Hi. I was just wondering what level III RNs think of level II RNs. The NICU I work is a level IIB and we have a big tertiary center 2 miles down the street which is where our neos come from. It seems whenever we have a transfer to go to the level III the transport team comes and acts like we are a bunch of idiots.
Example: I had a baby a couple of months ago that was term, out on mother/baby and at 24 hrs. of age became lethagic, poor feeder. After an ECHO/workup, it was found the kid had major CHDs, ductal dependant. We started prostaglandins, O2 and set up for a transfer to level III. Because of insurance reasons and some other stuff the kid didn't get transferred until like 12 hours later, but was doing fine, was stable. When the transport team came and were doing their assessment, the baby was crying. The one nurse goes "O, it's ok baby. They did ok for you here". OK?!?!? She's still alive and stable!!!! I think she's doing great!! It just hit me hard because I am not stupid nor are any of the nurses I work with.
I was just wondering what other nurses think of this... anyone ever have similar problems?
I have to agree with what most others have posted. I'm sorry you were treated like that... I'm even more apologetic that it's not an infrequent occurrence.
We are specifically trained in transport to be respectful of the referring hospital staff. And above and beyond, compliment them and thank them for their business. Be gracious and grateful. Professionalism should be a given.
This doesn't always happen. :icon_roll
In the unit I currently work in, there is a huge separation between the L2 and L3 nurses... and the transport nurses are "goddesses". The pecking order is horrendous.
Everyone has their own skills and contributes to the care of each patient they come in contact with. We couldn't do this without each other.
Can't everyone just be nice?
I feel for you and apologize for any L3 or Transport nurse that "puts you down". It's likely not going to be an isolated incident. Not all of us are like that though. I appreciate your work, effort and skill.
We are specifically trained in transport to be respectful of the referring hospital staff. And above and beyond, compliment them and thank them for their business. Be gracious and grateful. Professionalism should be a given.
Yup us too. They made a very big deal of us being repectful and courteous first. If there was a nurse or two on the team that always talked down to the refferring facility's staff, rest assured the rest of the transport team was rolling their eyes about it. I just think some people go into nursing for the wrong reasons, they have some kind of inseccurity or something and they take it out on others, whoever. New grads, residents, housekeepers, patients even.
Oh wait I forgot to answer your question. I prefer level 3 any day, cause level 2 kicks my butt. Give me a HFJV and HFOV side by side any night over 3 LO's that need to be fed...I just can't keep up!
I've worked level 3 nicu for 18 1/2 yrs. recently I've picked up hours at a level2 NICU because we are so slow. The nurses at the level 2 nicu are very nice and glad to have an experienced nurse there. I respect the level 2 nurses just like our level 3 nurses. My only preference is to have level 2 nicu nurses who have some level 3 esperience, if possible, because at the level 2 hospitals you really tend to be on your own and the level 3 experience helps a lot of you have a really sick kid.
Oh wait I forgot to answer your question. I prefer level 3 any day, cause level 2 kicks my butt. Give me a HFJV and HFOV side by side any night over 3 LO's that need to be fed...I just can't keep up!
No kidding..lvl 2 kicks my butt...too many kids that take too long to eat! give me any type of vent over that, please!
I will bite, please nobody take personal offense...
I have a somewhat negative view of level II nurses. ONLY because I have had some not so good occurances involving them. My unit has a pretty strict separation between level II and level III. Occasionally we will float between the two (usually level II comes to level III more-so than the other way around) but 99% of the time you are in your own little bubble.
So, there have been times when I've taken report from a nurse that floated, only to find some details omitted. Like the three times my primary was having a large amount of output out of her ostomy (had already passed her total output goal for the day at 1900) with no mention of it all in report. I realize that the fact she was my primary makes me even madder but for it to happen three times? And the time this other kid was having stidor so loud you could hear it in the next room "but the docs were OK with it"...And the time they wrote TPN D12.5 was running at 4.0 all day on the flowsheet, but it was really D15 running at 4.1 all day. Did she even look at the fluids hanging? Sigh.
That being said, I have gotten reports from many great level II nurses before and I've gotten bad reports from some level III nurses before. It just seems more things get missed with the level II nurses, that is all. And thank god that they chose to be a level II nurse because I could never do that. I am ready to chunk my 3 screaming kids out the window by 10 pm whenever I have a stepdown assignment. Give me an HFOV with multiple drips and blood products anyday!! (unless they are cardiac..)
I will bite, please nobody take personal offense...
