The War with the Floors

naja · Jul 11, 2006

At our community hospital bed control calls with the bed assignment, then ER call to tell us they are tubing report and then the patient arrives approximately 15 minutes later.

crickett85 · Jul 12, 2006

The "floor" also takes direct admits, post-ops, post cardiac caths, transfers from ICU/SCU/CCU/DOU and everyplace else. And guess what? They ALL have to give report. And they ALL require nursing attention. So do the patients already on the floor. We do NOT spend all of our time sitting on our thumbs avoiding ER admits. We actually take care of the patients that we already have.

As far as giving report. Take a number and get in line. I'm busy because I'm taking report from ICU/CCU/DOU or PACU, etc., etc., etc....I'm settling in the patient I just got from ICU...I'm checking orders on the post-op patient who needs pain meds NOW, and I am trying to get a phenergan order for the post-op patient who received pain meds but is now vomiting.

crickett85 · Jul 12, 2006

You must have been the nurse who took an admission up while the receiving nurse was coding the V-Tach she'd already tried to tell you about.

It's a shame when we can't just drop the code long enough to take your admission off your hands.

gooch951 · Jul 12, 2006

i really hate it when ER sends a patient 10 min. before the change of shift. Quality patient care goes to a low and all is rushed and unhappy!

LeahJet, ASN, RN · Jul 12, 2006

I would like to pipe in here and say that I really appreciate the "floor" nurses where I am currently employed.

I have worked in many ER's over the country and have been involved in these silly "us vs. them" games. I have seen ER nurses wait till the last possible moment to give a K-ex enema before rolling the pt. up...........or send up a dirty pt.........And I have been on the receiving end of the 1000 question mind game that some floor nurses are gulity of. That's where they ask every qustion they can think of, from the pertinent to the down right silly. When they stump you, the game is over and they win. :uhoh3:

That being said, I can really appreciate the professional and polite nurses that I work with now. They rock!

Mississippi_RN · Jul 12, 2006

Yes, funny...but let's turn it around...
I work in the ED and we are never busy. We just sit around the nursing station talking with docs or hang out in the ambulance bay flirting with the firemen. We do get a lot of patients, but we don't cover them, clean them, water them, or feed them. Hell, we barely speak to them. When a patient is ready to be admitted, we watch the clock and wait until we know the receiving nurse is at lunch, out smoking, or still in report. We are so bored in our department that we have time to keep track of the individual flooor nurses' schedules. We also know that the inpatient units are the only places in the hospital that actually work hard so try not to get too upset with us.
The shoe can fit on either foot. Can't we all just get along? :balloons:

Nope.

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.

LeahJet, ASN, RN · Jul 12, 2006

Wow, MississippiRN.......so ironic that the most professional and polite interactions between floor and ER I have experienced is here in Mississippi...lol. If you and I work in the same facility, maybe I have on rose colored glasses...or dare I say, a positive attitude??

I have found that you get back what you dish out. I am very friendly giving report, esp. if the receiving nurse sounds frazzled....and try to be as accommodating as I can. In return, most transactions have been pleasant.

weirdRN, RN · Jul 12, 2006

but mostly its just hard-working, good nurses with too many patients and not enough hands. Flaming doesn't help. This is where we need to take a deep breath, figure out the problem and if there's a way to solve it.

AMEN! I could not have said this better myself!

Mississippi_RN · Jul 12, 2006

Wow, MississippiRN.......so ironic that the most professional and polite interactions between floor and ER I have experienced is here in Mississippi...lol. If you and I work in the same facility, maybe I have on rose colored glasses...or dare I say, a positive attitude??
I have found that you get back what you dish out. I am very friendly giving report, esp. if the receiving nurse sounds frazzled....and try to be as accommodating as I can. In return, most transactions have been pleasant.

I doubt very seriously we are in the same facility. And I do know that you know absolutely nothing about anything that goes on in a day of mine... Therefore, quite the hypocrite arent we when suggesting I dont have a positive attitude. I simply believe in telling the truth, which a lot of people cant handle.. (Maybe you are one of those :idea: )

Geeg · Jul 12, 2006

Remember Divide and Conquer. It is to the hospitals's advantage when the nurse are at war with each other and have no energy to fight admin. I think that is why nothing gets resolved very well in the hosp environment.

sjt9721, BSN, RN · Jul 12, 2006

I doubt very seriously we are in the same facility. And I do know that you know absolutely nothing about anything that goes on in a day of mine... Therefore, quite the hypocrite arent we when suggesting I dont have a positive attitude. I simply believe in telling the truth, which a lot of people cant handle.. (Maybe you are one of those )

You may tell the truth, but you sure do sound unhappy in your long post describing your hospital. I'm sorry that things are so terrible there. All areas may be overworked in my facility (and others I'm familiar with), but thankfully we haven't reached the 'critical mass' that you illustrate.

LeahJet, ASN, RN · Jul 13, 2006

I doubt very seriously we are in the same facility. And I do know that you know absolutely nothing about anything that goes on in a day of mine... Therefore, quite the hypocrite arent we when suggesting I dont have a positive attitude. I simply believe in telling the truth, which a lot of people cant handle.. (Maybe you are one of those )

wow.

settle down. :lol2: