Is ER nursing Floor nursing???

Specialties Emergency

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This may be a dumb question but is ER nursing considered to be floor nursing? Do you do as much of the not so pleasant codes, bringing food and other things I really don't like so much about floor nursing? What other areas are considered to be non floor nursing positions? Cath lab? Thanks for any input.

Specializes in cardiology-now CTICU.

[quote=ERRN I really don't understand why they care if they get a patient 30 minutes before the end of their shift, they only have to take vitals and tuck them in.

I think all nurses should be required to float down to the ER to see what it is we really have to endure. Don't get me wrong, I love ER nursing, and wouldn't want to be a floor nurse, but some things need to be appreciated.

actually, there is a lot more involved in taking an admission than just taking vitals and tucking a pt. in. if i can't scramble and get it all done before oncoming shift gets there, then i am guaranteed a big ass fight about why i am not willing to stay for unpaid OT and finish and that is the same nurse i have to take report from when i come back. i really think that many ed nurses think that floor nurses are stupid and do not do bugger all. it reminds me of a statement made by an ed doc about how the ed is all that matters in the hospital. why, then, do pts need to be admitted? b/c they need a nurse to sit on their a**es and do nothing for them? no. b/c they need care. often time consuming and complex care. i know what it is that you have to endure- i have seen both sides. what i am amazed by is how quickly some ed nurses forget where they came from/forget the amount of intolerable BS on the floor that drove them out in the first place!

other ed nurses on this board have cited belligerant/smelly/rude/demanding/litigious pts as a reason why ed work is so challenging and deserving of respect. forgetting completely that ed deals with said unpleasant pt for a shift, floors deal with that pt for days/weeks/months day in and out.

whew. rant over. seriously though. we all deserve big props for what we do. the vast majority of us are hard working intelligent people who just want what is best for our pts. i'm sorry i got riled by what you posted.

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:roll

ER nursing, aaaaaahhh, I miss those days. Is it like floor nursing? To a degree but then again, not at all. I agree that Jennifer and Jen2 have said it best. I have had varied and wide experiences working in the ER, some good and some not so good. I also agree with shadowing an ER, or other area, nurse for that matter. It would benefit you beyond belief.

As for placing a foley when it isn't needed just as a convenience, think of how fragile that 80 year old hip fracture's skin is. Now is it a necessity or a convenience? I think it is necessary to prevent skin breakdown and it is convenient for the patient because he/she no longer needs to worry about PAIN when he/she needs to urinate. Not all hip fractures are surgically repaired. It is up to the surgeon and the patient or the patient's family regarding the treatment. So foley or no foley? I vote foley everytime because the patient will eventually get one in the OR if he/she makes it there or from the Ortho-Surgical floor nurse.

in the er it's

a

b

c

F... for foley!

(true er nurse's get this!:roll )

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Specializes in aged -adolescent.

Hi

Can someone please tell me what causes a person to vomit faeces. I am not put off by BM or vomit having cleaned up quite a few people, maggots I don't know how I'd handle. I am just curious and have never been in a situation like that. Excuse my ignorance but I want to know. Please help.

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Hi

Can someone please tell me what causes a person to vomit faeces. I am not put off by BM or vomit having cleaned up quite a few people, maggots I don't know how I'd handle. I am just curious and have never been in a situation like that. Excuse my ignorance but I want to know. Please help.

Large bowel obstruction.

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To answer yoiur question..the ED is a mix of every kind of nursing..from bumps and bruises to massively critical..you get what comes through the door..and be ready for it.

I read your reply also... and my gut tells me that you are either burnt out. looking for utopia..or should choose a whole other profession

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"I really don't understand why they care if they get a patient 30 minutes before the end of their shift, they only have to take vitals and tuck them in."

Simply tucking in a patient coming from the ER is just not the case. Not at the hospital where I work. Getting a patient from the ER means getting and documenting a complete health history and assessment, paging the doctor because the orders are incomplete, and at times having to re-starting an IV because the one that was started in the ER is not working. Many times the doctor will call and want thier patient ready for the OR "in 10 minutes" All of this, plus making sure your other 4 patients are "tucked in" with all of the meds given, pain managed, fluids running, TPN hung, and making sure all orders signed off and completed. There have been days that I ended up charting and caring for up to 8 patients because of discharges and new admits. Unless I get a really nice nurse who is willing to help me out at the beginning of thier shift, many times, getting a patient from the ER 30 minutes before shift change means that I will not be getting off until 9 PM.

