Flamed during report.

  1. I just need to vent a little because I'm feeling pretty beat down right now. I love my job in PACU, but some days I feel like every nurse in the hospital absolutely hates me. I try to always be considerate and professional to everyone when giving report, but many times, and today especially, I get flamed by nurses when I try to give them report on the patient they are getting. I can't help it that I'm sending you a patient, it's my job! And I can say that, because I used to be a floor nurse in general surgery and I used to get post-ops from PACU one right after the other too. I know what it's like. I know they think I don't, but I do. At any given time when they are getting slammed with patients from me, I too am getting slammed by the OR. I can't hold the patient for you, even though I'd like to sometimes. It just isn't possible sometimes. Please don't take it out on me when it's totally out of my control. And if I've tried more than 3 times to call report and the nurse still can't take it, then I have no other choice than to just bring the patient over and give a verbal report. I don't enjoy doing that, but once again, out of my control. OK. I think I've said my peace. Do any other PACU nurses feel the same way? If any floor nurses read this post, please reply and let me know how you feel. I truly admire you guys for the excellent work that you do. We all just need to stick together and focus on who really matters, the patient. Have a great week everyone!
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    About gentle_ben_RN

    Joined: Mar '06; Posts: 120; Likes: 22
    Specialty: 6 year(s) of experience in general surgery/ER/PACU


  3. by   seva
    Okay, already tried to post a response. Here goes my second:

    Just remember that we Med-Surg nurses tend to get slammed at/near shift change. We are usually juggling mx patients/demands/medications etc. We tend to get stressed out by admissions on top of our other, sometimes overwhelming, obligations. ("Mother needs another blanket/fresh ice/coffee for her guests") on top of scheduled meds/treatments, etc.

    Bearing all that in mind, you're just doing your job. Try to let other people's stress roll off your back. Call your report, do your best, and don't let the rest bother you. Yes, we med-surg nurses can be under a great deal of stress, but that doesn't have to affect you. Be flexible when you can, be professional when you should. Think of others and do your best.

    You're right when you say we have to stick together. We are all just nurses, part of a larger system, trying to do our jobs.

    Good Luck!

  4. by   RN34TX
    You are not alone in this.
    I too, started as a med/surg nurse but it doesn't mean a thing to them. They only know you now as a PACU nurse trying to slam them with patients along with the ER nurse who just sent them one and the ICU nurse who is coming down the hall with yet another new patient for them.

    For the med/surg nurses, the patients often do come "all at once" just like the OR does to us. The difference for us is that we can only take two patients max.

    When a select few of the notorious floor nurses at my hospital try to get dirty playing games in an attempt to dodge patients or give me a hard time, I try to think back to my med/surg days and what a miserable job it could be for me.

    Why the burned out ones don't move on to another area is beyond me, god knows I'd never work the floors again, but I guess some just choose to stay there because they are afraid to be the new kid in another specialty.

    Believe me, it gets on my nerves as well but I try to be understanding as most med/surg floors are understaffed and the nurses are given heavy and unrealistic patient loads and it's not right.

    I truely feel for them even when some get snippy or flat out lie to me about a room not being clean or ready. It's hard some days, but I try to keep my cool as best I can.
  5. by   jsully13
    I never worked on a Med/Surg floor, but I did work in SICU before PACU. It does suck to get admissions, but it has to be done. I was never able to say "Can I call you back in 5 minutes?"

    I think a big problem is that the majority of med/surg nurses (the ones that haven't worked recovery) don't know exactly how things work in the PACU. If they saw that we get slammed sometimes like they do maybe they would be a little more understanding.

