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.
Nurse to nurse report is always better than "check the chart." All nurses try to keep up to date to our chatting but we all know how easy it is to get behind. If I only rely on charting that could be even an hour behind could e life changing. Taking 5 minutes out of your time to give me a thorough report about the patient, their clinical picture and what you've done for them saves me time and could save their life. It is incredibly frustrating when I get a patient I know nothing about and have to get the patient settled and figure out what's happening with them too because you can't be bothered to give me report. Floor nurses give bedside report every time a patient's care is transferred, what makes you think you are above that?
Would you accept a patient from EMS without first obtaining a verbal report from them? Would you be very happy if they said, "Read the PCR, all their info is there"? I doubt you would be very pleased.
And like many of my colleagues have pointed out. On the floors, we are not caring for only 1 patient. We are caring for up to 6 or 7. We are also dealing with family members, attempting to do a med pass (on time), chart, answer call bells, toileting people when the CNA's are too busy in the break room or bathroom for the 10th time in their 4 hour shift, helping figure out why the sound isn't on the TV for pt, running to the same bed alarm for the 5th time, and so on.
So no....I can't just look at the chart. I'm not asking for their life history. Just how & why they came in, pertinent tests & findings, access sites, fluids & mental status. 5 precious minutes of your time can mean a world of difference.
I will leave out the part in where I also believe it's basic PROFESSIONAL courtesy.
Perhaps your ER could learn a bit about assignments. In the ED I frequent (I am blessed enough to be both an RN & an EMT), they have people assigned for trauma teams, bedside care, transfers, ambulance triage, & so on. So when someone comes in "not breathing", a nurse giving report knows it's being covered.
I do give report. And feel there are things that need to he said in report that can't be conveyed in the chart. I just don't think that it us necessary for me to read the pts history to you or tell you when their last BM was. I feel the pertinent information should be given in report but I have had nurses ask for the craziest things that they could just as easily look up as they are sitting there taking report from me. In my experience most nurses taking report ask me to hold on while they get a pen and paper...so that tells me they are where they can most likely log into the computer. If all nurses we're more thoughtful to each other instead of playing the "I'm busier than you" card and realize we are all playing for the same team then these questions would stop. Report should consist of why they are being admitted, recent vital signs, where the iv access is, abnormal labs/tests, and meds given. I'm not going to take time and call the admitting doctor for you because he didn't order pain medication for the floor, I'm not going to start his sliding scale insulin for a BS of 175, I have gotten the pt stable. The rest can be done after the admission. Also..why bother to tell the nurse that the pt is on O2 when you get him to the floor and then have to go search for an O2 tree so you can take the pt off the tank and attach him to the wall O2.or go find an iv pole after you told the nurse in report that they have fluids going. Why am I giving you report if you aren't going to prepare for the pt anyway? Also...having to search for you when you know that you have just received report and I'm on the way up with a pt....it's not just giving report...it's the lack of professional courtesy shown by the receiving staff that has ER nurses so frustrated. Sorry for the rant. But if I'm going to take the time to give report then you should be prepared to receive the patient.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I do give report. And feel there are things that need to he said in report that can't be conveyed in the chart. I just don't think that it us necessary for me to read the pts history to you or tell you when their last BM was. I feel the pertinent information should be given in report but I have had nurses ask for the craziest things that they could just as easily look up as they are sitting there taking report from me. In my experience most nurses taking report ask me to hold on while they get a pen and paper...so that tells me they are where they can most likely log into the computer. If all nurses we're more thoughtful to each other instead of playing the "I'm busier than you" card and realize we are all playing for the same team then these questions would stop. Report should consist of why they are being admitted, recent vital signs, where the iv access is, abnormal labs/tests, and meds given. I'm not going to take time and call the admitting doctor for you because he didn't order pain medication for the floor, I'm not going to start his sliding scale insulin for a BS of 175, I have gotten the pt stable. The rest can be done after the admission. Also..why bother to tell the nurse that the pt is on O2 when you get him to the floor and then have to go search for an O2 tree so you can take the pt off the tank and attach him to the wall O2.or go find an iv pole after you told the nurse in report that they have fluids going. Why am I giving you report if you aren't going to prepare for the pt anyway? Also...having to search for you when you know that you have just received report and I'm on the way up with a pt....it's not just giving report...it's the lack of professional courtesy shown by the receiving staff that has ER nurses so frustrated. Sorry for the rant. But if I'm going to take the time to give report then you should be prepared to receive the patient.
So you expect the receiving nurse to stay rooted to the spot (except for setting up for your patient) from the you call report until you show up? Never mind the six other patients requiring pain Meds, toiletting or family questions answered? That's pretty arrogant!
