well, apparently....ALWAYS check what the ER tells you. I'm sure there are some great ER nurses and staff out there...however, after last night, I'm a little ticked off at ours.
I got a patient from them...all I knew was DNR, fecal impaction...so I'm thinking I'll have to give some enemas, dig out, etc.....
Until they get to the floor and after putting patient in the bed, the ER nurse who brought them hands me the papers and goes, "oh, poor thing, her labs are wacky, she's septic, she's got a dead bowel." WHAT!!!!!!!! If myself or my charge had known that, we would have got them a private room for the family and patient. Nobody should have to die with a roommate.
The supervisor didn't know, I was told they called the doc, the POA was in florida, etc.
So then the family (with POA) comes in about 15 minutes later....what!!!!!
comfort care only, no special things....
Apparently, she passed before the primary doc rounded...he was ticked! BUt, I was told they called primary in ER...so I didn't think about calling him, I had pain orders, o2 orders, etc.....
Now it's a big hubbabaloo....but I think all that is coming of it is making a policy of calling attending MDs when patients get to the floor, versus just taking ER word or thinking that the other staff called doc....I should have known better when I didn't see any orders from the primary, just the ED doc...but lesson learned, and we move on.
So CALL your primaries when your patients get to the floor!!!!!! I was more worried that the patient wasn't a DNR, and she didn't get coded, and etc.....so I'm more relieved than anything...
Dec 16, '08
All of our admission orders that are written by the ER docs state "call primary doc to confirm orders".
It's not a bad idea to make this policy. At least the patient had what she needed, even if she couldn't be put in a private room. But it is still better than passing in an ER cubicle - or worse, a hallway bed.
Dec 16, '08
We do NOT call the primarys after ER admission--unless we need new orders. If the pt is critical/vented the primary may call in to us to get status updates. Then again if they are critical usually we have orders to call primary with recent Abg's/labs so we are in contact---
I hate shared rooms--we are all private now.
You did the best you could with what you had availalbe.
Sounds like things are going to change with communication at your facility.
Dec 16, '08
Our ER docs aren't allowed to write admit orders. Our ER docs are ER docs only and do not have admitting privileges. We must contact the PCP or use the call box to find an accepting admitting doc.
I do often find it frustrating in the ER that, as the nurse, I'm often not made aware of CT, Xray, US results. The labs will show up on the computer but it may take hours or even until the next day to see some results.
This is also one of the reason I try very hard to be the one who calls report on my pts. Sometimes it gets very hectic and it can't be helped, but calling report on a pt you haven't actually cared for is tough.
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