I'm a brand new RN on a MedSurg floor. I had a patient last night that had an awful nose bleed around 5am. The doc consulted an ear, nose and throat doc to come in since the bleeding would not stop. The only thing was that I had to take him down to the ER, and that doc would meet us there at a certain time. I guess the doc wanted us down there instead of him coming up to our floor because of the equipment...? I guess that's a common thing.
So I call the ER to let them know what my ENT doc said, and they said that I have to stay with him the whole time since he's my patient...and I can understand that too I guess. Anyways, I had to leave my other 5 patients upstairs with my preceptor, and she would give report to the day shift since all this happened right at shift change. (I don't know who I would have left them with if this happened a week from now when I'm off orientation...I guess the house supervisor since we don't have a separate charge nurse or anything.)
I wheel the man down to the ER about 5 minutes before the doc is supposed to be there, and I'm directed into Room 6 where I try to get him set up as best as I know how. Well...the little O2 "Christmas Tree" thing wouldn't come off of the metal part so that I could hook up his humidified O2...so I go out to one of the two or three nurses at the nurses station and say "I'm sorry...Can you come here for a sec?" Actually...before that, I asked where they kept the water bottles for the humidified O2.
Anyways...somehow it led to them telling me a bunch of orders that the ENT doc had called up there with, part of those orders were to draw up some lidocaine, and gather up a bunch of equipment/supplies/stuff that I had never heard of. (And they didn't tell me any of that until I came out of the room to ask about the O2...but that's sort of irrelevant.)
So when they tell me to get those things, I say "I might need some help with all of that, I'm a new grad and never heard of some of that." After I said that, one of them starts going on about how they're not responsible for him, and that I'm going to have to chart on him...as if they haven't already established that. I wasn't really asking for patient care help, just a point to the right supply room.
(And some of you may be thinking that I wanted someone to hold my hand, but believe me, the last thing I wanted was to ask any of them for help, because I could tell that they weren't pleased with the fact that me and my patient were there in the first place. Heck...I didn't want to be there either, but that was the doctor's arrangement, not ours.)
I don't remember what was said after that but I just go back in the room and try to draw up the lidocaine that I now noticed had been set out on a tray...but there were no needles to draw it up with. So I go out again, and I ask where the needles were. I walk over to the place where they're getting the needles from (so that they won't have to walk all the way back to me...I'm trying to please these people). So I'm trying to make small talk and I comment on how crazy the night was upstairs with the FIRE and all...lol. (Yes...we got 7 transfers at once because something caught on fire on another floor...then there was a crazy guy wandering the halls where the fire started.) Anyways...that nurse starts on how much more horrible her night was with a lady in cardiac arrest, and this guy and that...But she was doing it in a way where she just kept talking about it...Like in a "put me in my place" kind of way.
So I was like..."Yeah I know, it's the ER, I'm sure it was bad."
Luckily, the doc put up with me not being fast at handing him what he asked for, and I found a nurse that I kinda know that helped me find the things I needed.
I just want to know if you all think they were snotty, or did I do something that was rude or aggravating? I mean...is that just our ER, or is that a typical ER? I'd like to work in the ER one day, or ICU, after I get a year or so of MedSurg, but if it's that bad where it makes you that rude to people then I'm not sure. I did a couple of hours in the ER before, but I was just doing IV sticks and the nurses kinda seemed the same way...Just unwelcoming and unfriendly. Not that I expect a big hug or anything, but geez. And I know they're busy, but we are too and our MedSurg nurses aren't that unfriendly.
I understand people don't have time to hold your hand, but everything they said was defensive. They'd squint at me when I'd ask something, then in their response they'd look away with raised eyebrows and kinda shake their heads quickly while talking. You know the look. lol
If I weren't busy, I would have gladly helped you. And if I were busy, I would have asked one of my co-workers to help you out.
I have been an ER/ICU nurse for 10 years and in 4 states. I have learned a few things over the years. Usually....mean, rude nurses are that way because they are either lazy or incompetent. They use their attitude to try to keep people from asking for their help.
We do not take admitted patients to the ER for procedures. The night supervisor would be responsible to get the needed supplies together and bring them to the floor. Sounds like an arrogant doc.
