I read in another thread how a non-ER nurse (sorry, didn't see what specialty) was angry that the ER nurses don't start any of the admitting orders at her hospital. So, I wanted to ask the ER folks here, how does it work at your ER?
By the time I get the chart and admitting orders back from the doctor and the secretaries (who are the people that write down the room number and floor), the floor is usually calling for report in 10-15 minutes. Sometimes I have a chance to start IVF and sometimes I don't. Unless it is something that patient needs RIGHT THEN, such as pain or nausea medication, I don't have time to start the admission orders. Frankly, I don't feel that is part of my job if I am busy with my other ER patients.
Last week I was giving report and the other nurse gave a huge "sigh" after she asked if any of the orders were started and I said no.
Someone touched a nerve!!! Let me take this opportunity to reiterate that when someone is obviously venting, just get over it. Find whatever humor there may be in it, laugh, and move on. No one wants to hear the blah, blah, blah. Yeah, for you, such and such, and yadda yadda. We get it already.
If you don't like it when ED nurses type in all caps then FIND THE CARDIAC NURSE PAGES AND TYPE IN LOWER CASES THERE. Our jobs, life, and emotions are loud and we would like that reflected appropriately.
And finally, when you have had the crappy day you just described, then at the end of your shift, and are trying to move your pt on in his care and get him to the appropriate floor and in the process get walked on by the floor nurses, spend an hour calling obsessively, are put on eternal hold, hung up on, and are spoken to so rudely, it's almost like being spit on at the end of it, to have that floor nurse call and want to know "when are you bringing the pt up?" exactly 2 mins after a trauma alert x 2 for the ED has been paged, then you will get sympathy from the ED nurses. Until then, just leave us alone. We have a hard time at work and come here for relief. Your spiteful belittling is counterproductive. (Note, this next part is not about you) YOU CAN COME DOWN HERE AND GET YOUR PT WHENEVER YOU DAMNED WELL PLEASE, UNTIL THEN BACK OFF!!! So, if you don't like our messages and opinions, I do believe every nursing specialty is fairly represented on this website and I am sure you will find yours reflected equivocally elsewhere, especially as having us all get along is a priority for you. For future reference, if harmony is so important to you, then no attacking the ED nurse for her opinions. We are all entitled to them. Do you see that little red X at the top right?....
I'm sure I lost my cool in there somewhere and please know I don't mean to offend.....:wink2:--see how that works?
Huh? I'm a bit confused. First off, why are you yelling (using all caps indicates that one is yelling). Second, I never said I expected the ED nurses to start admission orders. In fact, I specifically stated that I do NOT expect them to do so.
As far as the floor nurse not being able to take a report at the moment that you attempt to call, I'm sorry, but that will take a little bit of a cooperative attitude on your part. I have no problem, if I am in the middle of patient care and cannot step away to take report, with asking the ED nurse if I can call them back in a minute. Our facility is so huge that you cannot simply step out of the patient's room and find another nurse to hand the phone to. My supervisor is the charge nurse, and he is very hard to find because he is busy placing patients and taking the admits that the nurses on the unit cannot take because they are swamped, and pulling sheaths because nobody else on our shift is trained to do it, and nobody has time to take away from their patient load to be trained to do it.
I worked an entire eight and a half hours last night with not a single break, not a bite to eat, not a sip of water, and not a potty break. In fact, I am on my period and did not even have time to change my pad, and could actually smell myself by the end of the night. It was humiliating and demoralizing. I had to stay over a half hour because my relief for one of my patients was a no-show, and the nurse assigned to take report on the patient had absolutely no sense of urgency about doing so. So please do not try and insinuate that we up on the floor do not understand what it is like to be busy.
It is a matter of mutual respect. I will respect your position and your need to get the patient stabilized and out of the ED as promptly as you can, and all I ask is that you respect my need to have some semblance of control over how my time is used. If we respect one another, and have an attitude of cooperation, then things will be much better.
