OK, I have a bone to pick with some ICU nurses, but before I begin, let me just say that I know not all of you are mean to the "lower" telemetry nurses ALL of the time.......
It seems as if every time one of my patients clinically disintegrates and must be transferred to the ICU STAT, the nurses up there are SOOO RUDE!!! And it's not just one specific unit or one specific nurse, it's the CVICU and the MSICU (our 2 main ICU's), AND multiple different nurses. My goal on the floor is to get them up there STILL BREATHING as fast as I can so more advanced interventions can take place before the patient further declines. I generally give bedside report, write out the transfer orders, assist in any way that I can while I'm up there, and then rush back down to the floor to my OTHER 4 patients and likely a new admission on the way.
What's so funny is that these ICU nurses act like they are high and mighty and smarter than the telemetry nurses, but when I receive a downgraded patient from THEM, I notice ALL KINDS of (basic) mistakes made!! In charting, in meds, etc. And I wonder, how can such mistakes be made when they have 1 or 2 patients max?!?
For example, I received 2 transfers from ICU yesterday. The first one was on a heparin gtt, TPN, and lipids. Okay. The patient comes to the floor with the ICU nurse and their tech. The heparin gtt, TPN, and lipids were NOT ATTACHED TO A PUMP. The roller clamp was left wide open and the only thing clamping off these infusions was the square clamp that goes directly into the actual pump (unattached). AND these lines were connected to the patient's central line!!!! When I brought this up to the "ICU" nurse, she said because she didn't want us to "steal" one of their pumps! OMG. Seriously? We can trade a pump, this is about patient safety. At least clamp the rollers!!
Next one, a STEMI patient going for CABG the next day. Also on seizure precautions and fall precautions. The patient comes with a tongue depressor taped to the bed and with 3 side rails missing off the bed!!! First, we DO NOT place ANYTHING in a patient's mouth if they are having a seizure....is this nurse living in the dinosaur age with the tongue depressor?! Second, WHY does a patient on fall/seizure precautions (or any patient for that matter) have side rails missing off the bed?!?!?! Aieeee I was so mad!!
Furthermore, the documenting/transfer orders on both these patients was HORRENDOUS, with multiple things not accurate and/or missing.
To add it seems like when I have to go to the ICU for any reason, there are multiple nurses playing on their cell phones, surfing the internet, and chatting about whatever non-hospital related thing is going on in their lives. And what's REALLY FUNNY, is when they get floated down to the floor, they are flustered, can't get anything done, refuse to ever come to the floor again, can't handle the patient load, calling it unsafe yada yada yada.
So, back to the original question: Why are ICU nurses SO rude to telemetry nurses when we must transfer a patient up there?!
About to pop some popcorn... too bad I'm about to go out on a date to miss this though.
- On another note, can't both ICU nurses and floor nurses just get over it. We already have too much other stuff to deal with than nurses at eachothers thought. We are have the same goal which is to provide quality care to the patient, all this placing blame is non-sense and immature !
Oh, and I'm loving the "how to organize lines" discussion. We use popsicle sticks too, but we don't tuck the lines under the stick. Lines go over the stick and are held in place with a rubber band that's stretched over it with it streched under both ends.
Can someone better describe the med cup version? I like the idea of the extra slack (especially for my mobile peds patients that don't know to be still!), but I can't picture it in my head what's going on there.
ETA: Actually, I'm going to start a thread! Get it out of this dump that will surely be shut down soon.
I find it really disheartening that there are some ICU nurses who feel that if a patient deteriorates and/or needs to be transferred, it has to be because the floor nurse missed something. Every deterioration is a failure to rescue?? That sort of attitude is really unhelpful, it puts people on the defensive and less likely to reflect on what has actually happened with the patient. It also makes it less likely that the real failures to rescue will be identified.
I take pride in looking at the big picture rather than focusing on tasks, I keep as close watch on my patients as is possible in the environment I work in, I notify the doctor if there's a problem or a worrying trend or even something a bit out of the ordinary that makes me feel uneasy about the patient's condition. I manage what I can, I call for help when it's out of my league. Sometimes something becomes clear in hindsight, and I learn from that.
If anyone knows of a way to do this better so that my patients never deteriorate unexpectedly or have a poor outcome, please come and show me! And I mean that sincerely.
^^ That's how I practice. And that's all you can do. If the patients were well, they wouldn't be in the hospital. Like I think I said earlier in this thread, I've had a few saves that I'm quite proud of. But there are some patients that are just going to crump.
