I get it, we on the floor don't see what you see- gunshots, knife cuts, fights, rape victims. But you chose that. Nursing is a wide, varied profession and ER is just a piece of it. So you work with firefighters, paramedics, police. Okay. But you're not a firefighter, paramedic or a police officer. You're a nurse. When you call the floor for report and we say we're too busy right now, we'll call you back, please don't call your boss, or the House Supervisor, and tell them we refused report. Again, I get it. Nobody is as busy as you. But we may have had our hands deep in poop, or in the middle of a dressing change, or with a doctor, or administering chemotherapy. Or we may be already getting report from the offgoing shift. And yes, another nurse is just as busy and can't take the report I would rather get first hand anyway. When we get report from you for a hip fracture patient and you say the BP is 191/92 and she has a history of hypertension, please don't get offended if I ask if you've covered the blood pressure. I know she's being admitted with a hip fracture and not for hypertension. But hypertension is something we're aware of, because it is also bad. If you send the patient up without covering the BP, by the time she's moved from gurney to bed that BP has spiked to over 200 and I have a possible stroke to add to that fracture. Will it kill you to walk over to your MD, the one with whom you enjoy a closer relationship, and ask for some Vasotec? And while you're at it, could you not forget some pain meds before you send the patient to the floor? You see, I have to call the admitting MD, that very MD your doctor just spoke with to admit the patient, and wait until he calls back, before I can give any medications. That can and does take hours. Meanwhile I have an increasingly uncomfortable, unstable patient and a family who is getting very concerned that this new nurse can't help their mother.
I'm sorry for the long post, but I just read another Megalomaniac ER blog slamming floor nurses as stupid and lazy, refusing report, fighting with ER because they're uncomfortable taking unstable patients ER wants to move because they need the beds. There is more than just you, ER.
If you read a page or two back someone explained it perfectly. I wouldn't have even brought it up, but LegzRN (I think) said something about an ER nurse looked at him wrong and it ruined his whole week.
But please, carry on the flaming, uh, I mean discussion...
that was a joke by that poster... as was explained a few pages back..... oy.
er nurses’ tears cure cancer. too bad we never cry.
er nurses can count to infinity - twice.
an er nurse sold his soul to the devil for his rugged good looks and unparalleled nursing ability. shortly after the transaction was finalized, the er nurse roundhouse kicked the devil in the face and took his soul back. the devil, who appreciates irony, couldn't stay mad and admitted he should have seen it coming. they now play poker every second wednesday of the month.
when the boogeyman goes to sleep every night he checks his closet for er nurses.
er nurses built a time machine and went back in time to stop the jfk assassination. as oswald shot, an er nurse met all three bullets with his sweet aviator sunglasses, deflecting them. jfk's head exploded out of sheer amazement.
they once made a er nurse toilet paper, but it wouldn't take sh!t from anybody.
a blind man once stepped on an er nurse’s shoe. the er nurse replied, "don't you know who am? i'm an er nurse!" the mere mention of being an er nurse cured this man’s blindness. sadly the first, last, and only thing this man ever saw, was a fatal roundhouse delivered by the er nurse.
that is h i l a r i o u s. love the tp one. love love love it.
Yeah. M/S nursing seems so much............................chase granny around the bed in circles telling her to lay down, at least some nights it does.
I want to go into the ER, but no way I'm doing it at my current facility. I just..............want more autonomy. A bigger problem to solve than, oh.................granny's tea doesn't have the right hint of cream the way she likes it.
Hmmmmm................I'm on vacation. Maybe time to start applying.
Any way of telling what my pt. ratios will be before I apply? (kidding, kidding).
On a good day -- 3ish sick patients, or 4-7 not sick patients. On a bad day, all bets are off. But -- the "worse" the day, the more autonomy. It's a daily demonstration of God's warped sense of humor.
ah, I think it's all in who you are and how people perceive you, whether you're a big male like you or a woman of average size and voice like me. Drug seekers and other annoyances alike know when I mean business and could give a rat's a@@ about the BS complaint. No one has even attempted to assault me, so I guess it's about your preparation too. I don't let anyone get close enough, my personal space is a big deal to me, as well as watching for signs someone might be agitated or getting READY to be agitated.... most know these signs if they've been doing this for a while.
Big and strong has everything to do with your demeanor and attitude, not your physical stature (or lack thereof) and gender. That's a common misconception. Don't misjudge strength of body or character.
Oh. He has that demeanor. I guess I do too, but I don't make an active effort to. I have told other nurses (when there is an ETOH detox pt. on the unit) "I don't give free swings on my person. It's not a matter of compassion or professionalism, it's just human nature, or fight/flight if you prefer. If someone attacks me, I'm going to put them on the ground. I'll worry about what Florence Nightingale thinks of it later, after I'm sure I'm not going to be hurt."
I guess, since I think that way, it shows. Those ETOH patients seem so aggressive with some nurses, and just go to sleep with others. When I'm there, they sleep.
I had someone say aggressive people are like sexual predators. There is a theory that sexual predators can walk in a room and without talking to anyone, pick out the person who is most vulnerable to their games. Its innate, somewhat animalistic, as if the vulnerable person is giving off a scent. Aggressive/violent people are the same, they..................."just know" who hits back and who does not and act accordingly.
On a good day -- 3ish sick patients, or 4-7 not sick patients. On a bad day, all bets are off. But -- the "worse" the day, the more autonomy. It's a daily demonstration of God's warped sense of humor.
I thought you were in education anyway? Am I confused? Why did I think that? Are you one of the one's who yelled at me when I said nursing is a labor, not a profession or something? I must be confusing you with someone.
