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?!
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.
I bet a lot more are due to the acuity and staffing than are due to "lazy floor nurses".
I bet a lot more are due to the acuity and staffing than are due to "lazy floor nurses".
And there we go assuming again. If what you had said was true I would have stated as such. And I didn't say it happened everywhere, I said it's what I have personally witnessed.
and there we go assuming again. if what you had said was true i would have stated as such. and i didn't say it happened everywhere, i said it's what i have personally witnessed.
there was a wise post a few above this one, said:
look at your responses, everyone is convinced they're right.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I have seen both laziness, acuity, experience and staffing issues all effect patient outcomes and interventions. I have also seen a ton of wasted time and energy spent complaining, pointing fingers, and flapping of the lips that can be time and energy spent being with the patients more productive.......JMHO
"Do I play on my cell at work? Hell yes. Sometimes, you have the time to."
quoted from a previous psoter...
I personally don't think any nurses shouold be on their phones at work.:spbox: Unless you are on your break you are there to work and be responsible to the patients. Not updating your facebook. Not checking yor e-mail. Not surfing the internet for today's news and staying "connected". Your focus should be on that patient.....Just like when you are driving PUT THAT @#$& PHONE DOWN! :flmngmd:
Distracted nursing is just as dangerous as distracted driving........JMHO.
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.
there is also a culture in nursing of "young nurses who think they're amazing, knowledgable, and know all they need about their specific speciality and cannot possible know any more than they do - and shun all others who are not just like them."
It's called immaturity from my standpoint. But nurses eating their young works too....
Sorry, OP, you lost me at the tapped tongue depressor used to keep our multiple lines in order, not for seizures, and we have to take the rails off to get into the tight elevator to the old building where the step down is.
While you will never understand having to manage keeping these guys alive with no where else to send them, I do get floated to the step down and have to perform.
You can't take step down knowledge, which is excellent in it's place and compare it to the complex tasks and minute by minute decision making we do, and find ICU nurses coming up short.
Rudeness is never acceptable, but when the step down continuously sends us traches plugging, tube feed aspirations and sepsis from step down acquired wounds. that wasn't noticed until two shifts without urine output, we get a bit protective of our patients and a touch testy.
We walk in your shoes, I suggest a few shifts in ours, and you'll never post like that again in the future. Just MHO.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Sorry, OP, you lost me at the tapped tongue depressor used to keep our multiple lines in order, not for seizures, and we have to take the rails off to get into the tight elevator to the old building where the step down is.
While you will never understand having to manage keeping these guys alive with no where else to send them, I do get floated to the step down and have to perform.
You can't take step down knowledge, which is excellent in it's place and compare it to the complex tasks and minute by minute decision making we do, and find ICU nurses coming up short.
Rudeness is never acceptable, but when the step down continuously sends us tracheal plugging, tube feed aspirations and sepsis from step down acquired wounds. that wasn't noticed until two shifts without urine output, we get a bit protective of our patients and a touch testy.
We walk in your shoes, I suggest a few shifts in ours, and you'll never post like that again in the future. Just MHO.
I am curious......why will the OP NEVER UNDERSTAND? Can't she be taught if someone was patient and kind enough to explain? Will she NEVER decide to become one of the brilliant and elite ICU staff? When I moved from one part of the country caring for open hearts to another caring for open hearts....what I did in one to secure my lines got me reprimanded, ridiculed, and bullied by other staff members because "They had never heard of such a thing!:eek:" when I had been working with the top surgeons in the country and treated me like the village idiot. When, where I came from, if we secrued our lines to a side rail in ANY fashion our surgeons would have had a stroke and a cow over the danger of them being pulled out by being secured to a stationary rail.
Patience and understanding is key. If they are having plugged traches, teach them how to care for them. Tube feed aspirations occur in ICU too. If U/O is not documented and it is an order write it up and let them know why it is important. Sometimes documentation, if this is a common occurrence, will get the staffing patterns changed.
I really think we need to be kinder to each other and respect each other in order to elevate the profession. This constant one upmanship is undermining the dignity of the profession and is stunting it's growth. The "I'm better than you because....." makes us appear shallow and petty. I wish I knew what the deal was between ICU,ED and the floors. I have witnessed bad care and behavior form all three sides but I have also seen very limited productive work being done at first as all the energy is spent pointing out what wasn't done and how the other unit failed.
