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.
Specializes in Emergency Dept. Trauma. Pediatrics.
ER nurses ARE COOL! LOL So are tons of other nurses, Peds nurses are pretty cool too! I have worked with some rocken Float nurses as well.
The personality you describe though is individual, not related to a floor IMO The nice thing about being a recent student and doing my Senior Practicum on float is I got to visit a lot of floors on a regular bases in 3 different hospitals. So I got a good insight into a lot of the dynamics. The personality you described though, there are about 3 of those in my class. Each clinical we new in post conference we would have to hear how they were super student. They single handedly saved their patients from certain death from their incompetent co-nurses and doctors. Each patient they had whether on medical, or Ortho was an ICU patient that just happened to be on a regular floor and none of our experiences or patients could have possibly compared to how hard their patients were.
I have no doubt they will be exactly the kind of nurses you just described no matter what floor they end up on.
ER nurses ARE COOL! LOL So are tons of other nurses, Peds nurses are pretty cool too! I have worked with some rocken Float nurses as well.
The personality you describe though is individual, not related to a floor IMO The nice thing about being a recent student and doing my Senior Practicum on float is I got to visit a lot of floors on a regular bases in 3 different hospitals. So I got a good insight into a lot of the dynamics. The personality you described though, there are about 3 of those in my class. Each clinical we new in post conference we would have to hear how they were super student. They single handedly saved their patients from certain death from their incompetent co-nurses and doctors. Each patient they had whether on medical, or Ortho was an ICU patient that just happened to be on a regular floor and none of our experiences or patients could have possibly compared to how hard their patients were.
Sounds like an allnurses conference, rather than a student conference.
I never have an attitude with my patients, I was simply asking why is it that it takes forever to get them through the ER and then when they finally are to be admitted it HAS TO BE RIGHT NOW? Honest question that you answered sufficiently. I have never had attitude about taking another patient, and perhaps that is why I have moved on to critical care so quickly. I actually like my job unlike some of my peers and a lot of the people on this site.
we have no control over bed control. Once the little room is ready icon flashes on, we call report asap. Charge is all over us "have you called report?" often, not always, but often, we have a hallway pt heading for that room.
One of my pet peeves is the unit secty who puts me on hold and leaves me there. If the receivng rn is with an iso pt, pushing meds or whatever, that's the job. Tell me so I can call back. Don't just put me on hold.
Plus, everybody in my hospital can see the er census. So, they know exactly how busy or not we are at any given point.
Lastly, asked my nm why er nurses think we're so cool. Her answer "it's in the job description"
Thanks for putting in that foley but how about removing the patients jeans first instead of just unzipping his pants and pulling his member out through the hole and putting that foley in. YES that REALLY did happen once. Some things just can't be made up!
That is so funny i would consider doing it as a joke.
And another thing I wonder, I have been to the ER here and sometimes, especially on weekends, it is quite busy. Other times it is not. Perhaps you work in a major metro area where the ER is constantly backed up with 50 people waiting to be seen, but that is not the case in many places.
tell me this, why would an ER "hold" onto an admitted patient when the room is ready and available upstairs? You write why does it have to be "right now" when they're been in the ED for so long, but how else do you think we have patient FLOW in the ER? If we didn't get on it right away, the ER bottle necks, and you have no idea when/if you can decompress. You cannot plan for those ambulance patients that come in the back door and HAVE to have a spot, nor can you plan for those ambulatory patients that come in through triage that are having CP, they need a room. The admitted patient has a room, time to move it along....
My sister is an ER nurse. And she thought she was cool way before she became a nurse:coollook:
I don't agree with her assessment of herself - she and I are very different, and she has always had a "better than thou" attitude to those around her.
Perhaps it just takes a certain kind of person to be drawn to ER nursing - I know it isn't me, but my sister has been doing to for about 20 years now so it apparently works for her.
My sister is an ER nurse. And she thought she was cool way before she became a nurse:coollook:
I don't agree with her assessment of herself - she and I are very different, and she has always had a "better than thou" attitude to those around her.