For me, it is isn't about who has the harder job, it's about working together to make sure the patient gets safe care. A patient who arrives on the floor 30 minutes before a shift change may not get the best care possible

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"I really don't understand why they care if they get a patient 30 minutes before the end of their shift, they only have to take vitals and tuck them in."

Simply tucking in a patient coming from the ER is just not the case. Not at the hospital where I work. Getting a patient from the ER means getting and documenting a complete health history and assessment, paging the doctor because the orders are incomplete, and at times having to re-starting an IV because the one that was started in the ER is not working. Many times the doctor will call and want thier patient ready for the OR "in 10 minutes" All of this, plus making sure your other 4 patients are "tucked in" with all of the meds given, pain managed, fluids running, TPN hung, and making sure all orders signed off and completed. There have been days that I ended up charting and caring for up to 8 patients because of discharges and new admits. Unless I get a really nice nurse who is willing to help me out at the beginning of thier shift, many times, getting a patient from the ER 30 minutes before shift change means that I will not be getting off until 9 PM.

For me, it is isn't about who has the harder job, it's about working together to make sure the patient gets safe care. A patient who arrives on the floor 30 minutes before a shift change may not get the best care possible

I am currently working in the ER, prior to that I worked in OB both areas can hit you with an unexpected case at the last minute forcing you to work ot just to complete documentation after e.g delivery or code. however the floor nurse really only have to do the basics for that pt they receive from the ER 30 mnutes before shift change (in most cases). I fully agree that the most important point to remember is the care we give our pts. Team work helps us to get it done efficiently and effectively. No matter where we work in the field of nursing it is still a matter of choice or preferance and the desire and determination to deliver the very best nursing care we can. (Is this not why you became a nurse?)No nurse is an island, we must work together, rely on each other to get the job done, Nursing is an essential service, continuous 24/7, so after you have done your vitals and document them then the nurse you relieves you will resite the IV or page the doctor to clarify orders etc.,and the work goes on....

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I am currently working in the ER, prior to that I worked in OB both areas can hit you with an unexpected case at the last minute forcing you to work ot just to complete documentation after e.g delivery or code. however the floor nurse really only have to do the basics for that pt they receive from the ER 30 mnutes before shift change (in most cases). I fully agree that the most important point to remember is the care we give our pts. Team work helps us to get it done efficiently and effectively. No matter where we work in the field of nursing it is still a matter of choice or preferance and the desire and determination to deliver the very best nursing care we can. (Is this not why you became a nurse?)No nurse is an island, we must work together, rely on each other to get the job done, Nursing is an essential service, continuous 24/7, so after you have done your vitals and document them then the nurse you relieves you will resite the IV or page the doctor to clarify orders etc.,and the work goes on....

Like I said, if I'm lucky the nurse coming on shift will help me with the ER coming at shift change. But this night nurse still must start her shift, pass meds, assessments on 5 or 6 other patients. I agree, teamwork is key, but as the nurse taking on the new ER, it is still my responsiblity to tie up the loose ends. My point was that nurses working on the floor just don't tuck in a patient and go home. This can be a very simple process or a complicated one.

Frankly the whole "Us vs Them" in nursing is ridiculous. Everyone chooses to work where they do for a reason. The bottom line is, hospital nursing can be difficult no matter where you work. Many things come into play when it comes to workload and job satisfaction. The hospital where I work at this time is trying to implement a policy that ER or recovery cannot send a patient to any floor 30 minutes before shift change. This is done not only for patient safelty but for job satisfaction. We had a patient come onto our floor from the ER right before shift change. The ER nurse brought the patient up to the floor, the floor nurse "tucked them in" and then gave report to the night nurse. By the time the night nurse made her rounds and went into the patients room, the patient had a PE and died. This is why I become reluctant to either accept the patient that late in my shift or just pass the care to the night nurse who I know is just getting organized for her own 12 hour shift.

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Specializes in 6 years of ER fun, med/surg, blah, blah.

The ER is about rescuing patients, but we have more than our share of floor nursing in the ER, with the boarder patients, & those waiting for a long time for admission orders. As far as giving out the lunch trays, I'm all for it. It keeps the psych patients busy & the blood sugars of regular patients & their familys up. Feeding patients & cleaning them is just as much nursing as working a code. I was a floor nurse & found those skills to come in very handy in the ER.:)

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I usually "work the floor" but I love ER...I call it "Love 'em and leave 'em". I don't have the same patients or families for an entire shift and I enjoy the variety.

However, you still have patients who poop/pee and puke. And they don't always make it to the bathroom to do so. Add bleeding (usually controlled before they get to the floor), and trauma cases, full cardiac arrest, gunshot victims, stabbings, etc.