I have taken report from ED nurses while dancing around trying to keep from peeing my pants, then running to the bathroom as soon as they are off the phone to relieve myself. I have put off my dinner break while starving and hypoglycemic, just to be sure I can take report and accept the patient from the ED. I have set aside my own needs, both basic physical needs and getting patient care done for my other patients, in order to accomodate the ED nurses. So please, do not assume that you, the ED nurse, have a monopoly on being far too busy than any person should.
Thank you.
Didn't mean to yell. I didn't have my glasses handy as they were down at the beach near my umbrella...lol....So I used caps to see the letters better. But hey, if you had a serious problem with it...sorry about the caps.
It's just not a matter of mutual respect. It's about you having the empty bed ready for the patient...meaning one less patient at the time. The ER doesn't have the luxury of telling triage not to fill that open bed of 60 seconds to wait till we are dumped on yet again.
When I call report, the bed has been ready....which obviously means you have one less patient at the time. I understand all nurses let their bladders overfill....been there done that.
Thanks for explaining. That's why I was a bit puzzled, because I couldn't understand why I was getting cyber "yelled" at.
Anyway, that's been a huge issue at our hospital, is housekeeping being able to keep up. Since they cut the bedmakers, the housekeepers take even longer to turn over rooms. There is one in particular that is the slowest moving individual in the entire universe as far as I am concerned. If we have a lot of discharges on a given day, we know we're going to be slammed with admits, and there isn't a clean room on the entire unit. As a nurse on the unit, this is beyond my control. Our NM and charge nurses have been working with housekeeping to resolve this, but it's still problematic. When the ED calls report and my room isn't ready yet, the charge nurse knows, housekeeping knows, everybody knows, and yet I still have to wait until housekeeping can get there to turn it over before I can take my admit. I think administration needs to pull their heads out and bring back the bedmakers and add more housekeepers. Until that happens, I'm afraid the tension over this will continue to be a problem.
That is where the mutual respect comes in, by my way of thinking. I want the ED nurse to understand that I am not delaying the admit for my own convenience, and that I am just as frustrated as they are that the room isn't ready, and that I understand their position. If I say I will call back the very moment the room is ready, then I will. As far as being grumpy on the phone, I really try not to be. It's not just reserved for ED nurses though. Anybody can be the subject of my annoyance if they call at the right time. I'm an equal opportunity grump!
Oh, I just wanted to mention that I did not come into the ED forum spoiling for a fight. There is a link at the top of the page that says "new posts", and when you click on it, it brings up all the new posts on the entire site, in every forum. I often use this function to browse the site, and respond to threads that interest me. I did not specifically seek out the ED forum.
Thanks for explaining. That's why I was a bit puzzled, because I couldn't understand why I was getting cyber "yelled" at.
Anyway, that's been a huge issue at our hospital, is housekeeping being able to keep up. Since they cut the bedmakers, the housekeepers take even longer to turn over rooms. There is one in particular that is the slowest moving individual in the entire universe as far as I am concerned. If we have a lot of discharges on a given day, we know we're going to be slammed with admits, and there isn't a clean room on the entire unit. As a nurse on the unit, this is beyond my control. Our NM and charge nurses have been working with housekeeping to resolve this, but it's still problematic. When the ED calls report and my room isn't ready yet, the charge nurse knows, housekeeping knows, everybody knows, and yet I still have to wait until housekeeping can get there to turn it over before I can take my admit. I think administration needs to pull their heads out and bring back the bedmakers and add more housekeepers. Until that happens, I'm afraid the tension over this will continue to be a problem.
That is where the mutual respect comes in, by my way of thinking. I want the ED nurse to understand that I am not delaying the admit for my own convenience, and that I am just as frustrated as they are that the room isn't ready, and that I understand their position. If I say I will call back the very moment the room is ready, then I will. As far as being grumpy on the phone, I really try not to be. It's not just reserved for ED nurses though. Anybody can be the subject of my annoyance if they call at the right time. I'm an equal opportunity grump!
I feel your pain, but as I said, I always wait until I know the room is ready. Especially because at our hospital, nurses on the floor have funky shifts as well, so I won't call until the room is actually ready till I personally call. I do like giving report to the nurse taking care of my patients.
I agree there should be mutual respect. We all should be in this together, form a group in our individual hospitals and take it to the VPs. It's us against them anyway, as they haven't a clue, ya know.