I personally think that the way the ER nurses behaved towards this new grad in a lousy situation was disgraceful. Apparently these nurses had forgotten that they were not hatched fully trained. My personal pet peeve of all time in nursing is PREDATORY BEHAVIOR. (The only the strong survive mentality) I love new grads and love to teach and help them (when I don't have a critical patient) and I especially love to hear a young nurse tell me they want to work in the ER, where we can always use the enthusiasm and vitality of the motivated learner. Sad that she was treated that way. I would suggest she apply at a DIFFERENT ER when she decides to make the leap, where maybe a rude culture hasn't taken hold.
This scenario is an EMTALA violation. I can only think that the ER charge nurse was new or something and didn't realize it....but you would think that the ER doctor would have known it. I'm sorry that the ER staff was not kind. There are many ways that I would be lost if asked to go to a floor and do something.
I personally think that the way the ER nurses behaved towards this new grad in a lousy situation was disgraceful. Apparently these nurses had forgotten that they were not hatched fully trained. My personal pet peeve of all time in nursing is PREDATORY BEHAVIOR. (The only the strong survive mentality) I love new grads and love to teach and help them (when I don't have a critical patient) and I especially love to hear a young nurse tell me they want to work in the ER, where we can always use the enthusiasm and vitality of the motivated learner. Sad that she was treated that way. I would suggest she apply at a DIFFERENT ER when she decides to make the leap, where maybe a rude culture hasn't taken hold.
Your post made me think and feel really bad about myself. I feel so pressured to get my job done and take care of my patients that I never volunteer to precept or help students in most instances even though I have alot to offer, I would love to help someone new to ER - it is just so hard sometimes when you are focused on your own occurences. I would however, never ever treat someone badly that is new or not help someone that asks for my help. I just wish I could do more sometimes.
Specializes in Surgical Nursing, Agency Nursing, LTC.
I'm sorry that you were treated badly. I know first had how busy it is in the ER BUT it gives no one an excuse for that treatment. I know of a lot of nurses in our ER that would have been a little more helpful. At least I hope so. Well I know I would have been. I know how it feels to go to another floor and ask for things and they act like they don't hear you or it's toooo
much effort to get their A-s up and help look.
Let it go and keep moving. What goes around comes around!!!
i want to first applaud your diligent evaluation and assessment of this patient and your obvious tenacious communications with the attending physician that prompted the ent consult. this is a trait that we don't find often anymore even in nurses with extensive clinical experience in and out of the critical care arena. had you not been as diligent in your nursing practice, this patient had the potential for a critical decline, possible cardiopulmonary arrest and ultimately death. you deserve more than an "atta boy award" you deserve to be held as an example to nurses everywhere related to what we are all here for, "the patient" and insuring patient safety at great odds.
perhaps the emergency department nurses that you were forced to deal with forgot that it wasn't you, it wasn't the doctor, it was the patient that was the issue in this here. we should never lose sight of the reason we are in healthcare and that is "the patient". i am assuming that this patient was awake enough to see and hear what was going on, i'd be curious as to what kind of an impression this unprofessional interaction made on the patient?
since we don't have the details related to the case and don't know what was causing the bleeding, we can only make some assumptions about the need to bring the patient to a specialized area (ent room) to provide definitive and emergent care. at the very least this patient was in a location where there was a "physician" immediately available if the "airway was lost" due to the bleeding or prompt intervention if uncontrolled exsanguination ensued. any of this beginning to sound familiar to those emergency room nurses that are feeling indignant about this event? airway, breathing, circulation the foundation of emergent management of any patient?
taking the ent room to the bedside, isn't generally a feasible option, because as soon as you attempt to do that, you will for sure have forgotten "something" and one thing in particular is the funky chair that will contort and get that patient into just the right position to work on orifices that aren't easy to access in any setting.
another thing to think about is the fact that this ent was on staff in that facility and that means that the emergency department nurses should have been familiar with him/her as well as the procedures that would be completed. what a collaborative nursing opportunity that was "missed". do you think those same nurses would have been any happier if they had been called to a code on the floor related to this patient?
