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Janet
New Member
Posts:9
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| 05/09/2010 6:11 PM |
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The other day we had literally just started report when the ED, for the third time this week, brought a patient up. We'd known the bed was assigned for at least an hour and a half but we had not received report. (ED is supposed to fax or call report at least 15 minutes prior to bringing a patient, and if they fax it they are supposed to call and make sure we got it) The nurse who brought the patient copped an attitude when she was told that we had not received report and she said she didn't know anything about the patient because she'd just gotten there and been told to bring her up. The patient's family member said "We've been waiting for a bed all night!" (Funny, the bed had been clean all night and the person who assigns beds knew that) The nurse who was to receive the patient called the ED only to be told that the nurse who had the patient all night had already left. The patient was not in emergent condition and was uncomfortable only because she'd been on the ED stretcher for several hours. The nurse who brought her got all kinds of huffy when she had to look in the chart and give the receiving nurse at least a rudimentary report
This is a pattern I've seen in about 95% of the hospitals I've worked in. ED seems to think they can hang onto patients until shift change and then dump them wherever they're going right in the middle of report, or right before. And they get away with it almost everywhere. The supervisors just shrug and say "It's always been that way," or "We can't do anything about it." In one place I worked there was a rule that no patients could be brought for an hour before or an hour after shift change unless they were going to critical care, but it was routinely ignored. The only exceptions were two small community hospitals where the staff all knew each other and it was understood there would likely be retaliation of some sort if patients were brought at shift change. Why do EDs have so little regard for the rest of the hospital? And why do administrations let them get away with it? |
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KY-RN
Junior Member
Posts:28
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| 05/20/2010 11:12 PM |
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| It sounds like your facility has a weak administration. Take a proactive role and ask for a meeting with the department heads of both departments and your chief nursing officer. Approach it with an attitude of wanting to bring about positive change and resist finger pointing. We have nurse conferences all the time where I work and it doesn't matter the level of the nurses involved. I have met with anyone from maintenance to the Chief Nursing Officer and the president of the hospital and have been very well received and have brought about lots of changes and it also gives you a sense of accomplishment. You will gain respect of your peers and be seen as a facilitator which can lead to better nursing care for patients and better care for the nurses. |
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DthFytr
New Member
Posts:7
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| 06/07/2010 2:16 PM |
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I've worked in ER's for over 20 years and completely understand your complaint as well as the "they're in the ER 8 hours and now they admit them" story. Let me assure you all this frustrates us as much as you, and we're just as helpless to do anything about it.
The ER point of vue. We've a certain number of beds, and often more than enough patients to fill them. Our goal is to get everybody in, treated, and out as fast as possible. If we can get ahead of the curve we have empty beds which don't require any attention from us. An empty ER is a happy ER. But like you we're at the mercy of things we can't control. Lab and x-ray take time. Calling in people for CT and ultrasound, more time. Once addmission is needed, the ER doc must find an attending to admit. And if they meat resistance (internal medicine and surgery each arguing the other should admit pancreatic cancer, for instance), or at 9AM the attending who says he'll be in after office hours (if he even remebers at 5 PM). Then we get admit orders all at once on several admits. We hate this system, and hate what it does to the floors too. Not calling or sending report is inexcusable. Admiting times and quantities are out of our control. It's the same in ALMOST all ER's. Sorry. |
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Susan
Junior Member
Posts:33
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| 06/19/2010 2:07 AM |
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Having worked in the ED and all over acute care I can tell you this, it just gets busy and the patient doesn't get transported because the RN is either busy taking your admit to CT before they bring them so you don't have to, or just when they were ready to transport them an L1 trauma came in and the whole crew is needed. Don't be hatin' baby. Of course there are those nurses in EVERY unit that hold a patient so they won't get another but that ignorance is not ED specific. I see them do it elsewhere all the time. Maybe it is just more noticeable from ED because you have to do all that admission paperwork. No need to be passive aggressive about it though. I find it helps to just ask why. Ask the nurse why it took all shift, see what s/he tells you? It might be valid, it might not, but at least you'll have addressed the issue.
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