Why don't you just read the chart?

NurseSpeedy, ADN, LPN, RN · Oct 11, 2016

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.

ERRN2016 · Oct 12, 2016

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!

Ruby Vee, BSN · Oct 12, 2016

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!

Because she's just paged the resident to come look at the patient, the wound care nurse to look at the butt decubitus or the Diabetes Nursing Specialist for recommendations on an insulin order. She can't leave the room for 20 minutes because she just pulled an art line and it's still bleeding. There are plenty of reasons to answer a phone in an isolation room. I would hope that the phone STAYS in the isolation room, however.

KimmiejsRN · Oct 12, 2016

Why don't you read the chart...

Well to start with since most charting is done electronically it could be hours before a H&P or any type of notes from the physician regarding current illness is in the computer. If this is the first time the patient has been at your facility chances are there will be no notes.

Why is it it so hard to give a short pertinent report to the receiving nurse? In addition to receiving patients from the ER we also can have up to 15 post- operative patients on any given day. Add 5 inpatients to the mix and it can be quite a hectic situation. Seriously, when you already have 6 other patients a good concise report from the ER is appreciated more than you will ever know. I also do not get this mentality. Aren't we all trying to give the patient care possible? Why is it so hard to give a report prior to the patient being transferred to the floor. Maybe I am old fashioned but telling an overwhelmed nurse working on an understaffed ward to look in the chart in my opinion comprimises patient safety and creates tension between the ER and floor. We are all working towards the same goal, delivering safe and compassionate patient care. Please, for everyone's sake do not act like a spoiled obstinate child when asked a few pertinent questions. Creating hostility between the ER and the floor is counterproductive and serves no purpose whatsoever. As a floor RN of 22 years all I ask for is to be treated the same way I treat you, with dignity, respect, and a little bit of understanding and acknowledgement that you understand I might already have 5 to 7 patients that I am already taking care of.

C33M18R · Oct 12, 2016

As a new ER RN and a former med tele floor nurse, I agree with the OP...to a certain extent, all I wanted to know were the things that weren't charted, like, is the family nuts? Can the pt walk? Are they gonna be a "problem child"? What did you do to stabilize this pt? That kind of stuff. The rest of the info takes two seconds to look at in the chart, I didn't have time to be on the phone listening to a nurse tell me about their labs, imaging, etc. when I already glanced at it. Maybe that's why I'm in the ER now, I like the big picture not the small details!

PRN17 · Oct 12, 2016

Ok I saw this question and I needed to respond. Being an ED nurse, our world is different from the floors, I get that. However all this talk about not having time, it does not take long for us to give report, we talk about the main concern, honestly we don't care about their last visit, or the last time the had a BM, we care about here and now. Yes, we stabilize and transfer, that is our job. Floor nurses complain that they don't have time, or have 4-8 pts, or make us wait to transfer a pt, because the nurse isn't ready or at dinner, well we get 4-6 pts, we get people coming from ems with no place to go, we are dealing with critical lives at any given time, all the time. We are quick and multitask all at once, and dinner what is that?. We are lucky if we get to use the bathroom once during our shift. . So when we say can you look at the chart for all the minor details, it's because we do not have time. We give the essential information quickly. Floor nurses forget that yes, you get a new person, but forget we have a pt already waiting at the door to come in.

We both work hard, we are both busy in our own way, you work with us and we will work with you....so when the ED calls and wants to give report, please don't make us wait, and understand usually if we are slamming busy, you will be too

crazyrn07 · Oct 12, 2016

As an ED nurse, you focus on the reason the patient came in. Such as chest pain. As a floor nurse, I'm focusing on everything else that was found while the patient was in the ED. And up to 5 other patients at the same time.

No, I don't always have time to look at your chart, nor do I always have access to it. The admitting practitioner may it. The facility may not have the same electronic charting in the ED and on the floors. There are any number of reasons as a floor nurse I can't look at the chart, so as an ED nurse, you will be asked questions, sorry.

GaleSRN, BSN, RN · Dec 4, 2016

I was an ER Nurse for 10 years. I totally agree with you. My time is just as valuable as your time. I am on the phone with you reading the chart to you, meanwhile the man in room 3 is having an MI, the Trauma room is destroyed because of the auto accident that just made it to the OR. The lady in bed 5 needs an IV started 5 minutes ago. Yes, report is important, but let's compromise. You read my notes and I will fill in any blanks.

SilleLu · Dec 4, 2016

I do both. I review the chart but also expect a verbal report as many times all the charting hasn't been done before they try to send the patient. Have caught several inappropriate placements this way. For instance, ER physician charting states patient had HISTORY of shingles. Nurse calling report says, you're not pregnant are you? This patient has active shingles. Um, No, I'm not pregnant, but the patient in the other bed is! And I've caught things the other way too, where the charting shows something but the reporting nurse isn't aware of it because maybe she just came on shift or is giving report for a coworker, etc. So for myself, I always do both.

That said, if I know ER is slammed, or I can tell nurse is in a hurry, I briefly state what I have reviewed ("I've reviewed current orders, labs, IVF and access, and it looks like you've given abx and pain meds) and ask "what else do you need me to know about this patient?" I get exactly what I need to know and ER nurse is happy with a quick report.

CommentClear · Sep 9, 2017

The EMR is hard to navigate and just imagine if while reading the chart while caring for 4-5 other patients, I miss something critical. I don't want that to happen. Speaking with you directly may help during that hand off. It is a patient safety issue. I don't require a face to face- but a voice to voice with someone who wants me to have a good patient outcome tonight. My favorite was the ED nurse at change of shift came up to make sure I had all I needed because she knew the patient was going to be hard. She stayed and helped me get him settled. We are a team after all.

ChrissyCasualty · Sep 27, 2017

Here is how it works at my hospital....

Yes, we have access to the ER charts. But we are not allowed to access them unless we are the charge nurse. And when we have an admit come in from the ER, the charge nurse has a TON of paperwork. We need IV size and location for our MS admission and our system does not transfer that over. We ask about meds because once they are transferred, the ER record is locked and requires admin to access it. All of the information you mention is standard report so it os expected of us to hand over that information in order for us to properly care for the patient

TXMedPsych, BSN, RN · Sep 27, 2017

Just reading the chart doesn't give me the chance to ask "Is there anything else you would want to know if you were me?" Yes, I really do say that.