When I wanted certain behaviors to stop on other people I showed them another way to be.....JMHO
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i am curious......why will the op never understand? can't she be taught if someone was patient and kind enough to explain? will she never decide to become one of the brilliant and elite icu staff? when i moved from one part of the country caring for open hearts to another caring for open hearts....what i did in one to secure my lines got me reprimanded, ridiculed, and bullied by other staff members because "they had never heard of such a thing!:eek:" when i had been working with the top surgeons in the country and treated me like the village idiot. when, where i came from, if we secrued our lines to a side rail in any fashion our surgeons would have had a stroke and a cow over the danger of them being pulled out by being secured to a stationary rail.
patience and understanding is key. if they are having plugged traches, teach them how to care for them. tube feed aspirations occur in icu too. if u/o is not documented and it is an order write it up and let them know why it is important. sometimes documentation, if this is a common occurrence, will get the staffing patterns changed.
i really think we need to be kinder to each other and respect each other in order to elevate the profession. this constant one upmanship is undermining the dignity of the profession and is stunting it's growth. the "i'm better than you because....." makes us appear shallow and petty. i wish i knew what the deal was between icu,ed and the floors. i have witnessed bad care and behavior form all three sides but i have also seen very limited productive work being done at first as all the energy is spent pointing out what wasn't done and how the other unit failed.
when i wanted certain behaviors to stop on other people i showed them another way to be.....jmho
i can understand the feeling that the original poster will never understand. someone who entitles a thread "why are icu nurses so rude?" and then goes on to pick apart the care they deliver with easily refuted examples is not the poster child for learning and understanding. she's already made the assumption that icu nurses are rude and then jumped to the conclusion that icu nurses not only aren't perfect (which is true, but then no one is) and proceeded to pick apart the care that was given, proving that she has no understanding of those aspects of care. yes, people can learn if someone attempts to teach them -- but first they have to be willing to learn, and the original post did not strike me as coming from someone who was ready and willing to learn about the way icu nurses do things and the rationale for doing it that way.
patience and understanding are well and good, but i find it hard to patiently teach and be understanding of the ignorance of someone who is perpetually on the attack. i'm not, after all, perfect.
For God's sake. Can't we just say some PEOPLE are rude and let that be the end? Every person is different. Every unit is different.
When I was a brand new nurse working nights, taking care of 10-12 patients on a med/surg floor in NYC, I thought the ICU nurses were being mean when they asked me questions I could not possible answer.
What is the patient rhythm? Not monitored here.
What were the last lab results? We did not have access to computer back then.
When did you push metoprolol? I didnt because floor nurses cant push metop, the doc had to do it, and he didnt return my pages!
And the nurse would get more aggravated with each answer. I understand NOW, that she wasn't angry with ME. She was annoyed at the situation. Heck, I would be too at this point in my career.
Perspective is everything.
I get report now from podunk community hospitals about preop CABG patients coming over via helicopter. It consists of vitals and last BM. What I want to know is what were the results of the heart cath, troponin levels and labs, any rhythm changes, etc ectopy and so forth.
But they can't tell me that! So I just thank them for report, and figure we'll sort it out when they get here.
I have encountered some ICU nurses who have or need some serious attitude adjustments, but on the flip side of that Ive worked with some med/surg nurses that couldn't buy a clue as to what was going on with their patients and have a patient being transferred or code on the floor when they could have acted sooner, but I've also witnessed ICU nurses sending patients to the floor too soon and they wound up having to go right back less than 24 hours later. We as people have to understand that yes sometimes things do happen that's totally out of our control, but if each nurse either in ICU,med/surg, Tele, ED wherever gave each shift each patient their 110% we would have less need for press ganey scores, etc and possibly much better working environments in our respective departments...
As an ICU who has worked in a few different hospitals.... Why are the ward nurses always so rude to us when we transfer our patients to you?
If you feel intimidated by us then I am sorry but this does not correlate to us thinking that we are better than you. I would suggest looking into your own practice.
And yes when you have patients who are on 15 infusions you become mindful in protecting the pumps! :-)
Mulan
2,228 Posts
I bet a lot more are due to the acuity and staffing than are due to "lazy floor nurses".