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I used to work as an ER nurse and now a house supervisor. Two things about the job that baffles me are the floor nurse and on call staff. What is with the attitude of some floor nurses and not... Read More
Feb 27, '02proud2bme, I think your issue was a problem with management. More specifically the house manager. It is her or his responsibility to make sure pts ar transfered in a timely manner.
I know at my hospital the super comes up to the floors and looks at bed status frequently. So she would have known that nurse was being lazy.
Yah some try to be slick about it. They will write the patients name on the board, like they are already there. All it takes is one question from the nurse in charge or super to find out if the patient has arrived. It dont have to be "did the patient arrive?' The question should be "how is your new admit?" And if she says it isnt here follow thru.
Yes, Hank that is baby sitting and we should not have to babysit adults, but guess what some people will get away with what ever they can.
If you want to end some of the crud going on assume that role.
Question what is going on. You know the floors that are notorious for holding off the ER---go to those floors and literally look in the rooms, question the charge nurse but also call the nurse who is refusing the pt on her behavior.
We had one floor at our place that was very bad about making their floor looking like it was full in the computer---they just would not discharge out of the computer, so the bed would look ocupied. Well, you guessed it--- walk that floor. Give the nurses time limits to get the pt out of the computer. They will do it, just because someone has finally busted them.
By the same token, you worked in the ER. You know which nurses down there have bad attitudes, dump undone tasks, left pts in the hallway etc. If you want respect from the floor nurses you have to show them you are not all for the ER nurses 150% of the time and vice verses.
Feb 27, '02Hear hear Dennie.
The comment about not having pts in the halls on the floors made me laugh. We DO have pts in the halls waiting for unavailable beds while we rush around transferring pts off and admitting the ER admits all the while we have oiur share of codes, carotid blowouts, PE's, MI's ect ect ect ect ect.. Geesh. I'm certain the double parkings in ER are much worse but I got the distinct feeling that this particular ER nurse thinks we sit around sipping java. They get the drunks, we get the DT's later on on the floor. Both jobs are difficult and I KNOW ED is incredibly stressfull but so is floor nursing. Not attacking ED nurses...I think they are awesome.
Feb 27, '02Furball -
I think they are, too. But I don't think they are necessarily *that much* more awesome than everybody else. Maybe I am just a little piqued that what little glamour image and respect there is for nurses, seems to be tilted to the ED nurses. They seem to do so much less "scut" work and the paperwork seems less intrusive, they have all the equipment and support, and they get all this glory. So my remarks probably came from a part of me that I'm not all that proud of.
A friend of mine was floated to the ED when she had a back injury - it was less strenuous than the floor she came from.
And floor nursing is NOT the same patients all the time. No, it's not dull.
DennieLast edit by NurseDennie on Feb 27, '02
Feb 27, '02Hank, I like the way Dennie put it best, your post really got up my nose too.
Seems like your background as an ER nurse has made you see things a little one-sided?? When the floor nurses give you "attitude", do you go up to the floor to see why? I am sure you are busy too, but maybe if you checked it out, and I apologize if you have already, you would see for yourself what is going on.
I did PACU, and we would get the runaround sometimes. There were times I would be pi$$ed at having to wait for 7pm on OT until the next shift agreed to take a pt. I'd go take a walk and find out for myself if the bed was empty. Sometimes it was, and I would find it was usually the same nurse who tried to BS me, other times I would bring a pt, even when they said I could, and I had one nurse who was so overwhelmed with her assignment, that she burst into tears as I gave her report! I could see she was stressed, and had too many pt's wo were acutely ill, transfusions she was supposed to be monitoring q 15 minutes, and 2 more post-ops waiting for beds. Her co-workers were just as busy, no one was sitting around filing their nails or had hands filled with coffee cups.
Maybe next time the flloor could use your hands to help them accept a pt. Maybe you could comfort the family of the pt who just died so the nurses can clean the bed since housekeeping can't be found, so they can take the admit sooner.
I'm sorry to say this, but in your original post and a few that followed, it seems that your attitude is one that promotes division among the staff. If there are certain offenders, you need to deal with them on an individual basis, rather than lumping all "floor nurses" into one category!! I find it very disturbing when managers do not address individuals, but rather post memos to everyone. I suggest you investigate the causes of why floor nurses are not taking admits in a timely fashion. Maybe there is really only 1 or 2 people you need to manage.
Feb 27, '02hank, what makes you think i was talking about you judging?
was my post reffered to you directly?
it wasnt, for the record.
and as for your quote about me "hearing" about the clean house thing being notorious
it was followed directly by "I've also seen it"
I am not judging anything, I'm speaking of my experience, and one of the reasons I am starting to dislike posting here is the way some people seem to dissect everything that is said and take it too personally, I am not here to ruffle any feathers I am here to share what I have been through , and offer my opinion , which is what I thought was the entire point of this.......
and we did report to the supervisor about the times when the code happened and she agreed that although in poor taste there is no policy regarding when ER Nurses call the floor to give report though she was going to work on the not calling during/just post code situation.
and its hard at times to go to a supervisor that you may not have complete faith in, but thats another issue.
Feb 27, '02It's good to get under certain people's skin. That is the whole point.. to bring up some dialogue about what can be done. There are obvious issues or people would not get so upset Sure my first posting was out of frustration having worked ER. I love how people read one post and assume that is my position. If you read my subsequent postings after listening to the other sides, I have agreed and disagreed but have also asked for suggestions.
