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At a mandated meeting (for newbies) we had several department managers come talk to us...one kept insisting that "ER is different because its more of a 1-1 care situation" ha ha ha ha ha ha ha ha ha ha LMAO!!!!!!!

Thought you all would get a kick out of that! She then proceeded to tell us stories about how everything is basically ERs fault- what else is new? LMAO

Posting from my phone, ease forgive my fat thumbs! :)

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it's amazing what people think ER nursing is like!

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At a mandated meeting (for newbies) we had several department managers come talk to us...one kept insisting that "ER is different because its more of a 1-1 care situation" ha ha ha ha ha ha ha ha ha ha LMAO!!!!!!!

Thought you all would get a kick out of that! She then proceeded to tell us stories about how everything is basically ERs fault- what else is new? LMAO

Posting from my phone, ease forgive my fat thumbs! :)

*****.... I wish I could've been there to tell her about my 2 vent patients and my other pt on a nitro drip! Yeah... 1-1 alright... Haha

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*****.... I wish I could've been there to tell her about my 2 vent patients and my other pt on a nitro drip! Yeah... 1-1 alright... Haha

???? I didn't even say a bad word! Lol oh well..

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Specializes in ED.

What is this 1-1 you speak of?

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Our hospital has been trying to increase the overall morale of the hospital by meet and greets for other floors with ER staff.

You know those pt's that we just CAN'T wait to admit and get rid of? Ya they have them their entire shift.. And if they work 2 days in a row, could have to deal with them still. I totally get that. I really do try to go out of my way to be friendly and build rapport with floor nurses.

On the other hand, IMO, those nurses have no idea what WE are going through. If it's RNF, these people are stable, can probably walk/talk/feed themselves/take themselves to bathroom. I'm sorry that them being admitted and transferred to a RNF means 'drama' for them. I don't appreciate the 'games' they play. They know they are getting an admit, they know I'm calling. They hide, they won't answer the phone, they won't take report. They figure when I'm calling is a good time to perform a procedure, draw blood, pass meds.

I would just love, in the perfect world, that there was a mutual understanding that both our jobs are hectic and chaos in their own way. It's not a personal thing that I want to make nurses suffer.

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Specializes in Emergency, Haematology/Oncology.

I laughed from the very deep, dark recesses of my very jaded, PPI laden belly when I read that but fortunately in my neck of the woods things are changing. At my hospital last year we proved that ridiculous length of stay in the Emergency Department and delays in definitive treatment/specialist care were largely due to sluggish specialist review (both senior ER physicians and inpatient teams) and delays in access to ward beds (who knew?). Following a massive collection of data and some serious staff restructuring / planning, a new system for emergency patients was trialled and implemented with a four hour rule. That's four hours from triage to either discharge / admission to a ward bed, or transfer to another facility.

Essentially this system has made length of stay in Emergency everyones' challenge and forced specialist teams to pick up the pace. If a ward has a bed available and the patient breaches the four hour time limit the ward is fined individually. The change is fantastic and we now have ward/floor nurses calling us to say "hey if you guys are too busy, we will come down and collect our patient". Brilliant. Ward nurses are getting to see first hand whats happening in ER and now have a big incentive to get their patients admitted. Best of all, patients aren't waiting FOREVER anymore- triage to appendectomy 1.5 hours and so on. Admittedly we are all working harder, but it is great for the patients. Also, the time wasters are seen by a senior doc quickly and sent packing accordingly.... The most gratifying thing about this system working is that we aren't the bad guys anymore....;)

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Specializes in Med-Surg, Emergency, CEN.
.... At my hospital last year we proved that ridiculous length of stay in the Emergency Department and delays in definitive treatment/specialist care were largely due to sluggish specialist review (both senior ER physicians and inpatient teams) and delays in access to ward beds (who knew?). ... ...If a ward has a bed available and the patient breaches the four hour time limit the ward is fined individually....

This is brilliant! Are there any down sides? Is there any feedback from the floors and specialists regarding overnight shifts?

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Specializes in Ambulatory Surgery, Ophthalmology, Tele.

I was a floor nurse (tele) in the past. (Now in Ambulatory surgery)

Sometimes I worked overflow in the ER, you know tele overflow. We (tele nurses) would come down and start the admission process while the patient was waiting for a bed. I got to know the ER peeps. They were my buds! bth_smiley_highfive.gif

I don't know where the 1-1 idea came from or what ER they were thinking about. :no:

As my friend would say, our ER was "Crazy Pants" busy!

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Specializes in MPCU.

I think it could be less about "people" not understanding the EC and more about what department managers understand.

