ER Reporting, or Lack Thereof


#1
Dear ER nurses,

I realize that you’re extremely busy, but would it kill you to know something about your patients that are getting admitted?

Sincerely,

Every floor nurse, ever.

 

Seriously, I’m sick and tired of being played by these nurses, and I know I’m not the only one. I’ll attempt to translate some ER statements for those of you that may be newer to nursing and haven’t already discovered this firsthand.

"They're A&O x 4, continent, and walkie-talkie"

A good rule of thumb is to play the opposite game with these nurses. This patient sounds like a dream, so in reality you're probably getting a mess instead.

They’re likely confused as hell, soaked in piss, and literally might not even have legs.

ER nurses must have another definition of oriented & continent. Either that, or they are just compulsive liars!

The other day I admitted a patient who was “Doing great.” His vitals were “stable” and he was “answering questions” and “pleasant.” He was “continent of urine and stool.” Finally, he was “not trying to get out of bed.”

We got him up to the floor and he was half dead. His vitals were so bad (see below) that we called a Code Sepsis immediately. He was not answering any questions, just making groaning sounds. He had stool smeared all over the bed, and actively started urinating on himself as soon as we pulled him onto the bed from the stretcher. By the end of the shift he was in bilateral soft wrist restraints for pulling his IVs out and nearly falling out of the bed because he was so confused.

"Their vitals are stable"

This basically means they just have vitals, nothing more. The ER is more concerned with keeping people alive rather than making them stable. So if the blood pressure is 70/20 or 240/140, that's at least A blood pressure...

I admitted a patient the other day who I was told was doing great, and his vitals were stable. The reality: BP 240/120, Temp 103.5, Respirations 45, Pulse 140, O2 Sat 92% on 2L.

You know who else has stable vitals? A corpse!

Like I said earlier, this was an immediate Code Sepsis. Did these vitals magically turn to shit in the 5 minutes it took to transfer the patient to my floor? Or was the nurse just lying her ass off to get rid of this train-wreck? I’m gonna go with the latter.

"Do you have any questions?"

This is supposed to serve as a "report," but it's actually a common run-around to try to avoid discussing the patient getting admitted.

Why? Well I can only assume that they really don’t know what’s going on with the patient, so they just are hoping you will say to send them up.

Either that, or they’re trying to annoy you to the point where you just hang up in anger, and they get off the hook.

My next favorite quote is, “It’s not actually my patient, the nurse is on break.”

These shady, bullshit reports need to stop. If you know nothing, at least admit it. Don’t lie and make us think we are getting one thing when it’s totally the opposite. We’re supposed to be a team!