Your Gettin a Patient - The Doors Open and In Rolls Your Pt.

Nurses General Nursing

Published

How does this happen???

Pt. arrives is seen in ED @ 2100 as a trauma alert. Primary/secondary survey, orders entered in CAPOE, plain films, CT scans done, etc.

I get a call from my AP (unit clerk) @ 0230, "you're getting a pt., report's in the computer." I knew there was no bed in the room, as I walk out into hall to get the bed to bring it to 17A, the doors open up and in rolls the pt. Fortunately, the pt. was A&O and could tell me his injuries. I stood there and read report in front of patient.

We won't even begin to talk about the crazy orders the first year put in... But in his defense, he was just hired a few days before to replace a first year that quit.

I don't mind short notice but how about 5 minutes... Hmmmm.... How 'bout 2 minutes.... 10 seconds just don't cut it.

Specializes in Trauma ICU, MICU/SICU.

Even now, when I know I'm getting a patient, I look up the labs and other test results before the patient gets to the floor. I've headed off a few inappropriate admits that way and been able to prepare the techs for special needs patients as well.

:yeahthat:

Specializes in Rodeo Nursing (Neuro).

At my last physical, after all the poking and prodding and recrimination, my doctor said, "This is the point in the exam where you get to tell me if you've been having any problems with ED."

I was stunned, but after a moment to think, I told him that they don't give very good report and they always seem to call right as I'm about to go to lunch, but at least I hadn't had to be a patient there in awhile, so no I didn't really have any problems with them.:uhoh3:

Not to mention trying to piece together what meds were given and when. Good heavens! What a nightmare.

(And a virtual goldmine for a professional complainer like me :D)

LOL. A woman after my own heart!!

My favorite ER admit while I was there: I was told I was getting a 40ish man admitted with "intractable headaches".

When he arrived, he looked like someone had gone upside his head with a baseball bat; turns out he'd been in a motorcycle accident sans helmet. Yeah, I'd say he's got a 'headache' :lol2:

(btw, I refused to allow them to place him in the room; called the supervisor and had him transferred to the trauma unit overnight)

Specializes in Emergency & Trauma/Adult ICU.
At my last physical, after all the poking and prodding and recrimination, my doctor said, "This is the point in the exam where you get to tell me if you've been having any problems with ED."

I was stunned, but after a moment to think, I told him that they don't give very good report and they always seem to call right as I'm about to go to lunch, but at least I hadn't had to be a patient there in awhile, so no I didn't really have any problems with them.:uhoh3:

;) :smokin:

Specializes in Utilization Management.
LOL. A woman after my own heart!!

My favorite ER admit while I was there: I was told I was getting a 40ish man admitted with "intractable headaches".

When he arrived, he looked like someone had gone upside his head with a baseball bat; turns out he'd been in a motorcycle accident sans helmet. Yeah, I'd say he's got a 'headache' :lol2:

(btw, I refused to allow them to place him in the room; called the supervisor and had him transferred to the trauma unit overnight)

Weird. I got one like that too. I took one look at the patient (young kid with I-can't-recall-what, but scheduled for brain sx the next morning) and glanced that the orders that said, "Neuro checks and vitals q1h" and marched my little fanny right up to the Charge nurse and asked her for either less patients or two more techs. Or maybe :idea: a teensy little transfer to the Unit for this fella?

So he was transferred. My tech was so thrilled she bought me lunch.

Specializes in Trauma ICU, MICU/SICU.
Or the man with the "rash", whose skin was literally sloughing off all over...

Oh my gosh, I think I had that pt. Same dx. Doors to our unit opened.... OMG, the stench!

This thing turned out to be a knock down drag out fight btw. us and bed management. Pt. wasn't ordered contact isolation and was obviously grossly infectious. They wanted to put a fresh traumatic amputee in with him. :smackingf:

We managed to keep them from doing that nonsense. But... they ended up putiing a severe head trauma awaiting xport to hospice in his room. It was just so wrong on so many levels. If I were that nurse (I was only a tech then) I would have called our director. She didn't think of that though... She just was screaming and yelling at bed mgmt (which is NOT effective) at all. BTW, pt. was on a litter next to the water cooler in the ED. YUMM!

At my last physical, after all the poking and prodding and recrimination, my doctor said, "This is the point in the exam where you get to tell me if you've been having any problems with ED."

I was stunned, but after a moment to think, I told him that they don't give very good report and they always seem to call right as I'm about to go to lunch, but at least I hadn't had to be a patient there in awhile, so no I didn't really have any problems with them.:uhoh3:

That is why I don't work in an ED . . . . .I work in an ER.;)

steph

Oh my gosh, I think I had that pt. Same dx. Doors to our unit opened.... OMG, the stench!

This poor guy was probably the saddest case I've ever seen. No intact skin, anywhere. Serous fluid pouring off of him. Called the primary in who transferred him to a burn unit (where he should have been in the first place) and he died soon after.

Specializes in Ortho/Neuro...now, Oncology Research.

At my old place, they started a new policy that ED had to call once to give us report and if we couldn't come to the phone then they could just go ahead and send the patient!! Hello? Are you serious? If I don't even have time to come to the phone, then how am I supposed to be able to admit a patient?? One time, and only time, I had a patient roll down the hall whom I hadn't gotten report, with a chest tube hanging down with a rubber glove tied around the end...don't freak out, it had some sort of special port on the end. But still, I had no idea what to do and I felt stupid in front of the poor family.

Notice I said, my old place, I got outta there fast!

Specializes in SICU, EMS, Home Health, School Nursing.

Last night I got floated to the ED and the squad called to tell us that they were bringing in a woman in active labor and they said that they were going to be there in 1 minute. Well 10 minutes passed and they still weren't there and when they tried calling the squad back, there was no answer. Everyone was freaking that they were delivering the baby in the squad and they started gathering all the necessary things. Then we see the squad guys walking around and we asked them what was going on and they took the pt straight to L&D and forgot to let us know. Needless to say, some of the nurses down there were ticked.

Specializes in Tele, Infectious Disease, OHN.

:trout:And then there is the thrill of going into a room you think is empty to try and catch up on 6 hours of charting, and there is a patient in there....no report... seems the ER techs ran then up and dropped them off...

Specializes in mostly in the basement.
:trout:And then there is the thrill of going into a room you think is empty to try and catch up on 6 hours of charting, and there is a patient in there....no report... seems the ER techs ran then up and dropped them off...

OK, I'll play.

Good catches on the floor, ya'all. It's crazy how we ER folk can have a doc see a patient, work them up, make a determination to where and what floor they are to be admitted after having been stabilized for hours in the ER, write orders for that floor and then thankfully you're able to see our combined foolishness and fix it. whew....

Those Q1 hour neuros? Absolutely right only a unit could do that AND keep up with their other 4 or 5 pts. Well, except for those last six hours that they did downstairs.

Mostly I'm grateful that so many are able to survive, night after night, the toxic gas that is released from the vents(I guess) that blinds and deafens everyone--clerk, cna's, rn's, etc. each time a 200 pound gurney with broken wheels goes aaallllllllllllllll the way from the entrance, past the desk, to the verrrrry last room--with a human being pushing it. Hear no evil--see no evil? Wish I had my invisibility superpower when I wasn't at work! My, what mishief I could do...

Hmm..I guess I like being able to rapidly assess a pt. and know how to keep them stabilized while I work out a bedding issue and not freak out. In a hallway even! I am an ER nurse.........(job #2---I survived #1. Who knew how great nursing could actually be! :)))

I think that's your phone ringing.;)

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