Why I guard the referral telephone like a dog...

Published

Specializes in GICU, PICU, CSICU, SICU.

Newer grad in the ER.

She somehow gets the referral telephone in her hands. She takes a call and hears the word sectio, type A, and (nearly) ruptured. So she reports to the coordinating nurse claiming a woman is coming in for an emergency C-section because of a (nearly) ruptured placenta. Not sure what to do about it but OBGYN gets paged and is waiting in the ER for this patient. And the newer grad is assigned this incoming woman and I'm to be her backup if she runs into trouble.

So in rushes the ambo from the other hospital with a 50 yo guy, full code, who turned out to have a rupturing type A aortic disscetion. So we still handle it pretty well without any notice ^^. I get the anesthesiologist to perform the thoracotomy as we page cardiothoracics and get the patient up with a pulse into the OR and later into the ICU. We ask the new grad what possessed her, "C-section really?" She goes "well they were speaking so fast and I figured it was urgent so I didn't dare ask them to repeat and I figured you could do a type A and B C-section apparently and we'd figure it out when they were here...". I wasn't sure what to do laugh, cry, smack or just continue looking dumbfounded. I ended up with the later.

Up Vote Up Vote ×
Specializes in Telehealth, Hospice and Palliative Care.

Holy crap.

Up Vote Up Vote ×

And that new grad probably got picked over me because I have no prior medical experience - but hey can't be a nurse without putting in time as a tech or CNA apparently... =( Even I know better thatn a type AB or C section...

Up Vote Up Vote ×
Specializes in geriatrics, IV, Nurse management.

been there in placement and done that in placement - the reporting nurses do have a habit of talking quickly. a few times i've asked the nurse to repeat herself - only to get a snarky attitude back. that was 3 years ago when i did my placement on the surgical floor from the emerg. i see the times haven't changed.

"

i wasn't sure what to do laugh, cry, smack or just continue looking dumbfounded. i ended up with the later."

and how do we all think the new grad felt? can we all take a moment to step in her shoes?

Up Vote Up Vote ×
Specializes in Pediatric Cardiology.

I have to agree with AngelicDarkness. Some nurses talk FAST and it can be hard to understand what they are saying especially when they are using abbreviations. And they do give attitude when needing to repeat back so I don't ask, look it up when they get to the floor.

I can understand why this would be annoying in the ED though. Having the right people ready is key and in that case she should have gotten a clearer picture of what was coming in.

Up Vote Up Vote ×
Specializes in PICU, Sedation/Radiology, PACU.

I don't think this post is very negative toward the new hire. It's written in a way that it explains the details of what happened, and the OP's reaction. No one came down on or was critical of the new hire.

I would, however, encourage previous (and future) posters to avoid passing judgement on this person's skills and abilities as a nurse, especially when you have never been there yourself. We all have made mistakes as new nurses. Some more serious than others. We have been in her shoes before. Some of us were chewed out by co-workers or superiors. Others were harder on ourselves than anyone else. I'm glad this situation worked out well.

Although, I'd hope that the new nurse has appropriately chastised herself for not seeking clarification. And I hope she's aware (or someone politely explained) that the situation could have been much worse without proper preparation. It's a good reminder to all of us- whether we're taking a referral, getting shift report, or taking a telephone order- to always seek clarification if we don't fully understand something that has been said.

Up Vote Up Vote ×

Exactly! I see this as a teaching moment or training. No need to make her feel worse! I'm more of a "find a solution" type person.

Up Vote Up Vote ×
Specializes in GICU, PICU, CSICU, SICU.

In no way was it negative towards the new grad that I like very much. We had a few good laughs over it lately and we can certainly find the humour in the situation tense as it was.

Up Vote Up Vote ×
I don't think this post is very negative toward the new hire.

I think the OP wondering if they should "smack" the new grad is fairly negative.

Up Vote Up Vote ×
In no way was it negative towards the new grad that I like very much. We had a few good laughs over it lately and we can certainly find the humour in the situation tense as it was.

Maybe it just didn't come across in the spirit it was intended? It can be hard to do on a 2-dimensional message board. I myself read "smack" as you were wondering if you should smack her.

Also: how can she get better at fielding calls if you guard the phone like a dog? What happens when you're not there and she's not been allowed to learn?

Up Vote Up Vote ×
Specializes in GICU, PICU, CSICU, SICU.

Keep in mind English isn't my mother language and smacking someone in Dutch isn't comparable to physical assault but rather an expression of frustration and I should have used a more fitting translation as opposed to literal translation. The post isn't about learning or not learning it's about how a few misunderstood words lead to a hilarious situation in hindsight. Expecting a young woman coming in having OBGYN there. But instead seeing a guy coming in in full code and all the thoughts in your head go "what the h*ll what happened to this woman, huh wait is it really a guy they're coding and you can't make sense of what's happening". Just read the post like that, a funny story...

On the question of learning, the answer is simple. All in due time. That's why we work with a junior and senior structure. The senior RNs are responsible for X amount of things in the department that don't belong to the scope of practice of juniors, e.g. referrals, in house codes and prehospital care. So juniors first get to build their skill on things happening within the ER itself before being exposed to the big bad world so to say. The biggest thing that went wrong was the telephone ending up in the wrong hands (read: untrained) which is by no means her fault but is the problem of the senior RN that let the telephone from her sight. Hence when I'm responsible I'm guarding the telephone as a dog and even take it to the toilet with me, paper towels make good writing paper ^^.

Up Vote Up Vote ×

When I read the first paragraph I had to read it again because I swear they said Aortic dissection but you mentioned OBGYN.

Up Vote Up Vote ×
+ Join the Discussion