Do you think, though, that maybe, just maybe you could try to do me a solid back by not making the 5 minutes actually 30 minutes, or asking me if I filled out the medication form 3 different times? Listen once and you'll save lots of energy in the future. Do you think a sarcastic "really?" is the most appropriate response to the fact that the patient has a 24 gauge IV that flushes very well? Sorry, if I could use voodoo to conjure up veins in dehydrated 98 year old DNR patients whose families rightfully don't want to put them through getting a central line, I totally would, but we didn't have a lesson in ancient magic during my internship. And while we're on that subject, I was also never trained in divination, so I don't know how to answer the question "what is her blood pressure going to be when she gets to me?" Also, riotous laughter about how shocked you are that an ER nurse actually did a skin assessment when I tell you my patient has non-blanching redness on her sacrum is not necessarily the most appropriate response, just so you know. Sorry if on the days I have a combative psych patient, a call light happy drug seeker and I dying ICU patient that I don't immediately think to run into the room of my immobile, non-verbal nursing home patient to explore what's happening under the diaper. I know that makes me an atrocious nurse and I should probably quit right now.
Seriously. It's so good we don't do bedside reporting. There would be so, so much more punching, that that's unprofessional.
Sounds like the floor nurses at your hospital are ridiculous as at mine!
ReplyDeletehttp://not-so-talltalesoftheicu.blogspot.com/2011/11/letters-to-floor.html
lol. yes, much more punching! I love it!
ReplyDeleteI'm a PACU nurse so I feel ya. 5 minutes is NEVER 5 minutes. Also PLEASE don't repeat everything I tell you as you are slowly writing every single thing I say down. Write down the important stuff because God forbid you do an assessment and find out where exactly on the left arm the IV is. They have an IV, does it matter if it's on the hand or the forearm? Also please don't sit at the desk as we come by with the patient on the stretcher and make me move the patient to the bed all by myself. I like my back, I really do. When you do finally come to the room don't act like you never knew you had to do post op vitals on a patient and then spend 15 mintues trying to find a BP machine. Ok, rant over. I can complain because I was a floor nurse for a long time.
ReplyDeleteMaybe if there were more punches, things would go smoother?
ReplyDeletehistory of why they came to the ER, admit diagnosis and the basic interventions, pertinent labs and radiology diagnostics IF you have them (we have computers too so we can look stuff up while they are the way up)), most recent vitals, general vicinty of IV and MOST important, are they coming up with a crazy family member. :)I can handle the rest. As an ex floor nurse always tried to practice keep it simple stupid.
ReplyDeleteThis post made me cringe because I recognize these nurses.
And when you get to the floor, 5 of 'em are standing there chatting at the desk, looking at Lia Sophia catalogues, and 0/5 of them walk to the room to help you slide the patient over. Even though my patient looks dead, I'm not making a morgue run, girls; put the Lia Sophia shit down and come on over and help me...
ReplyDeleteover here the floor nurses work their asses off, as do the er and icu but we all get along well usually, though it helps that we are a very small regional hospital and get to know eachother.
ReplyDeleteUh, sure we can do that. But in return how about if you ED nurses give us a report that might indicate that you have seen the patient. So the next time I get a report that says that the patient is self care and has been walking to the bathroom I won't have a WTF moment when he arrives on the unit and is a paraplegic. Or he arrives on the unit after being in the ED for 8 hours and as he moves to the bed I can SEE bugs crawling all over his hair. Why, there was not report of BUGS ALL OVER HIM. And by the way are you going to firebomb your room and stretcher down there? I know, you are so busy being important that you think us floor nurses are just reading magazines up here. Well I have news for you. I worked in a Level I trauma center before I moved up here to a Oncology/BMT Unit. We are not all idiots and we are busy. The grass is NOT greener on this side of the fence. So grow up and see the world as it really is. There is no easy job in nursing. Stop being a bitch and appreciate each other. There are plenty of stories to go around.
ReplyDeleteOoh girl. Please refer to the post before you start tossing the B words. I believe I mentioned I KNOW YOUR JOB IS HARD TOO. Damn. Sometimes stuff gets missed. Other times, people are just lazy, in all areas of nursing. Trust me, I see the flip, lazy holier-than-though ER nurses too, and they make me cringe. I'm not one of those people, and it irritates me when I'm treated like one when I obviously have my shit together and go out of my way to make sure things go smoother when passing on. That's the subject of this post. Not everything is a personal affront to you.
ReplyDeleteI believe Anon replied the way she/he did because your your post came across as quite sarcastic. I previously worked in the ER as a unit clerk and like the floors there are days when its busy and other days that its not. Now am an RN on a busy ortho/surg/med floor. We don't have a fancy electronic communication system to see whats happening in Emerge, so when I get your faxed report I am relying on it to be accurate and concise. I won't bug ya because if your report is accurate it has all the info I need to get started on a care path/plan. But when it isn't and the clinical presentation is something very different, or if pertinent information is missing you bet your ass I'm gonna call you on it if it compromises patient safety. On the lfip side, when one of my floor colleagues isn't pulling their wait and Facebook-ing when their call bells are ringing or their patients are soiled, or worse leaving a dirty room instead of planning and prepping for a potential admission, you better believe I'm going to push them to do their job and provide some decency and respect - for you in the ER and the patients.
DeleteIn the end, its about decency and respect for our patients and towards our professional colleagues. A little open communication, understanding, compromise and patience goes a long way. Do your job and I'll do mine, communicate with me and share the responsibility and things will go much smoother for both of us.
I truly think it would be good for nurses to occasionally spend time in other departments just to get an idea what everyone's day is like.
ReplyDeleteAmen to this post-- we fax our reports to the floor now, thank God so there's not a million questions about things that can be answered by looking in the chart for 2 seconds, or looking at the patient for 2 seconds. I agree, I wish we could all just get along but I think it would be better if the nurses on the floor knew the kind of shenanigans we have to deal with in the ER in addition to caring for a ton of "regular" patients.
ReplyDeleteDo you consider an aggressive, battering demented patient "regular"? How about the CIWA patient who is hallucinating and needing diazepam every hour. Or the post op patient who just came from PACU, and has 800ml output on his hemovac, needing stat blood for a hgb of 68 and is also retaining 500 of urine and needing catheterization? Don't forget about the ringer who wants his pillow fluffed, his channel changed and blankets pulled up because, you know...he has cholecystitis. On my floor, these ARE our regular patients and the shenanigans we deal with.
DeleteIt hurts me when ER/ICU nurses look at us floor nurses as dumb,lazy,slow stupid etc,etc,etc. I am a floor nurse and I do my job very well. I try my best to keep my patient alive. I rely on my clinical eye and gut feeling since we do not have all the advance gadgets like you have in your special units. It does not also help when doctors does not listen to us when we tell them something is not right with a patient just because we are only floor nurses. We sense it, we feel it from you, " the just a floor nurse". If we say we will call you back in 5 minutes but we were not able to because maybe we are in the middle of cleaning a patient, wiping poop all by ourselves because we do not have someone helping us coz most of the time we are understaff too.
ReplyDelete