    We've started doing a thing called a "Room Reservation". We call as soon as we get our patient settled in recovery and give a little 30 second report to either the nurse that will be getting the patient or to the charge nurse to pass on. We give a little basic info (IV side, drains, O2, etc.) AND we give an estimate of how long it will be until we call report. This does 2 things- It gives them the opportunity to tell us if the room is not ready AND they have an idea of when we will be coming in order to prioritize. Then there is the nurse who ALWAYS starts a bath 5 minutes before we are planning to call report...Oh well. It is what it is.
  6. by   sabadao22
    hello just want to ask is it difficult for a foreign nurse to work in OR/pacu?
  7. by   jsully13
    The girl I work with on the evening shift is Filipino. She works in the OR, and I work in the PACU. She is fairly new (she started about 6 months before me). I don't think she had a harder time than anyone else during orientation. Hope this helps!!!
  8. by   RN34TX
    Quote from jsully13
    I never worked on a Med/Surg floor, but I did work in SICU before PACU. It does suck to get admissions, but it has to be done. I was never able to say "Can I call you back in 5 minutes?"
    I've worked med/surg and ICU long before going to PACU and I was never allowed to stall admissions or transfers either, so I too have difficulty in understanding this.

    It goes on where I work now but I've been a nurse in other cities/states around this country and if I ever attempted to stall the PACU or ER they'd be paging the administrator stat and I'd be in big trouble.

    The most I could have ever hoped for in those days was to tell PACU "Hey I'm getting an admit right now from ER, can you please drag your feet in sending up your patient?" and just MAYBE it would buy me an extra 10 minutes between hits.
  9. by   muffie
    your nm needs to talk to their nm
  10. by   Nursonegreat
    i have experienced the floor rath as well. the floor would have sections divided up by room numbers, not by acuity or vacant rooms. so one nurse could get 3 PACU pts in a row and others nurses none from PACU. they would sound overwhelmed and we would have to space the pts out. well, i can empathize with the nurses but i cant help that your floor is run in a most idiotic way. the nurses who get all the admits have to confront the NM and rearrange how they do shift assignments. i have worked where it was divided as equal as can be, admits, ER or PACU were alternated between everyone and never ever ran into a problem. they dont seem to realize that if we dont move PACU pts, then the OR cant bring the pts out to us...we in the PACU cant say to the OR, can u hold that pt while i settle this pt. PACU seemed to have the least amount of "power" if u will...we could never stop up the OR but we also had to cater to ever single other dept...very very very frustrating. didnt help that our NM was a major moron and no help at all. seems this goes on alot tho.

