Patient Transfers.

[sparkplug]

When you are either transferring a patient from the ER or receiving one from the ER what specific behaviors demonstrate a lack of cooperation? I know we get pateints who are wet or had now orders that were not done. What is it like at your place and how do you handle it?

[suzanne4, RN]

It can depend on the facility............in many if the now orders are written on the admit order sheet, then they are done when the get to the floor. They are not required to be done in the ER.

Best bet is to check out your facility's policy. It should be documented somewhere. It also depends on how long that the patient has been in the ER.

[stidget99]

My biggest pet peeve is getting someone from the ED and they are wet/soiled. Another is if their IV is occluded.

[Aneroo, LPN]

I bet if folks on the floor answered the phone and take report when we called to give report, so we can get that pt out of the ER, they'd come up clean and with patent IV's. The ER is beyond hectic sometimes- breathing comes before the poop. -Andrea

[LeahJet, ASN, RN]

I bet if folks on the floor answered the phone and take report when we called to give report, so we can get that pt out of the ER, they'd come up clean and with patent IV's. The ER is beyond hectic sometimes- breathing comes before the poop. -Andrea

I hear ya.....! :chuckle

[begalli]

If something was written for in the ED but wasn't done, we don't do it until a new order is written by the ICU docs. Usually, everything that needed to be done in the ED is done by the time they reach us. I rarely look at the ED charting unless I'm looking for something specific...report usually suffices.

The patient may rarely come up with blood products that we will hang, but not much else. If by a slim chance something hasn't been done in the ED that really really really needs doing the reporting RN will let me know and I will give a heads up to the ICU team so they can be there right away to write or speak their orders.

I try to think of a messy patient in terms of the patient's dignity and not necessarily in terms of me having to clean stuff up. So if I get a messy patient from anywhere, I may sigh a disappointed kind of sigh, but I don't get upset with anyone about it unless it's obvious that the patient had been that way for quite some time.

If an IV has gone bad, I start a new one.

Everybody's busy everywhere. Lest we forget that.

[Tweety, BSN, RN]

This is probably going to turn into a bad thread. Soon ER nurses are going to chime in with thier complaints about floor nurses not talking report, etc. It's going to go tit for tat. (edit: opps....now that I've read the thread it's already started. :chuckle )

I recieved a patient from an ER nurse that was wet she said "We're ER nurses, we don't do that". I was floored at this attitude.

But also from doing house supervision I've seen the ER and most of the time they are out of control and are dealing with critical situations, traumas, etc. They are an awesome crew dealing with the most stressful of situations.

I have no complaints. If the patient's dirty, I clean them up. If the IV is bad, I start a new one. We institute all the orders on the floor, except for consults, they have to be called from the ER. If I'm busy, they usually give me a chance to catch up before brining up the patient. Mutual respect and cooperation can go a long way. :)

[BSN2004]

I am a med-surg-neuro nurse. when we get patients from ER the ER nurses do what the ER doc orders and we do what the attmitting Doc orders. They are a give and take ER, they look over the orders that they are sending with the patients and give us a heads up, or if its UA's or Blood cultures or IV fluids they usually do them for us because sometimes the patient wont get to the floor for another hour or so after we get report- or a Doc will order a EDG, CT or whatever before being admitted so they will go there after ER, before us.

My biggest irritation for any transfer's? They call to give report at nurses shift report, they are trying to get rid of them and we cant take them yet.

[traumaRUs, MSN, APRN]

There are many threads on this topic - what about a search?

[CathRN]

I have to agree with BSN2004 on the part that says the ED and PACU call to give report as you are giving your off going report to the oncoming shift, that is so irritating. I understand that they are trying to get the patient to a bed, more comfortable and all, but when I read the orders and see that the transfer was ready for over an hour, it does get frustrating. But, as others have said, we are all here for patient care, we all get busy with a patient going bad and the transfer had to wait, but when it happens more often than not...........

[sparkplug]

I bet if folks on the floor answered the phone and take report when we called to give report, so we can get that pt out of the ER, they'd come up clean and with patent IV's. The ER is beyond hectic sometimes- breathing comes before the poop. -Andrea

That may be but floor nurses are also busy and when half of them go to supper that can leave 2 nurses on the unit for 25 patients at my facility. WHen you are answering bells, doing IVP for pain and nausea and pumps are beeping it is alittle hard to answer the phone.

But all that aside the patient should not be left soiled because you are angry with the floor nurse, patients first. And I am not implying that this is what you do, but prior to transfering a patient should the patient not be as comfortable as possible.

I have to tell you I have worked both ER and med surg and I know both sides. I just really wanted to know how you implement change for the good of the patient and to decrease the stress of the staff.

Thank you.

[caroladybelle, BSN, RN]

I bet if folks on the floor answered the phone and take report when we called to give report, so we can get that pt out of the ER, they'd come up clean and with patent IV's. The ER is beyond hectic sometimes- breathing comes before the poop. -Andrea

Again with the tit for tat.

If we do not answer the phone, it is because we are busy. As every place in a hospital. The floor is also often hectic beyond belief. The floor also puts breathing before poop ....and before taking phone calls.

But it all has to get done. Would that we all, floor nurses and ER nurses, actually consider one another (and our patients) with kindness and just DO IT!!!!!!!!!

Instead taking sniping pot shots at one another. Because trust me, neither side comes up clean.