Radiology tech: "this patient has q0600 portable chest X-rays part of his old ICU order set. They normally DC these but they didn't DC his. Do I really need to do this?"
#2:
Me, to a different radiology tech: "we just discovered he might have foot fractures and I'm putting in orders right this exact second. Do you mind grabbing images of his feet while you're here?"
Rad tech: "the order wasn't already in so your, have to get that later."
Me: "the order is in right now."
Rad tech: "no."
Two seconds later, does the images anyway, because she realized it meant she'd have to come all the way upstairs again.
#3:
Respiratory: "Earlier MD asked for a different patient to have ABGs done at 0800" (after RT's shift would be over) "so we can just do this patient's in a few hours, too, right?"
#4:
Lab, after walking the whole unit to find me: "that patient has a PICC, why can't you draw her?"
Me: "I don't have orders saying I can."
Lab: "I saw her get drawn off that line last week, you need to draw her."
Me: "her line isn't being used for labs. I don't have an order saying it can be. I CAN'T use it. You need to draw her."
If it weren't the same people trying to get out of their orders every time, I'd figure they were just confirming things, but I am absolutely convinced they're trying to get out of doing their job, and they're trying to get the RN's "okay" so they can pass the buck to us, I am so done with this! If they want to questions orders, they should call the people writing them. :\
I'm sitting next to my mother's bed in the hospital as I type this. She's stable now but I was pretty concerned when we came through the ED - there was initial concern she was septic.
As usual, ED staff including nurses, techs, and providers were great. However there was one incident that left me shaking my head.
My mother is a notoriously difficult stick. An IV nurse and phlebotmist had attempted but only managed to get a portion of the lab work completed and no luck on IV access.
At some point my mom's nurse called phlebotomy and left a message detailing what labs were still needed. A phlebotmist showed up while the nurse was seeing to the many other things she had going on. I was leaning against the counter typing on my laptop - a few meds had changed and I keep my mother's med list so we can print it out but I needed to update it.
The lab tech asks me what labs still need to be done. I'm pretty sure that was in the message the nurse had left but I tried - and failed - to remember what I'd heard her say. I told the tech i wasn't sure and she got an irritated look on her face and said something like "Can't you check so I don't have to come back?"
I looked down at my snug black capris, bright pink tee shirt and comfy Skechers and then looked at the phlebotmist and told I wasn't the nurse. (Who was, shockingly, wearing scrubs in the color mandated by the hospital.)
I don't know if the tech actually thought I was the nurse and was just out of uniform or if she thought it cool to ask to ask a family member to do her work for her but sheesh. That was a little strange.
Thankfully like I mentioned, the ED staff are pretty great so I wasn't really upset just confused. Lol. And yes when I worked on the floor lab and radiology liked to call and ask if the orders for draws ans Xrays etc. were really needed. Ugh.
Don't have to worry about lab techs trying to get out of drawing a patient. We don't have any, it's always either nurse or nursing tech draws.
What always gets me is the radiology department calling and demanding I transport a patient to them for an 0600 X-ray. Uh, no. I have 5 other patients, and every single one of the 6 has not only 0600 but also 0700 meds and I have to get ready to give report at 0700, order 2 breakfasts for patients who can't read/see, get 3 people up in a chair, and d/c a foley. You'll have to transport that patient yourself.
I'm always astounded by the RTs who change the doctors' orders. How did q4 inhalation therapy and O2 saturation checks suddenly change into PRN?
Yes absolutely. But what about bodily fluids? Puke, poop, pee? Those are the things that I don't see why they can't be involved.
I have not come across housekeepers who refuse to deal with body fluids and I can not understand the rationale. Is it possible your housekeepers made up their own policy or put it in the union contract ?
I would have to investigate if a housekeeper refused to clean body fluids because they have the mop and supplies and we don't.
I have not come across housekeepers who refuse to deal with body fluids and I can not understand the rationale. Is it possible your housekeepers made up their own policy or put it in the union contract ?
I would have to investigate if a housekeeper refused to clean body fluids because they have the mop and supplies and we don't.
Ours will not remove NGT canisters period. If something is extremely soiled, they expect us to attempt a clean first so it's not so bad for them. They don't wipe down IV poles/pumps, keyboards/computer, or SCD machines. That's supposedly their policy. Found a used trach disposable inner cannula in a patients bed once (lodged between the bedrail) so apparently they don't always clean well what they are supposed to clean. This was a 24 year old patient who did not have a trach.