I have a somewhat negative view of level II nurses. ONLY because I have had some not so good occurances involving them. My unit has a pretty strict separation between level II and level III. Occasionally we will float between the two (usually level II comes to level III more-so than the other way around) but 99% of the time you are in your own little bubble.
So, there have been times when I've taken report from a nurse that floated, only to find some details omitted. Like the three times my primary was having a large amount of output out of her ostomy (had already passed her total output goal for the day at 1900) with no mention of it all in report. I realize that the fact she was my primary makes me even madder but for it to happen three times? And the time this other kid was having stidor so loud you could hear it in the next room "but the docs were OK with it"...And the time they wrote TPN D12.5 was running at 4.0 all day on the flowsheet, but it was really D15 running at 4.1 all day. Did she even look at the fluids hanging? Sigh.
That being said, I have gotten reports from many great level II nurses before and I've gotten bad reports from some level III nurses before. It just seems more things get missed with the level II nurses, that is all. And thank god that they chose to be a level II nurse because I could never do that. I am ready to chunk my 3 screaming kids out the window by 10 pm whenever I have a stepdown assignment. Give me an HFOV with multiple drips and blood products anyday!! (unless they are cardiac..)
I have DEFINITELY noticed the lack of respect for level II nurses by the III folks there.
I have DEFINITELY noticed the lack of respect for level II nurses by the III folks there.
Well excuse me for giving my honest opinion.
There is a difference between being on your game like the OP's post, and not being on your game like my post. I don't care where you work as long as you know what you're doing.
There is a difference between being on your game like the OP's post, and not being on your game like my post. I don't care where you work as long as you know what you're doing.
I think there is a big difference between true incompetence and small errors made by a nurse who has been pulled to an unfamiliar area and assigned a full load of unfamiliar patients. What you describe sounds like the pitfalls of pulling staff more than incompetence.
My unit has a pretty strict separation between level II and level III.
I wonder if this has anything to do with the anymosity. Our unit works as 1 big blob. Meaning there is no difference between those that work criticals and specials. As anywhere there are those that prefer 1 over the other. And of course there is tension/anymosity between certain individuals or cliques.
Specializes in Neonatal nursing (paediatric trained).
There's no difference at mine either. It's a Level 2 but used to be a Level 3 and still does some Level 3 stuff. We have an intensive care nursery and a special care nursery, separate rooms but within the same unit. The only difference is whether we've had a neonatal course (then you work ICU/HDU a lot more), but it's all in the same unit, nurse in charge over everyone.
There is a difference between being on your game like the OP's post, and not being on your game like my post. I don't care where you work as long as you know what you're doing.
I wasn't jumping on you for it (inflection is lost in text unfortunately), just saying I've really noticed the separation there. Someone there told me, "level two nurses are like houseplants..nice to look at but overall pretty useless".. that's a bit harsh. All I have to compare it to is a combo II/III unit where some nurses didn't take III pts, but I never sensed a superiority complex from anyone. I guess it's a good thing our place is pretty separated physically!
But there's a reason why they're separated... some nurses would rather work on the feeder/grower side and be more touchy (I guess that's the word..I'd use 'hands on' but it's pretty hands on in III..just more hands on equipment sometimes) with the babies and the parents and some are more into the higher acuity. Having been on both sides, I highly respect both. Dealing with 4-5 screaming kids that are poor feeders and having all of their parents there at the same time demanding your attention is stressful stuff.
Yup us too. They made a very big deal of us being repectful and courteous first. If there was a nurse or two on the team that always talked down to the refferring facility's staff, rest assured the rest of the transport team was rolling their eyes about it. I just think some people go into nursing for the wrong reasons, they have some kind of inseccurity or something and they take it out on others, whoever. New grads, residents, housekeepers, patients even. 
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Strange that this attracted my first post...
I have to agree with what most others have posted. I'm sorry you were treated like that... I'm even more apologetic that it's not an infrequent occurrence.
We are specifically trained in transport to be respectful of the referring hospital staff. And above and beyond, compliment them and thank them for their business. Be gracious and grateful. Professionalism should be a given.
This doesn't always happen. :icon_roll
In the unit I currently work in, there is a huge separation between the L2 and L3 nurses... and the transport nurses are "goddesses". The pecking order is horrendous.
Everyone has their own skills and contributes to the care of each patient they come in contact with. We couldn't do this without each other.
Can't everyone just be nice?
I feel for you and apologize for any L3 or Transport nurse that "puts you down". It's likely not going to be an isolated incident. Not all of us are like that though. I appreciate your work, effort and skill.