Why don't you just read the chart?

[Guest219794]

Hey floor nurses,

ER nurse with a serious question. The question only applies to nurse who have access to the ER's computerized chart.

Why don't you just read the chart?

It has all the details you ask me about. In fact, I haven't memorized all those details, I just peruse the chart as you ask me.

I don't mean read the whole chart, I mean scan it for the details you want. I have no idea why you need to know ahead of time what size IV and where it is, but it's charted.

As far as a history? H & P, last visit, etc, is all at your finger tips. As far as what time each med was given- when you ask I open the MAR, and read you the times. I even say "I don't know, but it's been charted, I will open the MAR an look". When I say that, I am hoping you will get the hint that it would be faster for you to have already done that. Somehow, you always miss the irony.

Please don't say that you don't have time. That doesn't make sense. Think about the difference between reading something, and having it read to you. I can scan a chart for 2 minutes, and know just about everything. Add to this the fact that I really don't know all the details you want- I just kind of guess. As an ER nurse I may have received that same PT with a 1 minute report. It's all I need.

There is no question that it is faster and more accurate to scan the chart.

So why don't you?

[TakeTwoAspirin, MSN, RN, APRN]

I know, let's not communicate at all with one another! Fantastic idea, just think of all the time we will save! Can't possibly see any problems with that affecting patient care/safety!

Are you feeling the irony?

[RobbieDenRN]

I've been a member of allnurses for several years now. I have never responded to a post until now. Please take this response in the way it is intended. I appreciate the ED nurses. I really do. We couldn't do what we do without you guys. You asked a question, so here is my answer.

We don't just peruse the chart because we don't have time. We are caring for 4-8 other patients - depending on the floor - all at the same time you are calling to give report. Why do we ask where the IV is and what gauge? Because we need to know if we need to be prepared to start another line...say if we need to start blood and the patient only has a 22 gauge. Why do we ask what fluids they have hanging? Because while we are caring for our other patients, we are also having to prepare the room for our new patient that you just triaged and we need to know how many pumps to have ready. On my particular floor, I am caring for 3-4 other critically ill patients. I need to know what is going on with this new patient so I can be prepared. Notice that I use the word "need" a lot. What if this were your family member? Wouldn't you want and NEED me to be prepared to care for them?

[Oh'Ello, BSN, RN]

Well, since ebp is pushing towards bedside face to face report between nurses on the floor....why would a less engaging report be more effective between nurses on different units?

And yes maybe it is "faster" for you if I read the chart....but how am I to know when the ed has completed their interventions and charting?

[smartin13]

Sometimes I am taking report from the ED in the middle of the hallway, or in a patients room while they are toileting and do not have easy access to a computer to check so I ask. I am sorry if that is inconvenient for you, however I am no longer allowed to ask if I can call you back when I have a free second as my hospital now says we must take report from the ED and PACU when they call, no exceptions, to help with patient "flow". If we do ask if we can call back incident reports are written, so you get asked all kinds of questions that I could easily look up if I had the time.

Also I realize report in the ED is different then how things are done on the floor, however so are the goals. The goal in the ED is to stabilize and then transfer out or send home. On the floor our focus is a little different. We have different expectations placed on us such as charting requirements that the ED does not have. Not that one area is tougher or better they are just different.

[NursesRmofun, ASN, RN]

If I had to sit down and read a chart, I'd be getting less done or will be later getting it done. The small amt of time it saves to get a verbal report versus "scanning" a chart allows me to give a pain med. a little faster when one of my patients needs it, get my I & O's calculated, go get new IV bags for patients, get a bedpan, things you do on the run (not sitting down). At the same time, a verbal report allows me to ask questions about situations like i.e., why a certain test wasn't done, etc. I understand that we are both crunched for time.

[calivianya, BSN, RN]

There have been plenty of times I haven't been able to log onto the computer between when I was made aware I was getting a patient and when the patient arrives because I'm so tied up with other things. I am counting on the ED nurse to tell me what I need to know in those situations.

Besides, at least to me, the whole idea behind report is talking to someone who knows the patient and what's going on. It's faster to rattle the IVs, vitals, and recent labs off the top of your head than it is for me to tab through multiple sections of an electronic chart. It takes less than five seconds to say, "He has a 20 in his right AC, an 18 in his right forearm, his BP is 90/40, and his potassium came back at 2.0." As someone who has never worked in the ED, I really don't get why the person who is taking care of the patient isn't the person I'm talking to on the phone. I agree with you - it's a waste of BOTH of our times for you to be talking to me when you don't even know the patient and have to look information up in the chart. Please hand the phone over to the person who knows what's going on, if possible.

[Been there,done that, ASN, RN]

By all means... just send them up. I will peruse the chart in my spare time for the information I need..

You appear to think your time is more valuable than the floor nurse's time. Any hand off should include the IV site! A clear concise report takes 3 minutes. I understand there are times when the receiving nurse wants too much information.. that is when a suggestion to check the chart is appropriate.

[OCNRN63, RN]

I know, let's not communicate at all with one another! Fantastic idea, just think of all the time we will save! Can't possibly see any problems with that affecting patient care/safety!

Are you feeling the irony?

Thank you! My thoughts exactly.

[Everline]

I am a new grad and sad to see that this kind of thing is a problem. I depend on a good report (doesn't have to be long, but should cover basic things like IV status and other particulars) from the ER when a patient is transferred. I do try to look at the chart (what I can access) before a patient arrives but I don't always have time, at that moment, to access the information. Also,there are certain things that are not covered on a chart/not documented and I have found those things to be some of the most important. There are times when patients are not appropriate for the particular unit where they are being sent and making sure they go to the right place can save lives. A good report is wonderful and I'm happy to say the ER nurses who I've spoken with do it well and quickly. I keep questions to a minimum. I know everyone is super busy.

[Pangea Reunited, ASN, RN]

I agree that it's better and faster, although it looks like I'm in the minority here. When I get report, I only want to know what's NOT in the computer. It drives me crazy when someone tries to read me each lab result.

[CelticGoddess, BSN, RN]

Because my time is just as valuable as yours, and I also have other patients. And guess what, I might have questions that can't be answered by looking in the chart. And NO, it is NOT faster and more accurate to scan the chart Guess what, the chart doesn't put an eye on the patient. You, the nurse does.