First of all, nursenick20, you are just RUDE. ICU nurses like you give the rest of us a bad name.
Nursing is hard enough without having to deal with rude nurses. I was a tele nurse for 7 years and been an ICU for 8 years. I have worked at big teaching hospitals and smaller community hospitals in MICU, SICU, CVICU, and CCU. I have seen this one too many times. It's totally uncalled for. When I was a tele nurse, I would see patients get transferred out, and they were a total mess....like they hadn't been bathed in a week. I have had patients code and the ICU nurse's would mumble to each other that we were stupid and it should have been caught earlier. I have seen many ICU nurses treat tele/floor nurses like crap. I, however, haven't ever done that. No one is perfect....even an ICU nurse like nursenick20. Yes, as an ICU nurse we know more than a floor nurse, but we are not better. When I go to a code or a rapid response, I always thank the nurses for calling or tell them "Good job" and "Good call".
Thanks for the clarification on my attitude. However, I am not perfect... nor did I say that I am.
Second, I'm almost positive the OP was the one on here venting, and I just gave my opinion of what my day is like. It may have been a little crass, but the OP did not write their post with the most tact. She was the one pointing out faults and acting like her stuff didn't stink. Sorry I didn't sugar coat it... I thought I was dealing with adults.
I will agree with what others say... a downward trend is most often missed and the patient codes. I understand that is not for EVERY situation. Not necessarily the nurses fault, other variables can come into play.
I'm glad you are all knowing with your experience and can delegate such a topic. You seem to have covered every possible indication for someone's attitude being rude on either end... oh wait... you didn't.
What exactly did I say that was so rude? Was it my short and to the point nature of the post?
Wow, quite a few harsh comments. I have been a bedside nurse since 1975. I have mainly been an ICU nurse. For the last 8 years, I have worked in the PACU. Yes, I have been exposed to rude nurses. Some of my co-workers are rude. I am one of the those nurses who has no problem floating to other units. I love seeing on the other side of the fence. Believe me, floating is an eye opener.
One thing that I want to say is that I do not know everything. I am always asking questions about new drugs, new procedures, and new protocols. I love it. In nursing, we can continuously learning from each other and our patients. I work with a heart surgeon that is one of the smartest surgeons that I know. Many of my co-workers avoid taking care of his patients. Frequently, I am assigned his post surgical heart patients. I love working with him. He is demanding, picky, and I learn alot from him. He told me once that he learns new things every day that is what keeps him sharp. He always makes sure that he does practice time in our teaching labs.
A big difference between ICU nurses and floor nurses is the doctors. In ICU, you are tripping over residents and physicians. On the floor, try to get them to answer the phone. Nurses can only do the things that we have orders to do. Many times, I have to "go thru the chain of command" to get the orders that I need for my patient. For one patient, it took me talking with four doctors (Who all visited the patient) to convince them that my pt had agonal breathing. Finally, ABG's proved my point. After a quick intubation, some meds, and time, he was transferred from the PACU to ICU. I saw him the next day, he was eating breakfast. I am sure that all nurses have experienced this kind of situation. These situations can be very time consuming and frustrating.
I am not a ICU nurse. But when I was in school the ICU nurses were some of the nicest ones I ran into. Most of the time that I floated to ICU they were swamped and I just stood back and watched or helped with minor things. But they explained EVERYTHING they were doing and why.
One time I went and my nurse I was shadowing a nurse and two of here three pts at the time were in surgery. So she had time to sit and talk to me. She went over so much info and I was able to learn so much from her. It was great. Then like the laws would have it both her pts. came back from surg a the same time. So things got crazy.
As a student I had the pleasure to sit back and see how xyz floor was different than the others. Each floor from what I saw complained about the other floor for one reason or anther. Usually it was not rude just dang I wish they would have done this because it would have made this easier. Sometimes it was rude.
I think we are human and no one floor is innocent or free from negativity. However over all as a whole from what I have seen each floor has many great qualities that made my time as a student a great learning exp. They for the most part seemed to really love what they did. Even when things got crazy, they still loved helping people.
There were a few nurses who always seemed to be a in a bad mood and hate their job but over all I do not think one floor was overly pig headed or rude.
Thanks for the clarification on my attitude. However, I am not perfect... nor did I say that I am.