After i give report that pt becomes her pt. So yes she should set up the room for her patient. I've been a floor nurse I've also worked ICU. I know that there is time to sit and read a chart during your shift because I have done it! I became an ER nurse because working the floor was not a challenge for me. But when I got a new admission I was in the room to greet that patient. I made sure everything was in the room that was needed for that patient or was able to go get it right away if it was missing. The other patients can wait unless they are coding or in distress. That new admit becomes a priprity because it is an unknown.I could also look over the pt and assess for any possible problems that the ER nurse may have overlooked. It's called doing your job.
I may become the enemy here but being in both the sending AND receiving ends of report (and still am) I agree with the writer. The opposition's points are less about having to read and more about concern for the accuracy of the charting. Then address the issue don't replace it with a heresay, not legally binding, "verbal" report. I put a lot of time And effort in to ensuring that electronic reports have all the necessary info. It takes at least 10-15mins of time (for a stable straight forward patient) in which I am not able to provide direct care. All this for receiving nurses, nursing partner or charge nurse to spend 2-3 minutes reading what you feel is important. Fix the system don't get upset with each other.
I work at a hospital that has a Rapid Decision Unit. It's part of the ED but is on another floor. It's frustrating not getting report for many reasons:
1. Sometimes the patient isn't in the system (on our unit) yet so I can't read the chart. I work at night so we have no unit clerk to look up patients. We do it all ourselves.
2. Many times nurses will draw labs and cultures before they're ordered so when I look up the patient in the chart they're listed as not done when they have in fact sent them to the lab already
3. If Patient is combative it's nice to know
4. Sometimes I'm unable to gain access to get a computer such as the other day I was on the toilet getting report.
5. We do a lot of Cat scans. They scan the contrast say at 10pm but the patient didn't finish drinking it until 11 pm. That can throw everything off
6. Last but not least, it lets us know if we are getting another patient so we can make sure the vital important stuff is done/given to our other patients.
i plan on moving to the ED eventually and really unless you have an emergency, it only takes 2,3 minutes to help out a fellow nurse. Is it really to much to ask?
Communication between nurses is key and also where we lack in our profession. It it vitally important to remain the patient advocate and gather all information important to deliver good care. Many times I have received reports that a certain history was indicated by the patient frim the ER nurse and never included in their history in the chart. Vital history is a must in order to have a complete understanding as to our next critical step. We gather history again after the admission is decided, however, as an ICU nurse, my priority is to quickly reverse my patient's critical state and to maintain stability. So, therefore, communication is key as it should be for all types of admissions regardless of where they are admitted to. We need to gel and make nursing a friendly world and stop arguing amongst each other. Find a common ground and work towards our common goal....the patient who depends on our excellent care and 100% attention with our unlimited knowledge. @ROCKON/NURSEON
Imagine if I as a floor nurse transfered a patient from my care to icu and suggested the receiving nurse just "read the chart"... Don't think that would go over well.!
Why not just skim the chart? Because as soon as I get off the phone the ER will be transporting the patient to me and I've had all of five minutes to prepare for this patient. Not to mention scanning the chart means getting a chance to get to a computer which I cannot do if one of my other six patients decides to have chest pain and now I'm in a rapid. Patient is placed in the room and I have zero information on them. It's about patient safety. I don't expect a lot, just a few minutes of the ER nurses time to tell me a few things such as diagnosis, code status, pertinent history (just the important things), if they have IV access/fluids, any oxygen/respiratory distress, things like that. I need to have the room ready with the equipment that the patient needs. Nothing worse than scrambling while the patient has already arrived to find an iv pump/pole, oxygen setup, suction, etc. I don't expect a play by play of what you did for the patient since they arrived, but a quick snapshot of the necessities I need to provide safe care is always appreciated.
As an ED RN, I can say that we focus on the problem at hand and worry about history later. We are treating emergent issues so when I get asked the last time someone had a BM I want to scream. Unless that said pt is constipated, it's irrelevant. I get that you are busy, but you are getting a stabilized pt from us ( if they are not then shame on that ED RN for sending them in the first place!) We often have another unstable patient waiting for that bed. So forgive us for being quick and to the point. If you would only take our calls within a reasonable time and not have 1000's of reasons why you can't, we would all get along and I wouldn't mind giving a phone report!
My favorite is when a Nurse answers the phone and says "I'm in an isolation room, can I call you back?"...ewww just eww why are you even answering!
DWelly14
35 Posts
Nurse to nurse report is always better than "check the chart." All nurses try to keep up to date to our chatting but we all know how easy it is to get behind. If I only rely on charting that could be even an hour behind could e life changing. Taking 5 minutes out of your time to give me a thorough report about the patient, their clinical picture and what you've done for them saves me time and could save their life. It is incredibly frustrating when I get a patient I know nothing about and have to get the patient settled and figure out what's happening with them too because you can't be bothered to give me report. Floor nurses give bedside report every time a patient's care is transferred, what makes you think you are above that?