Perhaps it just takes a certain kind of person to be drawn to ER nursing - I know it isn't me, but my sister has been doing to for about 20 years now so it apparently works for her.
I think it does take a certain kind of person, but not necessarily "better" or cool, however the definition may be.... just as I KNOW that I could not take (or would ever want) to work NICU or PICU. I just think I'd find it a painful experience all the way around. I think the same thing for burn units. Some nurses LOVE geriatric and geripsych nursing... there is truly something for everyone.
There are those that are drawn to what their path is... just embrace it. We are all needed in whatever path we choose.
I think to really be able to tolerate and grow in your chosen path, you HAVE to love it, otherwise you wouldn't survive, so in that vein, ER nursing does take a certain personality or belief system or some sort of ability to assess/triage and operate in critical care. Some can and some cannot.
I do find that in the ER, if you float there or think you want to start there, you need to know first and foremost to ask yourself one question: are you easily frazzled when you have 5 things to do RIGHT NOW with someone breathing down your neck? If you can't put that in a bubble and blow it away, don't work in the ER. Stress is a big part of the job. Not necessarily all emergent tasks, but being able to multitask and not blow up because you have to delegate and prioritize. I've seen so many people get so bent out of shape for something that is really easily manageable, should they know how to manage THEMSELVES. If you know that is who you are, then go for it, but otherwise if that simple question causes you stress... well then there you have it!
I had an ER nurse call during change of shift demanding that I leave the report I was giving the oncoming shift, in order to get report from her about a patient she was transferring to our facility. I had my tech ask her what was so urgent and the reason the tech was told was that the ER nurse "wanted to go home."
I put her on hold and finished giving report to the oncoming staff. After all, I wanted to go home too. Besides, my current patients outrank a transfer that won't even be at my facility for at least a couple of hours.
99% of the ER nurses I deal with are great. There's always that 1% exception though...but isn't that true in any field of nursing?
tell me this, why would an ER "hold" onto an admitted patient when the room is ready and available upstairs? You write why does it have to be "right now" when they're been in the ED for so long, but how else do you think we have patient FLOW in the ER? If we didn't get on it right away, the ER bottle necks, and you have no idea when/if you can decompress. You cannot plan for those ambulance patients that come in the back door and HAVE to have a spot, nor can you plan for those ambulatory patients that come in through triage that are having CP, they need a room. The admitted patient has a room, time to move it along....
You read one post without reading the rest? I had already received the an adequate explanation to my question from the other defender of the ER nurses. I have no problem with the ER. I have lots of friends that work there. Since I do not normally work in the ER, I am not familiar with the routine. I just know when the ER calls to inquire about bed availability and gives me a name of the patient to be admitted, sometimes hours can go by before they are admitted. And then all of the sudden it has to be NOW! If they know they are going to admit, they should go ahead and do it. I believe also that I had defended the urgent nature of the ER nurse in one of my earlier post. You can find it in this thread if you like to know what I really think. Some folks on this forum seem to want to argue more than talk abouit technical things that might help improve one another's practice. I of ocurse do not mean anyone that has posted in this thread however.
This was entertaining.
~Mi Vida Loca~RN, ASN, RN
5,259 Posts
ER nurses ARE COOL! LOL So are tons of other nurses, Peds nurses are pretty cool too! I have worked with some rocken Float nurses as well.
The personality you describe though is individual, not related to a floor IMO The nice thing about being a recent student and doing my Senior Practicum on float is I got to visit a lot of floors on a regular bases in 3 different hospitals. So I got a good insight into a lot of the dynamics. The personality you described though, there are about 3 of those in my class. Each clinical we new in post conference we would have to hear how they were super student. They single handedly saved their patients from certain death from their incompetent co-nurses and doctors. Each patient they had whether on medical, or Ortho was an ICU patient that just happened to be on a regular floor and none of our experiences or patients could have possibly compared to how hard their patients were.
I have no doubt they will be exactly the kind of nurses you just described no matter what floor they end up on.