As a charge nurse on a med/surg unit during the 7p shift, I am guaranteed to hear this at least one time each shift.
Yes, it's a busy shift; yes, I know you have another 4-5 patients; yes, I know Mr. Johnson needs his dressing changed and Mrs. Conner needs her PRN Norco...but it's your turn. You're up, everyone else has had an admit.
It's a simple fact on our floor--patient come to hospital; s/he is ill or has a surgical procedure planned; s/he is needing to be admitted; each admission needs a nurse. What is so hard to understand.
I help "my" staff lots with admits. I open and set up the room (if our aides are busy). I get all the stuff ready so you don't have to hunt for it--IV pole there; O2, Flowmeter, Christmas tree ready; tele monitor and leads there; admission kit on table; wound care supplies there if needed; NG tube or oral suction ready and waiting. And I'm gonna be in the room, so if there's something missing, I'll run and get it.
I help get the patient settled in and grab the orders.
I put the chart together, enter the orders, write out the MAR's, fill out the home med sheet and immunization sheet--if I can. The only thing I HAVE to do is put the chart together and enter the orders. The rest I do to help So basically the RN/LVN gets the patient in bed, assesses him, connects any tubes/lines, then take the completed paperwork. If there's any problems, I'll call the doc. I won't leave anybody hanging.
So that admit really wasn't that bad--half your stuff (paperwork) is done, your room was set up appropriately, all your orders are in.
I can't make it easier than that--do the computer assessment and care plan and you're done. (I do the computer stuff too, about 50% of the time).
Why is it such a big deal to get an admit? Why do you have to **** and moan about it? Why are you arguing that "it's not fair" or "it's not my turn"?
Put your big girl panties on, hush your mouth, and take the patient!
It really depends. I've worked on VERY busy med-surg floors where nurses are being piled on with seven...EIGHT patients. To me, that is just not safe. If I have five or six patients, I would NOT take a seventh on a med-surg floor (as a new grad, at least). That is just unsafe.
Back when I was a med-surg charge nurse I had to take a patient load equal or greater than the rest of my med-surg staff that consisted solely of LPNs. That said, for any new admit, I had to take the time to assess them, document it, give any IVP meds during the shift since LPNs here can't do that, and do anything pertaining to central lines, etc. This was on top of the sundry administrative tasks I had to do, plus as I was the only male in the entire hospital at night on my shift I frequently bounced to psych, critical care, and the ER helping out with "aggressive" patients or working with the code team or any other type of internal emergency. It was quite the burden, and it made me hot when the LPNs would complain that they had too many patients. I've since left that though, and my blood pressure dropped, within a week, from about 155/115 to 115/75. :)
At one point I was going to start calling the ED as soon as I got notice I was getting a patient and ask for report, and when they told me they were too busy to give report I would say "Oh but I'm ready for report RIGHT NOW and this is when I need to take report." And threaten to turn them in to their manager for not giving me report. Because that's what every admitting dept. in the hospital will do if you dare to not immediately drop everything and take their phone call.
I'd advise you not to do it. I did something pretty similar. Then got pulled into my boss's office for having a bad attitude.
Specializes in Addictions/Mental Health, Telemetry.
I work in the ER as the intake nurse for our psychiatric unit. I get all the complaints and moaning about sending up "another" admission. I can't help when the patient medically clears in the ER and only have a short window of time to get the patients out of the ER and onto the unit. Why can't any nurse take report when I call? Why does it only have to be the nurse that is assigned to that patient? Why can't the charge nurse take the report? Why does change of shift report have to take an hour and all the nurses take report on all the patients on the unit so nobody is available to take report? Really?? If we don't get admissions, we don't work, right? Come our slow season remember that when you get floated to a med/surg unit or cut! Thanks for letting me vent too!
I'd advise you not to do it. I did something pretty similar. Then got pulled into my boss's office for having a bad attitude.
As a med surge nurse the buck stops with us. It doesn't matter how crazy our shift is going we have to stop and take report and act like we are happy about getting that post-op or admission and all of the crazy charting that involves never mind that once the patient comes to the floor 9 times out of 10 you have to immediately start medicating them with pain meds and/or toileting them etc. The patient is being wheeled to the room and I hear them saying, "I have to use the bathroom". Most times it is the 2 person heavy assist that needs to pee. You can not tell me that this all consuming need to go to the bathroom happened just in the last 3 minutes as you were being brought from the ED to the floor. Sorry- just a pet peeve of mine......
When I am charge nurse with 2 RNs with me, I would usually help them as well to lessen their workload. After all, we are a team and I want to get things done in a timely manner.
As a charge nurse on a med/surg unit during the 7p shift, I am guaranteed to hear this at least one time each shift.
Yes, it's a busy shift; yes, I know you have another 4-5 patients; yes, I know Mr. Johnson needs his dressing changed and Mrs. Conner needs her PRN Norco...but it's your turn. You're up, everyone else has had an admit.
It's a simple fact on our floor--patient come to hospital; s/he is ill or has a surgical procedure planned; s/he is needing to be admitted; each admission needs a nurse. What is so hard to understand.
