Because... there will always be small-minded, selfish people in the ER and the floor that think the most important thing happening in the WHOLE world is what is happening to them right now. I don't know about it from the ER side, but here is the floor perspective:
We can be caught up ALLLLL day... maybe even what you would call qoute-unqoute "slow", but it NEVER fails..... at 6:30-7:00 pm, there WILL be a patient brought up from the ER and planted in the hallway in front of the nurse's station. Oh no... don't ask the nurse/transporter/resp therapist/dietary worker/maintenance worker to simply push the patient into the room and STOP... Merely taking the patient OUT of the hall so that the nurse can get into the room from closing charts, finishing up meds, checking on procedures getting done, clearing IV pumps, gathering I/Os, finishing "Hand Off Communication Checklist"s (i.e. "Patient Short Stories"), update the REAL report sheet, while checking sporadic beeping pumps, calls for ice, calls for bedpan/bedside commode, etc. NNNOOOOO... wouldn't dare ask them to do that... not even the little "play" nurse that is down there that is the Head Doc in ER's "wittle girl" who has taken boards 7 times and failed each time but still manages to work in the ER in the "Nurse" role MINUS the "Nurse" work.
Now, to be absolutely fair, I understand the ER is busy... I understand that it is a whole different kind of busy all together. I also understand that it is not necessarily the nurse's fault (sometimes the docs). HOWEVER (and a big however) ALOT of it could be helped with a little thing called "COOPERATION", which, I dont know about other hospitals, most nurses in our ER are seriously lacking, as well as basic interpersonal skills. In other words, they do not have the ability to "play nice". Which becomes a problem when I, especially as Charge have the tendency to not take the stuff I just spent an hour cleaning off the total care turn Q2 h NH patient down the hall's booty for the 40th time today off of many people, if any. You ARE NOT better than me because you work in the ER. You ARE NOT entitled to special "rules" because you work in the ER. You DO NOT get any more leadway, or respect, from me because you work in the ER. I give everyone the same amount of basic human respect that I would want shown to me....that is, until you do something (like act like the hole the stuff I just cleaned off the total care turn Q 2h patient down the hall's booty for the 40 th time today came out of) that makes me rescind that respect from you.
It would be wonderful...absolutely peachy-keen-oh-boy, if everyone in the hospital all walked around with smiles and sunshine and rainbows in there pocket with a piece of cake made out of baby's giggles and angels wings, always getting along, never passing without a smile and a kind word, and ALWAYS helping out wherever needed. But the truth of the matter is: they won't. Can't. Because we ALL, on the floor, in ER, in Radiology, in L/D, NBN etc, are OVERWORKED, OVERWORKED, OVERWORKED!!!! We have too many patients, too sick patients, not enough equipment, not enough help...not ENOUGH TIME to sufficiently carry our load comfortably... (You notice I said comfortably not preferably. Meaning, "making it", not "having it our way, all the time, or the highway".
Like it has been said before, need rule about not being able to put off report, and not being able to transfer patient between 6:30-7:30 am/pm UNLESS going to ICCU, Surgery, L/D or somewhere they need to go THEN.