No teamwork in ED

[hella_RN]

I thought my life was complete when I started a new job at a new ED which I thought was my dream hospital to work. Everyone is so nice but there is no teamwork! At my previous job, we had amazing teamwork. Every time we get new patients, we always help each other out whether it be doing an EKG, putting the patient on the monitor, checking a blood sugar, starting an IV, sending labs, giving meds etc. It was the definition of team work. I feel like at this new job, the culture is totally different. Everyone minds their own business and they have the "that's not my patient mentality." Where I worked before, we would always say, "that's not my patient but what can I help you with?" What attracted me to the ED was the teamwork. I love helping my fellow coworkers and I do offer help when I have the time but nobody is returning the favor! I feel like I'm drowning most of the time, and nobody cares that I am running around while they are all talking about how their personal lives are doing. They are great nurses but I I just feel like I do not belong here. I feel burnt out already and I don't know what to do. Just ranting I guess.

[muesli]

Is staffing and acuity different in your new job? Perhaps it's unreasonable to assume people are going to help you with routine tasks, but hopefully when the poop hits the fan in your assignment and someone else is less slammed with acuity, they will step in. The ED where I work has a layout which is not conducive to team nursing, but somewhat isolates nurses with their assignments. You really rely on your ancillary staff. With an average patient assignment of 6 in a busy level one trauma center people don't always have time to help on a routine level, but they are great at stepping in when acuity strikes, i.e. intubation, STEMI, code, etc. I've always believed you have to promote a culture of teamwork. I try to offer people help whenever I can in hopes that what goes around comes around.

[floridaRN38]

Lunch relief???

WE HAVE LUNCH RELIEF. WE GET 45 minutes. USUALLY THE CHARGE NURSE WATCHES THE PTS. OR ANOTHER NURSE IN OUR AREA. BUT I ALWAYS GET MY BREAK!!!

The teamwork is something that grows from the personalities of the people on the floor together. We just have each others' backs.

Usually, when I need a hand, someone's there without even asking. Likewise, I keep my eyes and ears tuned to the vibe of the pod and often pop in to see if they need help or to put patients back on monitors or get new orders going or whatever.

[Saflanut]

Team work sounds nice, but most of the days I feel that I am alone with my pts. Not everybody is willing to help in the ED I work. Onetime charge nurse got irritated when I asked if the float nurse can give meds to one of my patients because I was tied with a particularly hard stick patient. She said, I need to manage my time better, went on lecturing me for 5 min instead of finding a solution. Another charge nurse told me that she rather have three ED techs to stock up the rooms than start a line in one of my patients when I was triaging another patient who was brought in by medics. So I learned not to ask certain charge nurses for help. They make you feel inadequate and incompetent.

And some of the ED techs play favoritism, they only help the nurses who they are chummy with. In short, management is the key for smooth running ED. But I learned how to fly solo and do my job. Yes, sometimes I fall behind but I don't want to chase a tech and asks them to do something or explain to charge nurse why I need extra help. I find it exhausting.

We do have few good charge nurses and techs who jump in to help without me asking. Those days are usually more pleasant. Also, I do agree with the sentiment that ED is an extremely busy place, sometimes everybody is barely keeping their heads out of the water.

[prettymica, ASN, BSN, MSN, LPN, RN, APRN, NP]

I totally get what you are saying. I try to help everyone and I am the newbie on the block. I see people not coming to codes, hiding, playing cell phone games, using work pcs to do homework for the MSN program, getting the best positions(float) so the boss can talk to her bestie. Its not fair, but what do you do?

[z.RN.]

I have only ever worked in an ED with team nursing so I think I am spoiled on great teamwork. Don't get me wrong, when it is busy or you have a lot of critical patients it can still feel like you are drowning and you never see your partner, but I know they probably feel the same way. It is nice when a critical pt comes in every one chips in. The nurse who is actually "assigned" the room pretty much just charts. Medics and other nurses do rsi, IV's, grab equipment, sometimes even foley and ng. It all depends on how busy we are and staffing level but you are usually never alone. I think if we had an emergent critical pt come in and nurses sat around talking while one nurse was in the room struggling to get everything done, someone would get smacked haha.