I help "my" staff lots with admits. I open and set up the room (if our aides are busy). I get all the stuff ready so you don't have to hunt for it--IV pole there; O2, Flowmeter, Christmas tree ready; tele monitor and leads there; admission kit on table; wound care supplies there if needed; NG tube or oral suction ready and waiting. And I'm gonna be in the room, so if there's something missing, I'll run and get it.
I help get the patient settled in and grab the orders.
I put the chart together, enter the orders, write out the MAR's, fill out the home med sheet and immunization sheet--if I can. The only thing I HAVE to do is put the chart together and enter the orders. The rest I do to help So basically the RN/LVN gets the patient in bed, assesses him, connects any tubes/lines, then take the completed paperwork. If there's any problems, I'll call the doc. I won't leave anybody hanging.
So that admit really wasn't that bad--half your stuff (paperwork) is done, your room was set up appropriately, all your orders are in.
I can't make it easier than that--do the computer assessment and care plan and you're done. (I do the computer stuff too, about 50% of the time).
Why is it such a big deal to get an admit? Why do you have to **** and moan about it? Why are you arguing that "it's not fair" or "it's not my turn"?
Put your big girl panties on, hush your mouth, and take the patient!
Thank you for letting me VENT!!!
I feel for you! I NEVER complain about getting an admit. That's why it's called "work" :)
The original poster sounds like such a great charge nurse and not appreciated by some of the employees. My charge nurses have an assignment and usually unable to help unless there is a crisis and then they have to drop everything.
I work in the ER as the intake nurse for our psychiatric unit. I get all the complaints and moaning about sending up "another" admission. I can't help when the patient medically clears in the ER and only have a short window of time to get the patients out of the ER and onto the unit. Why can't any nurse take report when I call? Why does it only have to be the nurse that is assigned to that patient? Why can't the charge nurse take the report? Why does change of shift report have to take an hour and all the nurses take report on all the patients on the unit so nobody is available to take report? Really?? If we don't get admissions we don't work, right? Come our slow season remember that when you get floated to a med/surg unit or cut! Thanks for letting me vent too![/quote']
To play devil's advocate, why do you have to give report RIGHT NOW when I can clearly see by the bed board the ER isn't full? Why is your time (and thus your patients) more valuable than mine? And, even more important, why is the system set up in such an adversarial fashion? Unfortunately it goes both ways: floor nurses who drag their feet about the admit and ER nurses who think we do nothing more than sit around waiting for their call. Both types are terrible.
Back on topic, the OP sounds like a dream charge nurse to work with. I'd work with you any day!
I work in the ER as the intake nurse for our psychiatric unit. I get all the complaints and moaning about sending up "another" admission. I can't help when the patient medically clears in the ER and only have a short window of time to get the patients out of the ER and onto the unit. Why can't any nurse take report when I call? Why does it only have to be the nurse that is assigned to that patient? Why can't the charge nurse take the report? Why does change of shift report have to take an hour and all the nurses take report on all the patients on the unit so nobody is available to take report? Really?? If we don't get admissions, we don't work, right? Come our slow season remember that when you get floated to a med/surg unit or cut! Thanks for letting me vent too!
At change of shift, we now have to do walking rounds, giving report in the patients' rooms and addressing any and all issues that they have. And if you know our patients, as soon as they see a face, they want something. That combined with the occasion of having to get report from every nurse on the floor because the charge nurse has specifically catered a special assignment for you, then that takes time, too, because everyone that you need to talk to is talking to another nurse on their walking rounds. I personally think it would be ideal if the charge nurse takes report from ER on all new admits, especially if they don't have to take patients. But what do I know? I once worked under a charge who literally did nothing but sat at the desk and ate for the entire 12 hours!!!! It was disgusting!
I actually get tired of explaining to ER nurses that, hey, I'm holding the phone with one hand and holding this patients IV with the other; I can't take report. Obviously, I'm in a patient's room and I partially let go of what I was doing just to answer the phone. Next time I will just let it ring and then the charge nurse will have no choice but to take report.
As a float nurse, I get the undesirable patients, the computer that is known to die as soon as it is unplugged, and the cell phone with tape holding the battery in place that always pops off which labels me with the title of nurse who doesn't answer the phone. What do you expect? I'm the guest on the floor and this is how I'm treated. And always having the first admission, there is no wonder, I'm unavailable to take report. Let ANY of the other nurses take report for me since, apparently, I'm there to make life better for them for the shift.
I usually don't take a patient load. But I do the help with admits, make all calls to MD's, monitor our tele (no techs), answer the phone (we get all the hospital calls after 2000), help with MAR reconciliations, do all the checklists/equipment checks, and help the CNA's on the q2 turns/changes. I answer call lights and try to help the nurses as much as possible.
If the nurses are overwhelmed, I take patients. I do really try not to screw over anyone....usually. ;-)
If you were my charge nurse, is be elated! You can send me your admissions! Continue to vent, you clearly go above and beyond for your team.
ThePrincessBride, MSN, RN, NP
1 Article; 2,594 Posts
It really depends. I've worked on VERY busy med-surg floors where nurses are being piled on with seven...EIGHT patients. To me, that is just not safe. If I have five or six patients, I would NOT take a seventh on a med-surg floor (as a new grad, at least). That is just unsafe.