Oh. He has that demeanor. I guess I do too, but I don't make an active effort to. I have told other nurses (when there is an ETOH detox pt. on the unit) "I don't give free swings on my person. It's not a matter of compassion or professionalism, it's just human nature, or fight/flight if you prefer. If someone attacks me, I'm going to put them on the ground. I'll worry about what Florence Nightingale thinks of it later, after I'm sure I'm not going to be hurt."
I guess, since I think that way, it shows. Those ETOH patients seem so aggressive with some nurses, and just go to sleep with others. When I'm there, they sleep.
I had someone say aggressive people are like sexual predators. There is a theory that sexual predators can walk in a room and without talking to anyone, pick out the person who is most vulnerable to their games. Its innate, somewhat animalistic, as if the vulnerable person is giving off a scent. Aggressive/violent people are the same, they..................."just know" who hits back and who does not and act accordingly.
I agree. One who is aggressive can "sense" out those that are passive and may also be vulnerable. Psychiatric patients are like heat-seeking missiles with nurses who are passive, scared, or vulnerable too. They just know.
I thought you were in education anyway? Am I confused? Why did I think that? Are you one of the one's who yelled at me when I said nursing is a labor, not a profession or something? I must be confusing you with someone.
I dunno eriksoln ...
I am a staff RN, with some additional responsibilities for staff education and orientation within my department.
We may not have been on exactly the same paragraph of the same page regarding the labor vs. profession thingie ... but no worries.
Okay I think you have to work where I work! :) I worked on Med-Surg for 2 years and I always felt that way about the ER...why do you keep calling every 5 minutes for report? why do you think you've seen it all/done it all/heard it all? why don't you understand that I'm busy too? And we had a joke on Med-Surg that our elevator must be a secret killing machine because people all of the sudden came up in respiratory distress, or all of the sudden had a temp of 94.6 or all of the sudden had an elevated bp or all of the sudden started hurting...
But now I work in the ER so I can understand it a little better...I still don't get the sending people up unstable part and refuse to do that with my patients BUT one thing I do get is why they keep calling for report. At my ER we are pushed all the time to cut down on wait times...it doesn't matter if the person is admitted already and we're holding them, what matters is what time they literally leave the department. And also, it does get very busy in the ER. Unfortunately people tend to treat the ER like a clinic and come for toothaches, pregnancy tests, work excuses , etc...and the waiting room can go from empty to 20 waiting in a matter of minutes.
At my hospital we had to have a meeting between Med-Surg and ER to resolve some of the conflicts we were having. It has actually helped to a degree. Maybe you could talk to your unit manager about the problem and see if they and the ER's manager can come up with some solutions.
Okay I think you have to work where I work! :) I worked on Med-Surg for 2 years and I always felt that way about the ER...why do you keep calling every 5 minutes for report? why do you think you've seen it all/done it all/heard it all? why don't you understand that I'm busy too? And we had a joke on Med-Surg that our elevator must be a secret killing machine because people all of the sudden came up in respiratory distress, or all of the sudden had a temp of 94.6 or all of the sudden had an elevated bp or all of the sudden started hurting...
But now I work in the ER so I can understand it a little better...I still don't get the sending people up unstable part and refuse to do that with my patients BUT one thing I do get is why they keep calling for report. At my ER we are pushed all the time to cut down on wait times...it doesn't matter if the person is admitted already and we're holding them, what matters is what time they literally leave the department. And also, it does get very busy in the ER. Unfortunately people tend to treat the ER like a clinic and come for toothaches, pregnancy tests, work excuses , etc...and the waiting room can go from empty to 20 waiting in a matter of minutes.
At my hospital we had to have a meeting between Med-Surg and ER to resolve some of the conflicts we were having. It has actually helped to a degree. Maybe you could talk to your unit manager about the problem and see if they and the ER's manager can come up with some solutions.
I've seen this and think it's great. It should be mandated to all hospitals. Inter-dept. staff meetings focused on dept2dept cooperation. Many/most hospitals don't do it because they see the dollar signs of people coming in once a month for a meeting instead of having their nose to the grindstone on the unit, and they consider it a loss of money.
The hospital I was at that did it (while travel nursing) had three.............yes, the paid for 3 nurses...............three nurses go every month. They were "advocates" on the unit for good dept2dept communication and cooperation. It wasn't one of these things where the three nurses from our unit just went to the meeting and blasted the other departments for their mistakes and gave the same old "You don't understand how hard it is from our side" song and dance. No one was interested in any of that. The meetings were goal and solution oriented. The advocates, while working, certainly could report problems and probably got more attention with their write ups than the avg. floor nurse, but they didn't go at it from this direction so much. In fact, for the most part, they were very hard on their fellow nurses on their own unit...............pointing out to them when something was not kosher/ideal and needed fixed.
One thing they could do, if warranted, was an "intervention". The intervention was: A nurse who displays poor dept2dept relations on a regular basis would be taken off the schedule, for one day (not a weekend or holiday) to shadow the workers of w/e dept's they had issues with. Sooooooo..............the unit nurse who frequently refused to take report got to shadow the ER nurse for a day, or the CNA who refused to help the Transport get people up and ready got to do that for a day, so on so forth.
One thing they could do, if warranted, was an "intervention". The intervention was: A nurse who displays poor dept2dept relations on a regular basis would be taken off the schedule, for one day (not a weekend or holiday) to shadow the workers of w/e dept's they had issues with. Sooooooo..............the unit nurse who frequently refused to take report got to shadow the ER nurse for a day, or the CNA who refused to help the Transport get people up and ready got to do that for a day, so on so forth.
It was very effective IMO.
That is Dali Lama-Enlightened-Chuck Norris-Fabulous ... if there is such a thing.
, etc...and the waiting room can go from empty to 20 waiting in a matter of minutes. 
MassED, BSN, RN
2,636 Posts
that was a joke by that poster... as was explained a few pages back..... oy.