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.
You're quite welcome, I think I picked it up from my E.R. years- unfortunatly it hasn't worn off yet.
Seriously, I think name-calling and disdain are strong words. Look we all know "those" nurses. No matter what specialty. It's just been my experience that most I've met were E.R. nurses. I KNOW THAT'S NOT EVERYONE'S EXPERIENCE! Just mine. I've never claimed to be the one who KNOWS ALL, nor does my experience define a specialty. I'm just one opinion in the whole picture. I'm not claiming anything but my opinion. I'm also kind of upset that my hospital staffs the E.R. with more nurses than any other Dept. (Perhaps maybe I've had it easier than most ED nurses- oh well, I'm catching it on the floors now.)
"I'm also kind of upset that my hospital staffs the E.R. with more nurses than any other Dept."
Where the heck do you work where you have MORE nurses and not being short every night???? GEEEEEZZZZ!!!!
It is not the 3-5 mins it takes to get report. Its the 1 hr it takes when that pt hits the floor. We all have different priorities. For the ER nurse it is to get the pt to a unit as quick as possible. For me it is make sure that my other pts will be ok while I get that new admit. No that does not mean spoon feeding a pt but it does mean that none of my other pts need immediate intervention. We all need to have a little more respect for each other. And maybe an admit team.
What patient that is on the floor needs IMMEDIATE (read: emergent) intervention during your admit? If you had an emergency, then your admission could be delayed or another nurse could help you out with your admission or your immediate intervention.
When a patient is on the floor, after they've been in the ER, the IMMEDIATE things have been done. All stats have BEEN DONE. Other than a new problem arising, what couldn't wait? And one HOUR for a new admission? Seriously? I mean, really. Who has that much time to take on one patient that isn't a critical care patient?
What patient that is on the floor needs IMMEDIATE (read: emergent) intervention during your admit? If you had an emergency, then your admission could be delayed or another nurse could help you out with your admission or your immediate intervention.
When a patient is on the floor, after they've been in the ER, the IMMEDIATE things have been done. All stats have BEEN DONE. Other than a new problem arising, what couldn't wait? And one HOUR for a new admission? Seriously? I mean, really. Who has that much time to take on one patient that isn't a critical care patient?
At my hospital they have 8 hours once the patient gets to the floor to complete the admissions assessment paperwork (if the admit nurse didn't do it already). As long as the paperwork gets done within that window, it's all good. Sometimes it can be quite time consuming- the assessment, orienting the patient to the room and rules, getting the paperwork in to the floor's system that is not the same as the ED system, checking admission orders, sending admission meds and home meds lists down to the pharmacy and handwriting the meds in to the kardex (if the unit secretary is busy)....It's much more involved than what I do with a new, stable patient in the ED. But it's also not the end of the world if that stable patient hangs out for 30 minutes with only a quick hello and eyeball before getting in to it all.
Alright. Allow me restate this in a hopefully less "offensive" way. I have worked in E.R.s for a few years. In my experience it is easy COMPARED TO floor nursing. I did not say it was EASY, easy is a comparitive term. Like, "walk in the park". It's not a LITERAL walk in the park, but it's a metaphor.
I'm not attempting to be condescending, and obviously, there are exceptions to EVERY SITUATION. But, I meant, for the most part, in my experience, it's EASIER, than floor nursing. Some circumstances, some days may find it much harder than floor nursing, some circumstances, some days find it much easier than floor nursing.
If you think I'm wrong, why be offended? What's so disrespectful about an opinion anyway? I didn't demean your ability! O.K.
Thanks, leave the drama for the E.R., it provides great entertainment.
If that's what you call drama then you must lead a very boring life.
You start your shift at meal time, did you think about that? I'm not saying it's one departments fault, you need to look at it from both sides. So the patients we already have on the floor should take a lower priority than those that are coming up from the ED? Even if there is urgent nursing attention needed elsewhere?
So we shouldn't expect to call report for 2-3 hours around meal times? Please!
I have worked In almost every area. In My opinion, ER nurses do have attitude, have good prioritization skills, and are mainly concerned with moving the patient out, it can be a fun area if you fit in. ICU nurses think they are the smartest, and may well be and work well as a team (mostly) but can be arrogant. OR nurses are elite but are slowly being replaced by techs so they keep their negative thoughts to themselves while they are busy thanking their lucky stars. PACU, outpatient, GI, cathlab -- feeling lucky and happy they are not working the floors. MED SURG and TELE - overworked overstressed and under appreciated.
Kudos, my dear. I am a M/S nurse who dare anyone to walk in my shoes too. I volunteer to float ER anytime. ER to is very convenient MS floor with MD around to attend your need, no waiting for pharmacy, no phone call necessary with less patient. what is the percentage of real emergency that came to the ER? anyone know in a given night. I will tell you one thing a M/S nurse can survive anywhere. ER ICU pacu bring it on. we will have plenty time to focus.
Regardless of the percentage of real emergencies in the ED, ALL of them go to the ED, and one ED nurse might have 2-3 of them at the same time, and that will happen much more frequently than the m/s nurse will have one true emergency.
