Okay, why do ER nurses think they're so cool?

Nurses General Nursing

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I get it, we on the floor don't see what you see- gunshots, knife cuts, fights, rape victims. But you chose that. Nursing is a wide, varied profession and ER is just a piece of it. So you work with firefighters, paramedics, police. Okay. But you're not a firefighter, paramedic or a police officer. You're a nurse. When you call the floor for report and we say we're too busy right now, we'll call you back, please don't call your boss, or the House Supervisor, and tell them we refused report. Again, I get it. Nobody is as busy as you. But we may have had our hands deep in poop, or in the middle of a dressing change, or with a doctor, or administering chemotherapy. Or we may be already getting report from the offgoing shift. And yes, another nurse is just as busy and can't take the report I would rather get first hand anyway. When we get report from you for a hip fracture patient and you say the BP is 191/92 and she has a history of hypertension, please don't get offended if I ask if you've covered the blood pressure. I know she's being admitted with a hip fracture and not for hypertension. But hypertension is something we're aware of, because it is also bad. If you send the patient up without covering the BP, by the time she's moved from gurney to bed that BP has spiked to over 200 and I have a possible stroke to add to that fracture. Will it kill you to walk over to your MD, the one with whom you enjoy a closer relationship, and ask for some Vasotec? And while you're at it, could you not forget some pain meds before you send the patient to the floor? You see, I have to call the admitting MD, that very MD your doctor just spoke with to admit the patient, and wait until he calls back, before I can give any medications. That can and does take hours. Meanwhile I have an increasingly uncomfortable, unstable patient and a family who is getting very concerned that this new nurse can't help their mother.

I'm sorry for the long post, but I just read another Megalomaniac ER blog slamming floor nurses as stupid and lazy, refusing report, fighting with ER because they're uncomfortable taking unstable patients ER wants to move because they need the beds. There is more than just you, ER.

Specializes in Cardiovascular, ER.
Our ED nurses are the golden children of the facility. They call the shots how our floor is run. They send us pts with no report. One pt came up with pacer pads on. We had no idea why. Needless to say, she landed in ICU within 30 min of arrival. The problem are a the alpha nurses who run the place and run over the managers. Very frustrating. Right now, we are having meetings and trying to meet in the middle.

I think it can be done. But first we have to start respecting each other.

I wish you could see a shift in my ER - we are far from calling the shots on anything. We have 30 min from when a disposition of admit inpatient is decided to transport the pt upstairs or we get "dinged". I wish I had more time than that to call report upstairs and wrap up the ER orders.... as I sometimes have 2-3 pt's with that admit dispo and it gets hairy.

I can see your problem with pt's coming up to your floor inappropriately - I used to get those a lot when I worked the floor. The last floor l worked half of my pt's I received I would be wheeling off to ICU pretty fast and it gets pretty old. I hope your facility can work this out.

Running up to the room to check if I was telling the truth when I said it was dirty, is a good trick.

It seems to be a general consensus that ED is the only Dept. that is busy. A nurse has every professional right to refuse report/refuse to care for a patient if they feel the pt. is out of their limitations. Can you imagine a world where Charge nurses didn't know what type of patients they are set up to take? We'd be admitting MI's left and right to our med/surg floor instead of the cathlab.

And yes MD's DO try to send dumber diagnoses than that up to us on a MED/SURG NON ICU floor. (Oh, they were having chest pain in the ED but I gave them a percocet and they rated that it went from a 10 to a 9, you can take him now right?)

And should we DROP WHAT WE ARE DOING in a patients room to go take call for you so your night runs smoother? Rushing through patient care is a bigger concern to patient safety than them having to wait an extra 5 minutes for report. :redbeathe:twocents:

The world would function more smoothly if others took the time to realize that someone else MIGHT just be as busy as they themselves are.

Seriously, let's not exaggerate here. I highly doubt that anyone was talking about waiting only 5 minutes, but it's rarely ever JUST 5 minutes. I start my shift at 17:00 and can't tell you how often I've tried to give report between then and 18:00, only to be put off so long that my pt doesn't get to the floor until 20:00 or later because the floor nurse never "had time" to take report before 19:00, and then I had to wait for the oncoming nurse to finish getting report from the nurse going home.

You all can be as denigrating as you want to be of ED nurses, but this attitude only hurts the pts who have been waiting for hours to get to a room, and puts other pts in jeopardy if they can't be adequately cared for due to the lack of an ED room or appropriate attention from the nurse.

Specializes in ED.

Hey Gayle - don't let ANYONE steal your peace!

Running up to the room to check if I was telling the truth when I said it was dirty, is a good trick.

:rolleyes:

Hey Gayle - don't let ANYONE steal your peace!

i agree.

let the cat fights continue!!

leslie:icon_roll

Specializes in ER.
I wish you could see a shift in my ER - we are far from calling the shots on anything. We have 30 min from when a disposition of admit inpatient is decided to transport the pt upstairs or we get "dinged". I wish I had more time than that to call report upstairs and wrap up the ER orders.... as I sometimes have 2-3 pt's with that admit dispo and it gets hairy..

Agreed! We have 45 minutes to get a patient up to the floor. So if I wasnt *right there* to see the admit orders go up, because I, like every other nurse, have more than one patient, that's not a lot of time to do the paperwork I have to do to get them admitted, call report, and get them up.

As far as the ER being backed up, that's exactly what happens! I work in a 25 bed ER, when at even given time we have 3 or 4 people up for admission (cardiac hospital, so we get all the chest pains and CHFs), so if ALL of those nurses didn't have time to take report, imagine how quickly things get behind?

I know ER nursing is a lot of things, but easy? I find that crazy that somebody thinks that! If you've ever taken care of a pt on a vent, AND had 3 other patients you haven't put your eyes on in God knows how long because you're with your critical patient, it's a nightmare. Straight up stressful and awful. So that's maybe why we didn't treat the blood pressure. Because that pt was not the priority. Sorry, but the one going to ICU is priority over the one going to the floor.

Also, just a little tid bit, at least two of the docs I work with wont treat a BP like that if every time they come in they have a BP in the 180s or so. Apparently the latest research is saying that dropping a blood pressure fast in a pt that probably walks around like that all day every day can cause a stroke. I personally haven't done the research, but apparently they must be reading the same thing. Just food for thought!

Specializes in CCU, CVICU, Cath Lab, MICU, Endoscopy..

My hospital is very busy. I used to tell my interns the ER covers the abcs and ICU does the rest. Of course some will want to fight with each other til tomorrow while the patient waits for one of you to step up and do the right thing! Do you ever see physicians doing this to one another? Nope....what does that say about nurses? ........:devil:

Specializes in Peri-Op.

Lol.... that's all I have to say about the op's rantings....

ER nurses are cool. :coollook: Anyone who can stay cool, calm and collected in emergencies are way cool.

I am an office nurse; who no one thinks is cool. But I could care less. :D

I will say it, it's official, "...office nurses ARE COOL!!!!!" :)

I know this is off topic...but what is the steriotype of labor and delivery nurses? :o

Specializes in Periop, ER.

We are all nurses. We should band together and support each other regardless of what area we work in. We have all made the choice to work where we do. The rivalry, paired with eating our young, causes all the tension that is unnecessary. Someone has to do the areas we each find unglamourous- so let's just support each other and realize that everyone has their own battles where they work!!

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