They so help themselves to food in our break room without asking, especially if we have had a potluck.
Sorry, half of this is me venting again. I am sick of being nurse, phlebotomist, RT, PT, therapist, and housekeeper all in one.
We are not supposed to use PICCS for line draws for multiple reasons, but the biggest one is CLABSI. PICC lines are supposed to be closed systems. Only accessed if absolutely necessary.
Mostly the folks I work with are wonderful people who go the extra mile to make sure our patients are well taken care of and don't leave a huge mess for someone else.
However. There are always those fewe rotten fish that stink up the barrel.
The particular individual I'm thinking of is a PT, who has no business being a PT at all. Alongside expecting help to get a 'Up with assist of one' patient up, she would expect the nursing staff to have the patient ready and sitting on the side of the bed for her when she was ready to show up. She would turn the call light on and wait until someone came to answer it (sometimes, unfortunately, a very long time later since, you know, busy floor and lots of other patients AND being chronically short staffed) and ask for a blanket. Or a pillow ('It's on the windowsill behind you; what, too hard to turn around?'). Or say, "The nurse will change your bed while we go for our walk, won't you?" *sickly sweet smile, knowing that she's just trapped me even though the patient's not even mine and I have stuff to do*
My favorite PT story, though, was the one where I was in an isolation room holding a basin for a patient who was actively heaving with some of the worst nausea I'd dealt with thus far in my career. This PT pushed back the curtain and said to me, "Well? I'm waiting. I need your help with Mr. X." "Fine," I replied, knowing that Mr X had just had joint surgery and might, legitimately, be an assist of 2, "get him ready and I'll be there when I'm done here." Helped Ms Nauseous get cleaned up, gave her some mouth rinse, made sure she wasn't going to explode again, asked a coworker to grab some anti-nausea meds for me - about ten minutes of TLC. I come out and before I even wash my hands, the PT is on me demanding to know what took so long. I say nothing, and we go to Mr X... who is still in bed, hasn't been shifted, no immobilizers or even a gait belt or walker in the room. The PT said, 'well, go on, get him ready!'
I gave her a look that could have peeled paint, turned my back, and left. I refused to be in the same room as her after that; if she was assigned to my patients, when she called to tell me she was going to be coming at a certain time, I told her to be sure to bring a PT assistant with her, because there was no one on the nursing staff who had time. She was reported several times for her laziness; to my knowledge, nothing has been done. I told my NM straight up (when the PT reported ME for my refusal to be a team player) that I didn't have time to be a nurse AND a PT, it wasn't my job, and she could bring her own assistants since she knew very well that these heavy patients she kept signing up for were beyond her capability. I didn't hear a word about it after that.
Actually, no, I lied. My favorite story was when she was walking a deaf man down the hallway. He was on a walker, and the video interpreter was being wheeled in front of him so that the things the PT was saying could be translated for him. The PT kept asking him questions ("what kind of home do you live in, how many stairs, do you have someone at home to help you," etc), and when he would stop and lift his hands up to reply, she would screech, "Don't let go of the walker! Don't let go of the walker!" He finally gave her a piece of sign language that needed no interpretation and proceded to ignore her. The nursing staff chuckled over that for days.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I thought of this thread tonight after I've been wrestling with a demented patient who somehow managed to pull out his Foley, his art line, his NG tube and his PIV. After I replaced the Foley, the NG, the PIV and assisted the provider with replacing his art line, I sat down to chart. Miraculously, his trach had stayed put. About that time, though, the ventilator began to alarm. The RT is sitting down next to me, watching a movie on her iPad -- exactly where she's been the last two hours while I was busy taking care of the patient. Do you THINK she'd go see why the vent is alarming? Even after I ask her nicely?
The only department that has really ever given me grief really is housekeeping, I am sad to say. I adore some of the housekeeping people that I have worked with...but some seem to resent having to do things like empty the trash or mop a sticky floor even if I have already cleaned up the bulk of whatever bodily fluid was spilled there. And woe to the nurse that doesn't strip the bed or remove the patient's old food tray from the room before housekeeping comes to clean after discharge. Frustrating
Housekeeping is a tough job, yes, but it is so important that they don't skimp on their responsibilities. I hate seeing posts like these where EVS was too lazy or didn't care enough to do a good job. It can be a thankless job at times, but also one that you can get a lot of satisfaction out of it you just do a good job. I used to work in a hospital as EVS and then linen, and I always tried to do my very best and take pride in my work. It's unfortunate that not everyone feels the need to do that though, because it gives the ones that do go above and beyond a bad rep. I will say I was always super appreciative if the nurses or aides took time out of their busy schedules to empty trash or soiled linen, and especially if they stripped the bed and cleared some of the stuff out of the room after a discharge. Thank you for doing that for your EVS crew!