Second, I'm almost positive the OP was the one on here venting, and I just gave my opinion of what my day is like. It may have been a little crass, but the OP did not write their post with the most tact. She was the one pointing out faults and acting like her stuff didn't stink. Sorry I didn't sugar coat it... I thought I was dealing with adults.
I will agree with what others say... a downward trend is most often missed and the patient codes. I understand that is not for EVERY situation. Not necessarily the nurses fault, other variables can come into play.
I'm glad you are all knowing with your experience and can delegate such a topic. You seem to have covered every possible indication for someone's attitude being rude on either end... oh wait... you didn't.
What exactly did I say that was so rude? Was it my short and to the point nature of the post?
P.S. "Nurses eat their young"... I am the young.
So when the patient codes in ICU, it's your fault?
Thanks for the clarification on my attitude. However, I am not perfect... nor did I say that I am.
Second, I'm almost positive the OP was the one on here venting, and I just gave my opinion of what my day is like. It may have been a little crass, but the OP did not write their post with the most tact. She was the one pointing out faults and acting like her stuff didn't stink. Sorry I didn't sugar coat it... I thought I was dealing with adults.
I will agree with what others say... a downward trend is most often missed and the patient codes. I understand that is not for EVERY situation. Not necessarily the nurses fault, other variables can come into play.
I'm glad you are all knowing with your experience and can delegate such a topic. You seem to have covered every possible indication for someone's attitude being rude on either end... oh wait... you didn't.
What exactly did I say that was so rude? Was it my short and to the point nature of the post?
P.S. "Nurses eat their young"... I am the young.
Have you ever worked on a floor where you were responsible for 5, 6, 7, 8, 9, 10 patients or is ICU your first job?
Thanks for the clarification on my attitude. However, I am not perfect... nor did I say that I am.
Second, I'm almost positive the OP was the one on here venting, and I just gave my opinion of what my day is like. It may have been a little crass, but the OP did not write their post with the most tact. She was the one pointing out faults and acting like her stuff didn't stink. Sorry I didn't sugar coat it... I thought I was dealing with adults.
I will agree with what others say... a downward trend is most often missed and the patient codes. I understand that is not for EVERY situation. Not necessarily the nurses fault, other variables can come into play.
I'm glad you are all knowing with your experience and can delegate such a topic. You seem to have covered every possible indication for someone's attitude being rude on either end... oh wait... you didn't.
What exactly did I say that was so rude? Was it my short and to the point nature of the post?
P.S. "Nurses eat their young"... I am the young.
Never said I was "all knowing" and will never claim to be. Just try to see things from anothers perspective. We all go to work for one thing.....to take care of the patient. Attitudes just get in the way and noone benefits.
I guess I'm lucky, most of the ICU nurses I have come across have been very nice. I'm in awe of the knowledge they possess!
What does get me, though, is the "wanna-be" ICU nurses - the ones that come to the med/surg floor because they need some experience before they can move on to the ICU or ER. The ones who are much too good to work the floor, and who look down on those of us who actually like our jobs. The ones who complain every day about how floor nursing stinks and are counting the days until they can get out.
Not all of the future ICU nurses have that attitude, some have been an absolute pleasure to work with! But those others... well, I'm always so happy when they actually leave!!
Aw geez, everyone is misinterpreting and taking words sooo out of context. No wonder everyone complains about different departments acting *itchy to each other, look at your responses, everyone is convinced they're right. Take a moment to walk in another's shoes and look at situations from a different point of view. I personally haven't ever taken offense to another nurse being short because it rarely happens to me. Either that or I don't mind when spoken to in a direct and to the point manner or just realize someone is having a hectic/bad day.
I have seen a good majority of codes that could have been intervened. Why? Because of lazy floor nurses. I have witnessed a LOT of nurses too busy talking about their vacations/dates/children/personal illnesses/etc at the desk to notice their pt was tanking.
I'm not convinced either side is 'right' because there are too many variables that come into play. I can see both sides but I know I'm not perfect like some seem to think they are.
Oh and the med cup gets taped to the top of the upper bed rail upside down to help manage the lines and keep them from falling between the bed and rail or tangled in the bed.
I've never seen the tongue depressor trick, think I'll try it.
NurseLoveJoy88, ASN, RN
3,959 Posts
About to pop some popcorn... too bad I'm about to go out on a date to miss this though.
- On another note, can't both ICU nurses and floor nurses just get over it. We already have too much other stuff to deal with than nurses at eachothers thought. We are have the same goal which is to provide quality care to the patient, all this placing blame is non-sense and immature !