Oh yeah, and I have walked in your shoes. Well, not exactly. I used to float to any floor in the hospital except for OR and OB, but because I wasn't "core" staff on the m/s floor, I always got dumped on by the m/s nurses. I would consistently get more and sicker patients than the others, my assignments would be spread out all over the floor, and only one time did I ever get any help with my patients from those other nurses in a year and a half, including the charge nurse, despite me helping everyone else. I never even knew that the charge nurse on the m/s floor doesn't take an assignment until I after I quit working there. So I think I have a pretty good idea what happens, or not, on the floor.
I have worked In almost every area. In My opinion, ER nurses do have attitude, have good prioritization skills, and are mainly concerned with moving the patient out, it can be a fun area if you fit in. ICU nurses think they are the smartest, and may well be and work well as a team (mostly) but can be arrogant. OR nurses are elite but are slowly being replaced by techs so they keep their negative thoughts to themselves while they are busy thanking their lucky stars. PACU, outpatient, GI, cathlab -- feeling lucky and happy they are not working the floors. MED SURG and TELE - overworked overstressed and under appreciated.
Just my two cents.
Lol.... irrational rationalizatios.... states and joint com mandate that there be one RN per patient in OR. I challenge any of you m/s tele guys to do sedation on these sometimes quite critically ill patients in gi/cath lab with a physician in the room that usually can't even work an ambu bag much less a lifepak 20. Lol. I would also challenge you to come work in the OR but that is an entirely different skill set. However try some pacu nursing for a day or two.... I have worked in all of these areas and m/s is nothing in comparison to them.... you loose an airway real quick in these settings anyour patients crash real quick, you always have to be in a code mindset and on top of your game or you can have someone die real quick.....
How simple is that? The concept simple to me. OH! Don't let anyone else read this- this might beat me out for being "the most disrespectful thing I've heard from a fellow nurse".
What a fireball thread. Seems every country has their "target" speciality accused of putting its nurses on a pedestal. When I was in the UK it was ICU, here in France it's OR nurses.
Isn't the reality that every speciality has its difficulties and its conveniences? Don't we all have core skills and then specialist skills we develop wherever we work, ER, OR, geriatrics, pshych, oncology etc.? We all have things we can learn from each other. No speciality is the speciality of supernurses, and while a minority of nurses in certain areas think they're better than others, they are a minority so let's not tar everybody with the same brush. Most of us recognise we have different skills and can all learn from one another.
A little solidarity anybody???
Apparently not according to some. But that's ok. I would rather work an "easy" job and get paid more than the nurses on the floor who work their behinds off!
that is a hasty generalization. not all er nurses deal with floor nurses this way. it is entirely specific to who the nurse is, the floor, and the patient/scenario. there are some raging er nurses, just as there are some raging floor nurses who are all about the bm questions on a patient being admitted with cp/mi. really. some questions that totally waste our time, such as skin status on a young, ambulatory patient being admitted for a headache.... when we're trying to be quick, efficient, and get the patient out because we have fourty patients in the waiting room and ambulance patients lining up in the halls with no nurses available to take care of them. do you have to deal with that on the floors, i ask? do they admit patients to a hallway spot until "someone" can take care of them? no.
things are very different in an er. some nights are crazy and chaotic, sometimes not. sometimes we are neck deep in a c-dif patient, as well as out of control etoh'ers who are trying to elope, while also dealing with patients on call lights every 2 minutes with very needy families.
i get that sometimes floor nurses are mistreated, i really do. not all nurses are created equal and it's unfair to assume some are stupid or smart. assume they can all do their job until they prove otherwise. sometimes a nurse opens their mouth and removes all doubt about their lack of common sense.
i find that doctors that hang out in the er to admit patients tend to talk poorly about floor nurses because they are called about every little thing (including a temp of 99.0 at 0200 and wanting tylenol, i kid you not). i remind them that their orders call for those parameters. i think what the docs get frustrated about is when some floor nurses don't use their clinical judgment prior to calling the doc. maybe the nurses don't feel comfortable or able to do that, i don't know. i do know, for myself, that when i worked on a floor, i did not have the ear of physicians like i do now. they are willing to listen to what i think is going on with a patient when they're in the er talking to me.
as far as the anger between er and other floors go will never change. unless you have walked in my shoes, you don't get it. you never will. i, on the other hand, have walked in your shoes, and let me tell you this: er is harder. scarier. more chaotic, less controlled. sometimes a bit looser when the waiting room is empty or have some empty rooms, so there are less ears to hear when you cut up.
next time you deal with an er nurse, keep in mind, they might be stressed out too. we have pressures to get patients out of rooms and upstairs the second the room is ready. they chomp at the bit to get the next patient in the room, often putting the patient in the hall next to the room so you can start treating them. do you do that on your floor?? i don't think so.
easy to judge when you haven't walked on my wild side. try it. for at least some perspective.
How dare you!
MassED, BSN, RN
2,636 Posts
Freakin' hilarious.