Slightly off topic but since several other posters have mentioned it... Does anyone know why housekeeping won't/can't clean body fluids when they turn over a room? Or bags on IV poles? Our environmental services staff won't touch this stuff. What's the difference from taking out an NGT canister (oh no!) and having to mop up a pool of diarrhea off the floor (which they can do).
I just don't get it. I feel they should be trained on dealing with any body fluid or waste that they encounter in the hospital. Instead they basically 75% clean a room and leave the yucky stuff to us (if we have time before he ED sends that new patient up!).
I can sort of get it with the IV bags... They aren't trained to know what can and cannot be harmful medications. But they should be trained on all body fluids.
Sorry, venting here :/
It's odd to me that EVS doesn't do that stuff where you work. When I was working in EVS, we were expected to do that and trained to deal with hazmat, bio, chemo spills, sharps... anything and everything... That was part of the job. If we weren't sure about an IV bag or canister, all we had to do was ask and then take care of it if it was something that we were allowed to handle. Sorry that you have to deal with that. :/
Well, I kinda feel lucky. I can't say I have too many complaints from our ancillary departments. In the ER, the two main departments we work with the most is radiology and housekeeping.
Radiology most of the time will call our voceras and ask if the patient is ready for xray/ct/us. My biggest complaint with them is taking patient off wall o2 and using the portable o2 on the bed and then leaving the patient on the portable when they return the patient to the their room. I feel that is indicative of additional teaching on their part rather than pawning off their work onto us.
Housekeeping is probably where I have the biggest complaints. We have 1 designated housekeeper per shift and they also seem impossible to find. Not all of them are like that though, there has been an increase in new staff. So perhaps its just not properly training rather than them intentionally not doing their work.
Our housekeepers will NOT touch anything human waste - no matter the circumstance. Anything like used suction tubing or canisters, ambu bags, even urinals and emesis containers. I understand then not touching IV bags and tubing - thats fine - It'll take me 15 sec to get ride of those. Other than replacing the trash and floors - I don't think our housekeepers in the ER do much to the patient rooms. We have to clean the rooms ourselves and dress the bed for the next patient.
We really don't work with the other ancillary departments very often. In the ED, we do everything ourselves. Being so independent from others, there really isn't too much to pawn off on us that isn't already something we do.
Nurse Leigh
1,149 Posts
I'm sitting next to my mother's bed in the hospital as I type this. She's stable now but I was pretty concerned when we came through the ED - there was initial concern she was septic.
As usual, ED staff including nurses, techs, and providers were great. However there was one incident that left me shaking my head.
My mother is a notoriously difficult stick. An IV nurse and phlebotmist had attempted but only managed to get a portion of the lab work completed and no luck on IV access.
At some point my mom's nurse called phlebotomy and left a message detailing what labs were still needed. A phlebotmist showed up while the nurse was seeing to the many other things she had going on. I was leaning against the counter typing on my laptop - a few meds had changed and I keep my mother's med list so we can print it out but I needed to update it.
The lab tech asks me what labs still need to be done. I'm pretty sure that was in the message the nurse had left but I tried - and failed - to remember what I'd heard her say. I told the tech i wasn't sure and she got an irritated look on her face and said something like "Can't you check so I don't have to come back?"
I looked down at my snug black capris, bright pink tee shirt and comfy Skechers and then looked at the phlebotmist and told I wasn't the nurse. (Who was, shockingly, wearing scrubs in the color mandated by the hospital.)
I don't know if the tech actually thought I was the nurse and was just out of uniform or if she thought it cool to ask to ask a family member to do her work for her but sheesh. That was a little strange.
Thankfully like I mentioned, the ED staff are pretty great so I wasn't really upset just confused. Lol. And yes when I worked on the floor lab and radiology liked to call and ask if the orders for draws ans Xrays etc. were really needed. Ugh.