new to ER - more questions....

Specialties Emergency

Published

Hi everyone,

After a long job hunt I finally got my first ER position after years in ICU. I'm still on orientation. I really enjoy it when things are going well! But I am finding that time gets sucked up troubleshooting computers, meds in pyxis not be loaded properly, blah blah blah. The inefficiencies that just make the job crazy when you have back to back admissions etc. I'm trying to adjust to the pace of it all, and sometimes it seems that my patients are being discharged and I'm never told, the order just shows up in my computer and I have no idea how long it has been there. Last night my patient was discharged and I realized later that urine was never sent and it was a stat order - don't the MDs look for results of full work up or is it up to me to say we still don't have all test results back? Or if they are ok to send the patient home I guess they don't care about UA results anyway and I shouldn't worry about it? I realize a UA is not always the highest priority test...

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Specializes in ER, Trauma ICU, Peds ICU.

Welcome to the ER!!! Having been an ICU nurse before becoming an ER nurse I understand your concern. The answer is yes and no, It depends on why the patient is in the ER. Are they there for UTI symptoms or Abd pain then yes I would say "Dr. Happy did you know the UA has not yet been sent?". Dr. Happy may have looked at the wrong result. If they are there for a cough or knee pain that no I don't care about the UA and the Dr. doesnt either.

In my ER all orders are stat and we use alot of protocol and order sets, the UA is in almost all of them. And the Dr. never tells us or the patient they are being discharged. We have to check the computer often.

Good Luck!!!

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Specializes in ER, cardiac, addictions.
Welcome to the ER!!! Having been an ICU nurse before becoming an ER nurse I understand your concern. The answer is yes and no, It depends on why the patient is in the ER. Are they there for UTI symptoms or Abd pain then yes I would say "Dr. Happy did you know the UA has not yet been sent?". Dr. Happy may have looked at the wrong result. If they are there for a cough or knee pain that no I don't care about the UA and the Dr. doesnt either.

In my ER all orders are stat and we use alot of protocol and order sets, the UA is in almost all of them. And the Dr. never tells us or the patient they are being discharged. We have to check the computer often.

Good Luck!!!

It's the same in my ER. One thiing I'd like to mention: the U/A order should be cancelled at this time, if the doctor doesn't want it.

One of the quality measures that's tracked in my ER is how quickly the patient is discharged after the doctor writes up d/c orders. The chart is placed on a discharge rack, and any nurse can discharge that patient----it can save a lot of time and aggravation, both for the patient and the nurse.

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Specializes in Emergency Midwifery.

One thing my manager told me is the ICU is controlled chaos.......

the ER is not! :lol2:

I am grateful that we usually only have one nurse running the ED, and if the doctor wants or doesnt want something then they have to tell us. The computer system is in infancy and as nobody knows how to use it we are safe for the time being. :rolleyes:

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Specializes in ED.

just like Portcity rn said,

if the UA is relevant to the pt's symptoms I would make sure the doc knew it wasn't resulted yet.

if its not relevant, then I wouldn't mention it and cancel it. We have a lot of protocols started at triage with urine's included, and many times they aren't pertinent, or the other lab work elicited the needed information to get the pt safe to d/c home

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