in agreement with the OP, but not fully. I can recall getting report on someone with pneumonia, and asking how their lung sounds were. "I dunno, I haven't seen him" wasn't acceptable. Look at the patient or make sure the information is in the notes, before you call.

Wuzzie · Mar 13, 2017

I am more in agreement with the OP, but not fully. I can recall getting report on someone with pneumonia, and asking how their lung sounds were. "I dunno, I haven't seen him" wasn't acceptable. Look at the patient or make sure the information is in the notes, before you call.

Okay, I have a question for you then and I'm NOT being snarky. What do most patients with pneumonia sound like and is there any reason to expect differently? How do their breath sounds change your immediate plan of care? I'm talking breath sounds not respiratory distress.

Now, if this person was caring for the patient and didn't know that's one thing. But if they are giving report for another person who cannot, for whatever reason, they are not going to assess the patient rather they are going to be the messenger and deliver whatever information they have received. One would hope that they would have been made aware of significant issues but if they don't that's not on them. Generally speaking someone giving report for another is usually done on the fly because something is happening that prevents the nurse who primarily cared for the patient from coming to the phone. My experience has been, and yours may be very different, outside of codes coming in the only reason I had to have someone else give report for me was when I tried to call it nobody from the floor would take it.

allnurses Guide · Mar 13, 2017

Well, exactly where the crackles, rales and absence of air movement does matter. Also not being snarky, but things can change fast and having the initial assessment to compare to is just good practice. It seems really obvious to me that getting report from the actual nurse rather than someone reading it by rote is safer and more likely to be thorough. Errors in documentation do occur and questions should be able to be asked. This is not blaming the ER nurses, it is just standing up for best practice. It comes across as blame of the ER nurse when, in fact, it is more blame regarding staffing levels.

Wuzzie · Mar 13, 2017

Well, exactly where the crackles, rales and absence of air movement does matter. Also not being snarky, but things can change fast and having the initial assessment to compare to is just good practice. It seems really obvious to me that getting report from the actual nurse rather than someone reading it by rote is safer and more likely to be thorough. Errors in documentation do occur and questions should be able to be asked. This is not blaming the ER nurses, it is just standing up for best practice. It comes across as blame of the ER nurse when, in fact, it is more blame regarding staffing levels.

I totally get what you're saying and in a perfect world of course this would be the way to go. Unfortunately it sometimes doesn't happen that way. I guess I just don't see it as a huge problem because although I know all floor nurses have had it happen from time to time I don't see it as something rampant. Best practice would also be for the floor nurse to actually take report when the ED nurse calls but that doesn't happen all the time either so sometimes we have to shoot from the hip. Regardless, copping an attitude with someone as the OP did isn't an effective means of finding a workable solution which I truly think both sides want.

Kooky Korky, BSN, RN · Mar 15, 2017

Then your experience is not the norm because it happens very frequently due to the nature of the ED. There is no malintent. People are just doing the best they can in whatever situation they are in at the moment. You have no idea what that nurse had done in those two hours (if in fact he actually had been there for two hours as most EDs have multiple shifts. I worked 9a-9p for instance) perhaps he was busy with other sicker patients and had another nurse lay eyeballs on this particular patient. You are implying that he neglected that patient without any evidence that he had. So what if it didn't "sit well" with you. You got report on a stable patient and had no right to cop an attitude with him. That's the bottom line.

I don't read "neglect", I read that she is frustrated because the reporter didn't know certain info that the receiver believed relevant.

Whatever the case, God help us all because this "lick and a promise" type of care we are forced to give because of improper staffing or laziness or inexperience or whatever probably kills a lot of patients. And it probably shortens the lives of workers, too.