there is absolutely never an excuse for anyone, whether it's a nurse, a physician, or an environmental serves rep to be rude or turn our backs on other members of the healthcare team as well as patients and their families. we're all in this fight together, just from different perspective in the wheel spokes.
in my personal opinion, the nursing supervisor should have accompanied you with the patient to the emergency department to ensure that you received the assistance that you needed to care for your patient in this critical situation as well as ensure safety. the supervisor could have impacted the negative interactions.
again, god bless you for your diligence, caring, and professional behavior, you are going to have an exceptional nursing career and will without a doubt provide a positive impact to patients and healthcare for years to come. it sounds to me like your emergency department could use a "few nurses" like you on board.
i want to first applaud your diligent evaluation and assessment of this patient and your obvious tenacious communications with the attending physician that prompted the ent consult. this is a trait that we don't find often anymore even in nurses with extensive clinical experience in and out of the critical care arena. had you not been as diligent in your nursing practice, this patient had the potential for a critical decline, possible cardiopulmonary arrest and ultimately death. you deserve more than an "atta boy award" you deserve to be held as an example to nurses everywhere related to what we are all here for, "the patient" and insuring patient safety at great odds.
perhaps the emergency department nurses that you were forced to deal with forgot that it wasn't you, it wasn't the doctor, it was the patient that was the issue in this here. we should never lose sight of the reason we are in healthcare and that is "the patient". i am assuming that this patient was awake enough to see and hear what was going on, i'd be curious as to what kind of an impression this unprofessional interaction made on the patient?
since we don't have the details related to the case and don't know what was causing the bleeding, we can only make some assumptions about the need to bring the patient to a specialized area (ent room) to provide definitive and emergent care. at the very least this patient was in a location where there was a "physician" immediately available if the "airway was lost" due to the bleeding or prompt intervention if uncontrolled exsanguination ensued. any of this beginning to sound familiar to those emergency room nurses that are feeling indignant about this event? airway, breathing, circulation the foundation of emergent management of any patient?
taking the ent room to the bedside, isn't generally a feasible option, because as soon as you attempt to do that, you will for sure have forgotten "something" and one thing in particular is the funky chair that will contort and get that patient into just the right position to work on orifices that aren't easy to access in any setting.
another thing to think about is the fact that this ent was on staff in that facility and that means that the emergency department nurses should have been familiar with him/her as well as the procedures that would be completed. what a collaborative nursing opportunity that was "missed". do you think those same nurses would have been any happier if they had been called to a code on the floor related to this patient?
there is absolutely never an excuse for anyone, whether it's a nurse, a physician, or an environmental serves rep to be rude or turn our backs on other members of the healthcare team as well as patients and their families. we're all in this fight together, just from different perspective in the wheel spokes.
in my personal opinion, the nursing supervisor should have accompanied you with the patient to the emergency department to ensure that you received the assistance that you needed to care for your patient in this critical situation as well as ensure safety. the supervisor could have impacted the negative interactions.
again, god bless you for your diligence, caring, and professional behavior, you are going to have an exceptional nursing career and will without a doubt provide a positive impact to patients and healthcare for years to come. it sounds to me like your emergency department could use a "few nurses" like you on board.
I think the scenario you describe could happen in any ER--it just depends on who was on duty. I agree with the previous comments that the ED is not the place for Inpatients to be sent for procedures since the ED is technically an Outpatient area.
I also agree with the previous comments that the ED is the one hospital area that is not allowed to say "STOP" we are too busy, close the doors etc. The ED becomes the dumping ground for all types of patients and might have multiple emergencies going on at once and with questionable staffing levels on top of that.
All that said, we do have to think about the patient and the availablity of needed services. If the ENT doctor was not able to find a facility other than the ED to take care of this patient, then the ED was the ONLY choice.
Sorry about your experience, we aren't all grumpy!
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LeahJet, ASN, RN
486 Posts
Sorry for your bad experience.
If I weren't busy, I would have gladly helped you. And if I were busy, I would have asked one of my co-workers to help you out.
I have been an ER/ICU nurse for 10 years and in 4 states. I have learned a few things over the years. Usually....mean, rude nurses are that way because they are either lazy or incompetent. They use their attitude to try to keep people from asking for their help.