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I laughed from the very deep, dark recesses of my very jaded, PPI laden belly when I read that but fortunately in my neck of the woods things are changing. At my hospital last year we proved that ridiculous length of stay in the Emergency Department and delays in definitive treatment/specialist care were largely due to sluggish specialist review (both senior ER physicians and inpatient teams) and delays in access to ward beds (who knew?). Following a massive collection of data and some serious staff restructuring / planning, a new system for emergency patients was trialled and implemented with a four hour rule. That's four hours from triage to either discharge / admission to a ward bed, or transfer to another facility.

Essentially this system has made length of stay in Emergency everyones' challenge and forced specialist teams to pick up the pace. If a ward has a bed available and the patient breaches the four hour time limit the ward is fined individually. The change is fantastic and we now have ward/floor nurses calling us to say "hey if you guys are too busy, we will come down and collect our patient". Brilliant. Ward nurses are getting to see first hand whats happening in ER and now have a big incentive to get their patients admitted. Best of all, patients aren't waiting FOREVER anymore- triage to appendectomy 1.5 hours and so on. Admittedly we are all working harder, but it is great for the patients. Also, the time wasters are seen by a senior doc quickly and sent packing accordingly.... The most gratifying thing about this system working is that we aren't the bad guys anymore....;)

Did you guys publish this information or is it just an internal thing? We have something similar- if they are there longer than 3 hours we are pushed to do something, but as a PP said, the floor doesn't answer the phone. I've been told (from the floor charge) that XX nurse whose name was listed next to my pt as the receiving nurse DOESN'T EXIST IN THE STAFF!!! Can you believe that? In the short time I've been there I've seen my charge call several times and literally chew out other CN for refusing to take assignment or for their nurse conveniently not answering.

Posting from my phone, ease forgive my fat thumbs! :)

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Specializes in ER, progressive care.
Our hospital has been trying to increase the overall morale of the hospital by meet and greets for other floors with ER staff.

You know those pt's that we just CAN'T wait to admit and get rid of? Ya they have them their entire shift.. And if they work 2 days in a row, could have to deal with them still. I totally get that. I really do try to go out of my way to be friendly and build rapport with floor nurses.

On the other hand, IMO, those nurses have no idea what WE are going through. If it's RNF, these people are stable, can probably walk/talk/feed themselves/take themselves to bathroom. I'm sorry that them being admitted and transferred to a RNF means 'drama' for them. I don't appreciate the 'games' they play. They know they are getting an admit, they know I'm calling. They hide, they won't answer the phone, they won't take report. They figure when I'm calling is a good time to perform a procedure, draw blood, pass meds.

I would just love, in the perfect world, that there was a mutual understanding that both our jobs are hectic and chaos in their own way. It's not a personal thing that I want to make nurses suffer.

I was a floor nurse for nearly two years before transferring to the ER. I worked on a very busy tele/step down unit. Reading this post just makes me chuckle...I never purposely tried to "hide" when the ER nurse would call the floor to give me report on an admission...but there were times when they would call and I would tell them to call back in 5-10 minutes because I was in the middle of administering medications to one of my patients (I know you mentioned that, but it happens!) I do know of other nurses that I worked with who would purposely try to "hide," do some procedure, "forget their phone" (we had phones that we carried during our shift) or something....anything, just to delay their admission so they can get something done.

I admit, I hated when the ER called right at shift change and would bring up the patient shortly afterwards (or right before my shift would end).

But it's true. As a former floor nurse, I had NO IDEA what the ER nurses were going through.

Now from an ER RN perspective, all I can do is laugh because I truly understand that when the ER RN calls to give report, it needs to be done NOW and the patient needs to be brought up promptly because we need the beds in the ER. Or if it is at shift change, that off going nurse who has taken care of that patient for the past few hours needs to call report because they KNOW the patient. It just makes more sense. Sure, I've had ER nurses call report on a patient that they haven't even laid their eyeballs on. I understand both sides, but I do get annoyed when I try to call report and the floor nurses are like "can you call me back? thanks." Dang it, it's like chaos down here and who knows if I'll be able to call you in the next 5-10 minutes. Makes me want to repent for all of the times I told the ER nurses that when I was working on the floor! :lol2:

With that said, I am now calling report to some of my former coworkers. There was one patient I had for several hours...doc finally decided he was going to admit them and admitting doc finally accepted them. It was 0600. I called report. The patient was to be admitted to the floor I used to work on. The nurse begged me to keep the patient down there, saying, "you're my friend, please..." um, NO. They need to go upstairs.

I called report on another patient at around 2040 (again, being admitted to my old stomping ground lol) and the nurse gladly took report when I called, but then said to me, "if you can wait until after I am done with my 2100 med pass that would be great." I told them that definitely wasn't happening, but i was nice about it.

:sarcastic:

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