Comments on: How The Other Half Lives

By: andrea

andrea — Wed, 25 Nov 2009 03:33:51 +0000

the answer is “see you when you get here”. always. if everyone practices this like ER nurses the flow would go a lot smoother. we don’t NOT work up an active cp b/c we’re out of monitored rooms or heck, even a room! we don’t ask an ambulance to circle the block. we say “see you when you get here” we never ask a medic to wait on the dang phone while we find the nurse that is going to get that patient. in the moment its so busy everyone running with their heads cut off. but you hurry and tackle it then it’ll calm down again. if you take “no” and all the excuses out of vocabulary, the people that matter would be happier, the patient and administration. i’m sorry i’m saying we don’t in this equation, but it’s a voluntary army. if patients aren’t happy, then they aren’t returning. and if patients aren’t happy and / or returning, then administration REALLy isn’t happy, and guess what, they PAY us! so, i’m all about making the two happy. and i’ve never seen administration encourage pt holding in ed. i’ve never seen a press ganey with glowing scores when a pt waited 8 hours in ER for a bed. i work for a private one owner hospital and i realize how pt satisfaction and paying the bills of the hospital go hand in hand. there are studies out that say holding a pt in ED tacks on admittance hours of total stay. this is a constant battle and its senseless. the answer is “yes”,, always “yes, i’ll see you when you get here” or “i’m an RN and can take report”

By: Jessica

Jessica — Sat, 16 Feb 2008 15:17:18 +0000

Okay thanks Bryan and Jill. I have recently (in the last year) changed from floor nursing (oncology) to ER. I remember bad mouthing the ER for sending up a patient without having their stat orders done or complaining because of the lack of report but now�. I know better.

Okay when we are up to our elbows I can have:
rm 6 a confused GI bleed playing in his bloody poop with blood hanging (your pt)
rm 7 a patient actively seizing despite medical interventions
rm 11 trauma (count the holes and pluge em)
rm 12 overdose

oh and ems just called with a cardiac arrest and its got to go to rm 6 but the nurse wont take report so I move the patient to the hall space by the nursing station on portables, Cleaned the room (yes me not the EVS folks remember he�s been flinging bloody poo), and prepare for report of about two seconds as they wheel the guy in.

AND YOU SAY GET BETTER STAFFING?!? Who? Where? Show me a hospital not in need for staff ! Its just not that simple if there is not a qualified person to fill the hole!

Oh and I would love to count the number of times I had only a cup of juice to keep my blood sugar from dropping.

(BTW I Still LOVE my job)

By: Melissa

Melissa — Fri, 05 Oct 2007 15:35:05 +0000

I have worked on a Med/Surg/Rehab floor and TCU floor. The only time I have heard of us refusing to take a patient from ER is because they were too unstable for our floor and needed to go to the ICU instead.

By: er rn jill

er rn jill — Tue, 04 Sep 2007 05:24:41 +0000

i don’t want to hear sob stories about being buried in poop, there is someone on the unit who can take report. if a trauma rolls in there is always a nurse there to run the code. it’s simple to take off the gloves and put on new ones. i have gotten the most lame excuses for not taking report….putting a pt in restraints, starting a line, one heifer even said she was at lunch.. lunch break? what’s that? i ate my sandwich in two bites on the toilet. and they say they’ll call back, they never do. or it’s shift change, they’re in report. yeah, your report takes half an hour mine will take two min. no, i don’t know the last bm, the pt came in dead now has a pulse, i’m sending him up. further more, it does take a good half hour to get a pt up, espec if on a vent. so, in conclusion, when i have an acute mi in one room, two strokes in the other two, and one baby tripoding and breathing 50 times a minute, i don’t give a damn that the poor ICU nurse already has 2 pt, one which is down graded to tele and doesn’t count because ems is coding a pt on the wall because we don’t have a room. all nurses should have to do a month in the er before they dictate protocol.

By: spc

spc — Tue, 24 Jul 2007 21:30:34 +0000

I have been working both critical care areas for 30 yrs and I finally came to the conclusion a couple of decades ago that if I just tell the ER nurse to not tell me her problems,and that it’s fine on this floor, she goes away.
Not happy, but the important thing is, she finds something else to do with her spare time.

By: JMo

JMo — Sun, 22 Jul 2007 07:20:22 +0000

my sister works in er, and I work in icu. I tell her that if her staffing is bad, and she is caring for 4 icu pts then she needs to fix that within her own dept. push for more staff? Just because her work environment isnt the best, doesnt mean we should endanger our pts by accepting someone we know we cant care for. some do take advantage of the veto power (refusing a pt)and should be more flexable. My hat goes off to er nurses, they are a special breed of people.

By: Kelly

Kelly — Sat, 21 Jul 2007 17:26:40 +0000

Sounds like those nurses who use the fax report then deliver patient 30 minutes later seem to think it works well. I’m trying to imagine such a system on the OB unit where I used to work: we often didn’t even have a unit secretary on nights. Who would get the fax? Everyone was loaded down with labor patients or too many post partum clusters, charge nurse with her own patients, nurses answering the ringing phone when the passed by the desk.

The fax would hit the floor and when the patient arrived on the unit, there would undoubtedly be no clean room, (housekeeping would be at lunch or not answering their page), and there would certainly not be an available nurse. I miss nursing, but not scenarios like these!

By: Bryan

Bryan — Fri, 20 Jul 2007 15:55:29 +0000

When I worked in the ED, the big complaint from the floor and ICUs was “I’ve got too many patients, that’s not safe.” While that is true, what we often saw in the ER was an even LESS safe situation where the nurse trying to get rid of the patient might have had 3 or 4 ICU patients. I don’t know what the answer is though…

By: cileag

cileag — Thu, 19 Jul 2007 11:41:54 +0000

I just switched about a month ago to OB after working 2+ years in med/surg and I really appreciated this entry. It IS tough on both sides–yes, the ER doesn’t get a break, and it sucks for them—but when it comes down to it, I’m going to prioritize the patients I see in front of me over the ones down stairs. And if I can’t keep up with the ones I have—because there’s a confused, septic 90 year old in 4 point restraints, a vomiting quad with diarrhea and a painful bedsore that has to be changed every hour, along with “just” a routine hysterectomy or mastectomy and all the pain control, movement, much less emotional issues that go along with those—well, it’s not for lack of sympathy that I refuse a patient.

By: MyOwnWoman

MyOwnWoman — Thu, 19 Jul 2007 11:21:15 +0000

I’m one of those notorious ER nurses. Like Kim, we write our reports out on a form, fax it to the floor and they have 30 minutes to get ready for the patient. It seems to work out far better than calling report and being told that the nurse is at lunch or busy or…. you get the idea.

As I read your post though, I thought about one of the posts I read in the “Nursing Voices.” This attitude we have with EACH OTHER merely helps perpetuate the hunger that causes us to eat our young. Our anger should not be towards each other, but towards the ones that cause us to have these difficulties. Am I allowed, this one time, to blame “administration” for putting us in such dire straits?