    we did have a few nurses that shot around the PACU transfers...after a length of time we would just ask for the charge nurse and say, listen its been 45 mins we been holding this pt and we are desperate, u will have to take report for nurse x....amazing how that nurse was always able to take the pt at that point. oh well.
  11. by   dali92
    I have also worked both sides, & I do try to be understanding when sending M/S a new post-op. I have held patients when able- but my experience is some floor nurses will take advantage of that- I'm told "the nurse will call back in 10 min" & then it's 20 min. later & I'M calling THEM again to see if they're ready yet. It becomes a game, as if the floor nurse envisions the PACU nurse sitting there filing her nails w/her one or 2 patients! It gets old to hear that the nurse taking that patient is at lunch (who is watching her other patients then?) & that it's shift change & they're "all in report"- yeah okay, but what if a patient needs something? Since report is taped, you can always go back & listen once your patient is settled- been there, done that. Some of my coworkers have resorted to calling the supervisor, particulary for the "room isn't clean" excuse. We are not sending unstable patients w/out of control pain- & when assisting w/transfer of the PACU patient from the stretcher to the bed, it is a little uncomfortable for the patient sometimes, so please don't ask us "Have you given ANYthing for pain?" One point that the floor nurses can't seem to fathom though, is that (at least where I work) PACU nurses are on call Friday from 3:30p.m. until Monday at 7 a.m. & we are expected to be at work Monday, even if we were there t 3 a.m. for a c-section. Yes, I can hold your patient for a few minutes, but please remember that we want to get home & try to get a few hours of sleep b/f coming back when you are getting to go home.
    Last edit by dali92 on Feb 3, '07
  12. by   dali92
    One thing that has seemed to help, is our NM met w/the floor NMs & supervisors about expediting transfers, and now the supervisors are to be called if the floor nurse is not able to accept a patient- this has made a HUGE difference & cut way down on our "hold" times in PACU; and amazingly the supervisors hardly ever have to get involved.
    Last edit by dali92 on Feb 3, '07
  13. by   deehaverrn
    I work in an OB unit which has its own OR and Pacu. We always had to hold our pts until postpartum was ready whether it was vag deliveries or postops. I was once reported by the postpartum unit when I brought them a post op at 0100, who had been discharged from PACU at 2230. The bed was clean but they had to give shift report and then the night shift needed to finish rounds.. The pt was uncomfortable on the stretcher, she was large and edematous and actually had deep grooves in her arms and legs from the stretcher rails. I was reprimanded despite the fact that another labor nurse and I completely settled the pt in to her bed before even getting the postpartum nurses..and we had given them one of our staff nurses to assist them for the entire shift!! So I know where you're coming from. Also, I would work 12 hour days without a meal or break, have a pt deliver at 1700, then the charge nurse would tell me I needed to get her transferred before leaving, I would transfer at 1830..then be made to start a new admission or cover someone else for a meal! And the postpartum nurse would give me grief.
    On our high risk unit we sometimes get med-surg overflow. One problem with this is that the admissions office will not always have all the facts so they will assign us pts which are not appropriate for us, or that we need to change rooms around to accomadate. (We don't do telemetry or have experience in chemo or triple lumen caths or stuff like that...just like med surg doesn't know how to do fetal monitoring) Its not appropriate to double a room with a postpartum patient who has a newborn in the room and someone with a contagious disease. Putting a pt who just had a VIP in with a preterm labor pt doesn't work. Sometimes it takes more than 10 minutes to figure stuff out..so please be patient. And when we tell you that this pt is not something that can be sent to our unit, we're not just trying to get out of work. The patient needs to be somewhere else..for their own good! I admit I haven't done med surg in 15 years...and they didn't give us any refreshers when they decided to start dumping this stuff on us.
    And also, please don't send us pts who are screaming in pain, and who the transport person confirms was doing this when she was picked up in PACU. I realize that sometimes this happens because of the transport movement or because the last med wore off..but I'm not stupid. And now, I have a pt in pain who is PO'd along with her family member and only has oral pain meds ordered for me, while the PACU had IV stuff on their orders but hadn't given anything.
  14. by   natsfanrn
    As a surg floor nurse, I truly try to understand the pressures the PACU nurses are under and be ready for PACU admits. but please, a few thoughts from our side...

    1. If you call and say you're bringing a patient up in 10 minutes, please bring that patient up in 10 minutes. If something has delayed you, please let me know so that I can grab a quick lunch, do a procedure with one of my other patients, or do one of the many other low-priority things that I've put on hold while awaiting a PACU pt. Can't tell you how many times 10 minutes has turned into 45 minutes or an hour or more.

    2. When you give report, we really don't need to know how many mics of fentanyl the pt rec'd and when he rec'd it. If it's something we can't give on the floor, we honestly don't care...and it takes forever to wade through that to get to the part that we DO need to know (we tape report here, so prob not as applicable for face-to-face reports).

    3. Please premedicate the pt as much as possible for pain/nausea; even if the pt hasn't had much of either in the PACU. More often than not, the transport will make even the most comfy pt hurt/nauseous, and when they get to the floor, we have to wait 15-20 minutes or more for pharmacy to get the floor orders and get them into the system.

    4. Do understand that it's difficult to provide a safe transfer of care at shift change and/or when we get multiple admits at once. We want (and are required) to be in the room when a post-op arrives, and we can't if we're still getting report on our other 5-6 patients. Even the most stable patients can take a bad turn after transport, and we need to be able to give them our full attention when they arrive.

    As someone else said, we're all on the same team. Now let us floor nurses know what else we can do to help make your lives easier....