(I will not quote them... go back and read for yourself)
Hoolahan.. sure I check on the floors. There are times the floor are short nurses... have critical patients.. I always offer my assistance. But you should know that there is only so much I can do. I can't get tied up in patient care but can offer starting IV's (which is another story, maybe not for you but here it is) or take care of the paperwork with a death. Majority of the floor nurses are great. Same for the charge nurses. But there are enough bad apples that have to and need addressing. I have had several one on one chats with some. Maybe my postings say otherwise, but I am comfortable in the job that I do. And you will find staff that like me and hate me. Is not that true for everyone. You are not going to please every staff member.
If I ruffle feathers, get up your nose or tick you off then I have done my job.
If you do your job correctly, you should have nothing to be upset about as my comments are not directed at you. Not ALL floor nurses are lazy. Yes there are ER nurses who are rude.
I will say this.. for those that give the impression that you are above all this...
Please come work here. We could use some good nurses like yourself
Feb 27, '02Originally posted by deespoohbear
Our ER is notorious for holding patients for 3 or 4 hours, and then bring them up for admission at shift change. Usually in our small hospital there is not a wait for a med/surg or tele bed so that excuse is blown. I truly believe that our ER does the "clean the unit out" routine before their next shift starts. Another thing that gripes me is when the patient comes up from the ER on a monitor and no IV access!! Somebody is asking for trouble. I don't usually deny to take an admit at any time, but there are times I sure get frustrated!
Does a RN need to be present, IV started, etc.?
Are you writing incidents down for your director if ER is not doing something they should?
Feb 27, '02Originally posted by hapeewendy
I dont judge, so please dont make assumptions about floor nurses based on limited experiences with them.
for the record - the clean out house thing is notorious and ive heard ER nurses AND MD's talk freely about the plan to get everyone admitted just before they are going off shift, so its not a myth or "coincidence" , the problem is , our ER gets off at 1900 hrs and we dont leave the floor until 1930, so you guessed it, if we get report at
1900 hrs the pt doesnt show up til exactly 1925-1930, it can be frustrating, I can admit that it annoys me , but the patients never know that I am frustrated and to tell you the truth, neither do any of the nurses.
"and as for your quote about me "hearing" about the clean house thing being notorious
it was followed directly by "I've also seen it"
I don't see that
Hmm.. I'm sure I'll upset you with that
About the limited experience.. I am guessing that I should not refer to everyone based on one or two experiences? Yes that is correct.
But I am referring to those who don't do there job based on experiences over the years.
Feb 27, '02Ok Hank, and if you do your job correctly, then my comments shouldn't upset you either. Truce.
I have put in my time in hospitals, but I prefer to stay in home health, where my patients can have my undivided attention and I don't have any reason to find fault with what my co-workers did or didn't do or not do. It works for me. When that stops working for me, I will go work nights in Wallmart, and I am dead serious about that! $22 per hour for Wallmart isn't too shabby. I started my HH job at $22.73 per hour after 20 years of experience!!
Feb 27, '02From reading your posts I get the feeling you are 150% for the ER all the time. Even if you are not the staff will think you are, because I can bet that is where you spend most of your day.
I say that with no offense intended. It is only natural to spend the extra time you have in the environment that is the most comfortable. So they are among the group that will get most of your sympathies, because you are there seeing them run their legs off.
Feb 27, '02hank - in a post before the one you replied to I recounted a story about three admissions rollin thru the doors to the floor at the same time , thats what I meant by I have seen the whole "clean house phenomenon" in person..
and as for the term limited, maybe that was the incorrect word to use, I understand your "years of experiences" and negative ones at that, however surely all of your experiences with "floor" nurses cannot be negative ones? if they are I would be interested to know a.where these experiences took place and b. how you proactively tried to become part of a solution to the problem
your posts dont "upset me" everyone is entitled to their opinions, what bothers me a tad is that when someone responds to a post with their own opinion/experience base that it turns into a battle royal half the time
we are passionate people, I get that, I too am a passionate person when it comes to beliefs and opinions, possibly the idea that we get upset at posts like yours is that we "floor" Nurses feel lumped in some less than flattering pool of people.
no matter whether we are great nurses,or less than stellar ones, there seems to be some stark generalizations made by some people regarding floor nurses.
Just like ER nurses come to bat for eachother when insulted etc, so do floor nurses.
everyone could go on for hours about stereotyping diff types of nurses based on negative experiences, enough floor nurses have brought up striking resemblences throughout ER's all over america/canada but does that mean we should judge all ER nurses by the same marker? of course not
good bad or evil, we are all nurses, the greatest of us and the worst of us end up in all departments in a hospital , at any given time
its not about "being all above all of this"
its about the fact that a floor nurses job may be on the "floor" or unit or whatnot but that does not define him/her. so sometimes we get a little
*ahem* passionate about negative statements about unit nurses, its just sometimes frustrating when other depts dont see the other side to the whole "admit the patient" story, I certainly KNOW That the ER Is a madhouse, and that the nurses are run off their feet there, its just sad that sometimes people are blind to the issues surrounding the nurses that work on very busy med/surg/tele etc units.
yet again, I'm not directing my statements at any one person (IE - hank) because as youve said before you understand the work of a floor nurse.