I mean, they were when I worked on the floor. I'm just wondering, because lately, we're getting a lot of complaints about "unfinished business" after transferring a patient to the floor.
I'm not talking about sending up an unstable patient. I'm talking about busting ass on a patient who is going to a regular med/surg floor. Listen: you have most of the same training I do. You're certainly able to give meds, and put in a Foley, and page the covering resident for order clarification. Actually, you're MORE able to do those things, because your patient load gets capped off after about 6 patients. Mine doesn't; ambulances keep coming in. Also, I can have ICU and tele patients in my care, and unless you work in those units, you don't. Also, my patients are all more unstable than yours due to the nature of the emergency department. Here are my requests:
Don't complain to the nursing supervisor that a Foley wasn't placed on your patient in the ER, especially since the admitting doc was the one who ordered it six minutes before the patient went upstairs. We both were taught how to do this in nursing school. I know you haven't forgotten.
Don't call me complaining that the patient is "unstable" just because he has a blood pressure of 180/90 on arriving on your unit. His pulse is 78. He is asymptomatic. He has a history of hypertension. He's being admitted because his private doctor wants his hypertension under control. If his pressure had gone down in the ER, we would have DISCHARGED HIM. Call the covering resident and get some admitting orders. What, you can't give metoprolol or labetolol on your floor? You DO medicate your patients, do you not? I don't get excited about a BP of 180/90. I need at least 220/110 to start getting my panties in a bunch.
Look, I'll happily START a blood transfusion on your patient before he comes up. But once I've established that there is no transfusion reaction, the dude is coming up to you. I am not keeping him in an uncomfortable ED stretcher for two to four more hours just because you don't want to document the end of the transfusion. Also, I need the space for other patients who are coming in.
And speaking of which, if I call you and ask if a patient's bed is clean, and you tell me that the ROOM is clean and ready, but that there is no actual BED in it for some reason, don't get all pissy with me when I send the patient up in a stretcher to lie in that spot till YOU get building services to send a bed. If he can lie in a stretcher downstairs, he can lie in a stretcher upstairs, and don't threaten me with calling the nursing supervisor—I already called her and told her what I was doing. You won't get any sympathy from her. I need the damn space.
Seriously, folks, I'm busy. I have things to do.