I just don't get the work flow. Today, I came in and had an infant who was admitted. Why is he still down here? We always have Peds beds. So 30 mins into the shift, there is suddenly a bed. Obviously, this bed was always available but we needed to wait until after shift change for the floor's convenience, never mind it creates more work for an ED nurse. Then I call report. You know that feeling you get when the person you are giving report to isn't really listening? Yeah, yeah, uh-huh. "Look, the room isn't ready, we have to go set it up and plus, we just got report?" What? I don't understand what your just getting report on other pts has anything to do with this pt coming up. What does it matter? I already have a new pt going into this child's room. He is being seen by the MD in the hall right now and I will have pending orders on him any minute. It's now 45 min after shift change. You just got report? Maybe the problem is long winded reports. Rap it up! So, I am trying to be nice because apparently things are falling apart on peds this AM and say, "fine, how long do you need?" She says, "we need to set the room up." Oh, ok, like I even have a clue what the hell she is talking about, much less how long it's gonna take. Are they painting? So I ask, "Ok, but can you tell me when to send the pt?" Again, she is clearly not listening, "We just got report and we need some time to get the room together." Are we having 2 different conversations? So, like all of my uneducated pts, I break it down, "do you need 15 min?" She is all excited now, "No, give us like 30 min!" So, I'm okay with this and say, "Ok, some how we'll manage." I just don't get the mentality. I did absolutely nothing for the pt in those 30 min. He could have just as well been up there, getting no attention for 30 min, of course only if the room was "put together" or whatever. Just delay the care of the pts in the waiting room. EMS loves holding up the wall, whatever....
See, I did good. This was my harmony attempt of the day. Of course, it was my only 1!
Yeah, that's different. If there is a bed ready and they're just jerking you around, I can definitely understand why you'd be upset. I agree, though, that these admins that make these idiotic decisions don't seem to have any idea how things work in the real world, and how these things affect the care we're able to provide. We *are* all in it together, and instead of ripping into one another, maybe we should take a stand together. Thank you for your understanding! I think I'd like working with you.
Thanks for the tip. Sometimes I can't give a specific time estimate, like if the room is still dirty and I have no clue when housekeeping is going to make an appearance, but when the room is ready and I just need some time to get it together to be able to take the admit (like at shift change), I'll remember to give a specific amount of time, like 15 or 30 minutes.
ThrowEdNurse, BSN, RN
298 Posts
Someone touched a nerve!!! Let me take this opportunity to reiterate that when someone is obviously venting, just get over it. Find whatever humor there may be in it, laugh, and move on. No one wants to hear the blah, blah, blah. Yeah, for you, such and such, and yadda yadda. We get it already.
If you don't like it when ED nurses type in all caps then FIND THE CARDIAC NURSE PAGES AND TYPE IN LOWER CASES THERE. Our jobs, life, and emotions are loud and we would like that reflected appropriately.
And finally, when you have had the crappy day you just described, then at the end of your shift, and are trying to move your pt on in his care and get him to the appropriate floor and in the process get walked on by the floor nurses, spend an hour calling obsessively, are put on eternal hold, hung up on, and are spoken to so rudely, it's almost like being spit on at the end of it, to have that floor nurse call and want to know "when are you bringing the pt up?" exactly 2 mins after a trauma alert x 2 for the ED has been paged, then you will get sympathy from the ED nurses. Until then, just leave us alone. We have a hard time at work and come here for relief. Your spiteful belittling is counterproductive. (Note, this next part is not about you) YOU CAN COME DOWN HERE AND GET YOUR PT WHENEVER YOU DAMNED WELL PLEASE, UNTIL THEN BACK OFF!!! So, if you don't like our messages and opinions, I do believe every nursing specialty is fairly represented on this website and I am sure you will find yours reflected equivocally elsewhere, especially as having us all get along is a priority for you. For future reference, if harmony is so important to you, then no attacking the ED nurse for her opinions. We are all entitled to them. Do you see that little red X at the top right?....
I'm sure I lost my cool in there somewhere and please know I don't mean to offend.....:wink2:--see how that works?