Things you'd like the ER to Know

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I'm working on an education program on Critical Care Education for ER Nurses. My question is;

What things the you as ICU nurses know that you'd like the ER nurses to know?

for starters I"m working hemodymic monitoring and how to use MAP.

Specializes in ICU/Critical Care.

My favorite was "Yeah, this patient was A/O x 3 when he arrived to the ER, he's a COPDer, on a non-rebreather with 100% O2 and now he's obtunded".....Me: "did you tell the doc, this is a change in mental status?" ER RN "No"...Patient comes up from ER, needs immediate intubation because his ABG was not compatible with life and I can only describe his respirations as hiccups.

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This is great that you guys are saying all of this. After working in the ER as a tech for 3 years I've learned tons of bad habits, unfortunately.

I see stuff like this happen every day and every single time I try and say something about it, whether it's to a manager or directly to the nurse caring for the pt they give me some ratty excuse "It's called emergency for a reason!", "we don't do that down here", "This will be easier when the pt is more stable"...

It ****** me off that the nurses in my ER don't even know how to really care for a pt!!!!!!!!!!!

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Specializes in ICU, CVICU.

I get that it's ER and it's busy- I don't mind cleaning up a dirty patient but you have got to tell me the MEDICATIONS AND DOSAGES that have been given. I can figure out if the pt. has a foley, IV access, etc by looking at them but I can't guess what drugs and dosages have been given. Just fill out the darn MAR and don't make me read through a mess of nurses notes looking for (and not finding) many of the drugs you told me you'd given during report. That's all I want! A med list!!!!

but I do love our ER nurses. They are fun and hilarious and my friends during a code :)

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

i'm not too fond of getting dead patients, either. if you're bringing a patient up for arrhythmias and he's monitored, please look at the monitor from time to time. trust me, i will not be happy if you bring me a patient in vf and cannot tell me how long he's been that way. i won't be happy if you bring me a patient in vf and tell me he's been like that "since we got on the elevator" either.

don't bring a patient up with a blood pressure of 60/systolic, lying in a bed full of bloody stool and a 22 gauge iv with d5w hanging.

if i tell you the bed isn't ready, trust me, it's not ready. don't send your secretary or cna up to look in all of our rooms to see if we really do have a clean bed. it ticks me off, annoys my charge nurse and doesn't please the icu resident, either.

if you don't have time to do the ct, i get that. but kindly know whether or not the ct has been done.

please don't tell the families that "the icu nurse will get you all (12-15 of them) pillows and blankets so you can stay all night with the patient," or "the icu nurse will feed you all (at 2am)." we don't have food at 2am. nor do we have enough pillows for our patients, much less for 15 family members who should be going home to sleep anyway. (honestly, i overheard the er nurse telling the family members that the icu nurse would take care of them.)

if the patient's wife is agoraphobic, suffering from dementia, intoxicated or tripping please don't assume that because the icu nurse only has two patients we'll have time to take care of her, too. send her home with the patient's son instead of sending her to the icu with the patient. (yes, this has happened. more than once.)

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Specializes in Med Surg, ER, OR.

I am glad to be reading this as a med/surg RN, knowing that we deal with lots of the same crap you guys do, too.

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Specializes in ICU, CVICU.
I am glad to be reading this as a med/surg RN, knowing that we deal with lots of the same crap you guys do, too.

I hope not from ICU nurses :chair:

:)

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Specializes in adult critical care.

if you have a trauma patient the hemodynamics you need to worry about the most is obviously blood loss. acute blood loss is very easy to miss, since the only change you may notice is increased heart rate. but the cure is easy. do a type and cross. have blood available for your trauma patient. by the time you see signs and symptoms (low bp, poor urine output, increasing tachy) you are behind the curve. a low h & h is the last symptom. remember, its the golden hour for trauma patients. resuscitation can't wait until they get to the unit. yes, we have had trauma patients die from lack of a timely type and cross.

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Specializes in Not too many areas I haven't dipped into.
(I for one am reading the books the residents received in the ICU so i don't lose all my skills!)

Hope that helped! :D

~Lindsey

hey, care to share the titles of the books you are reading?

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Specializes in Not too many areas I haven't dipped into.
TWICE! seriously?

lol

I actually had a patient rolled in on top of a body bag...lmao

They say it "skews" their numbers if the pt dies in the ED...well, I guess if they leave the body in the ED...lol

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Specializes in Not too many areas I haven't dipped into.
I wonder if the ER forum on allnurses has a thread titled "things you'd like the ICU to know"

I would actually be interested in reading that. It might help me better understand them

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RNFelicity,

Sure! The best book (by far) that i have picked up is:

The ICU Book (second edition) by Paul Marino

My preceptor when i first started working in the unit read it and she was one of the smartest nurses i've ever met. They have all kinds of info in this book. Like i say, it's one that the residents usually have to know...so loads of info. It's quite pricey (last i checked around $90.00 or so)...i'd check amazon.com and see if you can find one used. It's very much worth the money though! :wink2:

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it helps to read all of your thoughts on ER patients going to ICU...reminds me all the things that used to drive me insane when i worked ICU and the ER patients would come up all messed up. I really think it's an "ICU nurse" thing to want the linens exactly straight, no wrinkles, etc... haha :) I find myself in the ER still making sure all the blankets are straight, the patient looks nice, etc. Not all the ER nurses are like that (i assume the ones that haven't worked ICU before). But, it kinda helps me to have been to ICU first...that way i try to get the things done that used to drive me insane when they WEREN'T done before coming to the floor!!!

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