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Nurses General Nursing

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Specializes in ED, House Supervisor, IT.

I used to work as an ER nurse and now a house supervisor. Two things about the job that baffles me are the floor nurse and on call staff.

What is with the attitude of some floor nurses and not wanting to take patients. When I call to place patients, oh the attitudes and excuses I hear.

Sure, ER should help out where they can and when they can. But when the waiting room is full and the hall beds are taken, cut 'em some slack. Do floor nurses understand the ER has an "open door policy." How many floor nurses have worked ER? It's a different world down there.

Remember most patients are admitted through the ER and it is their first impression of the hospital. Do you know what the biggest complaint on patient surveys are?

Second... on call staff. Two things to say about that. Save the whining for your spouse and if you don't like on call... Taco Bell is hiring.

Hank

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Originally posted by RoaminHankRN

Save the whining for your spouse and if you don't like on call... Taco Bell is hiring.

Hank

I hear ya Hank, I hear ya:roll :roll :chuckle :eek: :eek: :p :p

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Specializes in jack of all trades, master of none.

I just wish that there was a Taco Bell in my town.

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That is the way it is. You said you have worked the ER, have you ever worked the floors? It is without a doubt two different worlds.

I personally have no issue with taking admissions----Job security. Thats what I say. However, I am in the minority. Most nurses I work with will find a reason to not take or at least delay an admission. That is a a given.

However, being on the other side and also in charge. I can tell you it is not cut and dry. I have had the ER books beds that we already had a patient in and then get mad because we could not take the patient.

I have had the ER roll a pt on the floor and not even call and give report, let alone have the house super tell us the pt is coming.

I have had the ER roll not 1........not 2...... but 3 patients onto our floor at the same time. How safe do you think that is when you have 3 nurses on the floor and all 3 are tucking in a fresh admit. Who is wathching the other 22 patients?

Each one of thees times I took the patients from the ER staff and said nothing to them. This is a system issue that needs to be resolved by management.

I do not agree with nurses giving attitude when it is their turn to take an admit......in fact I read them the riot act when they do. However, at the same time I will not tolerate the ER dumping on me, because some other nurse on another floor gave them attitude.

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I don't mind taking admissions at all....but why wait to give report and send the pt up 10 minutes before end of shift. What is with that? The other night I had 2 cp's come up back to back literally 20 minutes before end of shift.:(

In order to take ER admits we frequently have to transfer other pts out to make room. It isn't so cut and dry especially when you need private rooms for transplants.

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Specializes in ED, House Supervisor, IT.

I agree 100%. In your situation and that instance the ER would be at fault.

There needs to be better communication.

But I go back to one point. And regardless of who is at fault or what ever the reasons are... The patient having to wait. Who explains the delays? Who deals with the patient waiting 2,4,6,8 or longer for a bed. Who deals with the family and visitors.

You speak of 3 patients rolling in at the same time.. with 22 others to carry for...

How often does that happen?

(you have other issues if it happens every day)

When the floor is full, are patients placed in halls?

When ER is full, guess where patient care takes place?

The norm in the ER is patients present and they don't call from home giving you a report. Sometimes 1, 2, 3 or 10 roll in at the same time

I will put an ER nurse on the floor before bringing a floor nurse down to ER.

I do commend you for calling people to the carpet when they drop the ball.

As the super, I do ask ER do give the floors time between admissions...

However ER gets poopy and asks if I could tell the ambulances the same thing.

It is a different world.

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Specializes in ED, House Supervisor, IT.

Fur..

So?

Patients come in 20 minutes before the change of shift in ER too... why should the floor be treated any different. If there is team work of the floor, the oncoming shift could lend a hand.. Unless it is filled with a cup of coffee.

Remember

Patients come in at the same time with similar complaints..

Your shift is from 7a-7p (or whatever it is)

Not 730a to 630p.

Again. let's tell the patient that the floor nurse is going home in 10 minutes.. let's wait until the next shift comes in before you go upstairs.

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I've been on both sides. Ortho, CCU, ER. I still don't understand why the floors and units make such a big deal about getting admits.

Furball, While you got your 2 CPs, I was getting 2 ambulances. 1with a GSW to the chest, and one with a stubbed toe. (thats another issue) Oh yea, and the walk in with the active MI, and the asthma kid, carried in by his dad, that needed to be intubated, NOW!

I do it 'cause I love it. I'll keep doing it when I can. Let's be a

B]TEAM[/b] , and all try to get along, eh?

Here's an article I think helps describe it quite well:

http://www.rnweb.com/be_core/MVC?mag=r&action=viewArticle&y=2001&m=09&d=01&article=erattitude.html&path=/be_core/content/journals/r/data/2001/0901&title=Why@ED@nurses@have@that@attitude&template=past_issues_show_article.jsp&navtype=r

If that doesn't work, look at RNWEB, go to the back issues, Sept. 2001, and the article is Why ER nurses have that attitude.

just my $ .02

ken

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Specializes in LDRP; Education.

My only complaint with the ER is when they get involved with obstetrics - which they clearly shouldn't!!!

:p

Or when they call us to admit a patient, but won't bring her up! We have no one to go down and get her either - so there the patient sits, and sits, and sits. It's not that we don't have room for her - we just don't have the staff to leave the floor with an emergency C-section going on and pitocin drips and questionable fetal heart tones.

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Specializes in ED, House Supervisor, IT.

So complain to management to hire tech/transporter. Or the traige nurse should bring the patient up. Some hospitals, security does it. ( I don't agree with that)

ER does not want to get involved with OB patients. Babies are not meant to be born in ER.. you are the pros on that one!

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Specializes in LDRP; Education.

How does that go? "I don't know nothin' 'bout birthin' babies!"

:D

We've complained about the transport issue; unfortunately has fallen on deaf ears. Usually we just bust our butt to go get the patient, even if we ask a nurse from a neighboring floor. We'd hate to have that patient sitting in the ER waiting room without a monitor on when god knows WHAT is going on with her!

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my ultimate respect goes to the ppl who work emerg

its crazy hectic frantic and nutso almost all the time. thats a given, my fellow "floor" nurses can all agree to that...

however, let it be said that although some of the floor nurses hesitate on admissions sometimes and whatnot, that the nurses who work in the ER are quite capable of their own nasty moments also.

each of us can only speak for our personal experiences, but I had an ER nurse say to me , after I had asked her if I could call her back for report because my patient had coded , a young forty something man , totally unexpected etc, and didnt make it, i had just called the family and they were coming etc etc, her words were "well your patient doesnt need your attention right now, and this patient needs a bed, what is with you "floor" Nurses and putting off admissions anyway?"

I couldnt believe that... it was a night shift, only five RN's on for forty patients , it was my duty to support this patients needs even after death! we are different types of nurses sure but emergencies happen on the "Floor" too .....

one night we had 2 codes within 2 hours....

i respect what the emerg nurses do cuz ive been there as a patient but why cant floor nurses get the same respect at times it seems like ppl think all we do is sit around and plot how we can avoid admissions.

some nurses are habitually lazy, on the floor it happens but there are also lazyasses in emerg and other floors too....

like the time I got a fresh GI Bleeder, getting blood on the way up , line totally out , blood everywhere, pt full of melena stool ,alert and oriented x 3 stating that he had begged for someone to change him for the last 3 hours..

my supervisor went down to the ED to see what was up cuz she had to investigate the pts complaint and the ED supervisor told her that she had just finished talking to the nurse involved because he is notorious for this sort of behaviour, with no reason - ie - no serious trauma to deal with no code etc etc

its apples and oranges ppl, we have different areas of expertise....one is not better than the other its just different, and I too have a problem with getting three admissions wheeled in at the same exact moment- which is not untypical on our floor either for the record, its mistakes waiting to happen on both ends , the ER sent up the wrong chart and meds for one and neglected to do any charting on the other...

it shouldnt be a battle between the 2 depts , sometimes it seems that way..

I've been hung up on by ER Nurses, and I have never hung up the phone on anyone in my life EVER

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