And we do feed patients in ER.

It is not where you go to get away from these things.

Neither is psych. If it's an acute psych floor you still have patients who cut on themselves (ingenious how they find items to do self harm)...bleed, overdose and are even incontinent.

Office work would probably be ideal for anyone who wants to avoid bodily waste and food.

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I hate the "tray pass" I really don't know why. I don't feel demeaned, I don't resent feeding my pt's.

I used to work at a large rehab hospital. The meal pass took FOREVER. I was always frustrated at opening cartons, cutting meat, buttering bread (without, godforbid, touching it) and being a waitress when I was worried about how I was going to get all my noon meds passed...I think I understand what the original poster was trying to say.

that being said...I think the floor and ER are different orbits of the same planet. We all want what is best for the pt and families. We all want to give good care. The floor has to keep these pt's and families for longer, the ER can love em and leave em. But, The "floor" may not see the chaos in the ER or the 3 pt's waiting in chairs for a pt's bed...they cannot have this bed until the "floor" nurse takes report and the pt. However, "ER" nurses don't realize that the "floor" nurse is up to her armpits in sterile dressing changes or med passing...Like I said...Same planet--just different orbits.

I like the pace of the ER. It better suits my personality. If you are wondering if ER is the place for you, it would be a good idea to shadow and ER nurse for a while. But, keep in mind, you will be doing your fair share of code yellow, brown, green etc...oh, and providing food to pt's in the ER is alot less complicated then your traditional tray pass.

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Specializes in neuro/ortho med surge 4.
Like I said, if I'm lucky the nurse coming on shift will help me with the ER coming at shift change. But this night nurse still must start her shift, pass meds, assessments on 5 or 6 other patients. I agree, teamwork is key, but as the nurse taking on the new ER, it is still my responsiblity to tie up the loose ends. My point was that nurses working on the floor just don't tuck in a patient and go home. This can be a very simple process or a complicated one.

Frankly the whole "Us vs Them" in nursing is ridiculous. Everyone chooses to work where they do for a reason. The bottom line is, hospital nursing can be difficult no matter where you work. Many things come into play when it comes to workload and job satisfaction. The hospital where I work at this time is trying to implement a policy that ER or recovery cannot send a patient to any floor 30 minutes before shift change. This is done not only for patient safelty but for job satisfaction. We had a patient come onto our floor from the ER right before shift change. The ER nurse brought the patient up to the floor, the floor nurse "tucked them in" and then gave report to the night nurse. By the time the night nurse made her rounds and went into the patients room, the patient had a PE and died. This is why I become reluctant to either accept the patient that late in my shift or just pass the care to the night nurse who I know is just getting organized for her own 12 hour shift.

I agree. When I have a patient come up at 2200 or 2230 I have to attend to them. If I do not the patient will have to wait for change of shift report and then start all of the admit paperwork including making sure the med rec is complete and signed by the doc so it can go up to pharmacy before the pharmacist goes home. I am sure my 90 year old patient and there 88 year old spouse do not want to wait till after change of shift to start answering questions after a long day in the ER. There are certain things that must be done right away and cannot wait for the next shift. When I have a COPD patient or one that comes in with SOB I go in right away to make sure they are not in distress. Also, if you go in the room and try to just have vitals done and to tuck them in the patient/family ususally have requests that they want addressed right away. Some have home meds that must be sent to pharmacy before it closes. It is never as simple as it is made out to be. Sometimes I have to attend to other patients at 2200 and 2230 and cannot possibly get into the admit until 2300 except for a quick visit to make sure they are not in distress and to explain that you will be beack as soon as you can . The oncoming nurse is not responsible for any of the admit if the patient comes up 35 minutes before the end of shift. With most patients you cannot even start the admission process until all of their basic needs have been met- toileting, eating, pain, etc. Just getting one person toileted may take 10 to 15 minutes from start to finish, never mind chasing around food for the patient. I know all of this stuff can be delegated but our aides are busy too and people cannot wait to use the bathroom or have not eaten or had anything to drink in many hours. Believe me, the aide wants to go home at the end of their shift and will not help out at all when they are reporting off to the next shift during change of shift.

I know that the ER is busy and must get the patients up to the floor. I am not in any way bashing the ED or any other nurse. I just think we do not understand what the other's job entails. Unless of course the nurse has worked in both areas. There is no way that I would leave a new admit alone at change of shift unless they were completely A+O x 3 and all of there basic needs have been met. Sometimes change of shift can take an hour and the new nurse may have situations she/he has to deal with right away on other patients. What can you do? Some shifts are just crazier than others.

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