chiming in
whose fault is it?
why are patients being held up in the ER?
patients who crowd the ER for real concerns of unknown or scary but non emergent cases. can you blame them?
diagnostic tests techs who are squeezing in non emergent cases while waiting for emergent ones and are in the middle of something when the emergency test is being ordered. is it their fault if some of the machines either play up or just all of a sudden stopped working? can you blame them?
housekeepers who have been paged to clean three isolation rooms before they get the call to clean a room stat, for an admit, and can’t make it because they are in the middle of their 30 minute lunch break which was supposed to be hours ago, but they never had the chance to take? can you blame them?
patients who are supposed to go home, their family on the freeway, but there was an accident so they were late in picking up. can you blame them?
doctors who are forced to deal with a number of patients more than humanly possible to handle. those who get weary and forget to write or ask a few things and end up eating more of the very small time the ER nurses have. can you blame them?
floor nurses who are sitting on their chairs, doing nothing, who have no idea they’re supposed to go up the ladder and take off the old curtains so the isolation room can be ready ASAP. those who, after four straight hours of assessment, cleaning, repositioning, suctioning, changing linens, changing dressings, calling docotrs, following up lab draws, giving meds, changing diapers, following up with pharmacy, feeding, reassuring families, have the audacity to sit down and catch their breath just because. can you blame us?
well, maybe you can blame some of us. but you can’t blame ALL of us.
there maybe patients, techs, doctors, or nurses who delight in nothing but delay. they find it very amusing that ER nurses are up to their necks with things to do, and a place so chaotic, they end up very edgy. some people probably wake up each day, thinking of things they can do to create a sense of imbalance in ER, and to annoy the ER nurses.
there is a possiblity that some people are like that…but not ALL people are like that.
when i receive a patient from ER whose bottoms are covered with hardened stool, (the kind of stool that even a ten year old will know have been in there since who knows when) i gather the things i need, and clean the patient. i won’t lie and say i was happy i get to clean the patient when he should have been cleaned a decade ago, but i don’t go around telling everyone that ALL ER nurses don’t have the heart to care enough to clean a patient. i reason out that there must have been some emergency trauma cases that poured in one after the other, and seriously, nobody really died from an unclean ass. saving lives is more important than cleaning poop. i get that.
when i see ER nurses sitting, doing nothing, then i get an admit from the ER,whose urine leaked under the sheets and was soaking wet, it is NOT automatic for me to think that “ER nurses are lazy and superior, they don’t think keeping a patient clean matters”.
is it then too much to ask, that ER nurses NOT automatically think that floor nurses who are sitting, doing nothing are lazy asses causing the delay in patient admission?
some things are just unavoidable. it is not a sin to see a messed up system and believe no one is to blame. sometimes, it is just a series of unforeseen, unfixable events. sometimes, despite heroic efforts to make things move faster, there are still instances when delays happen. sometimes, there is absolutely no one to blame, and it is absolutely no one’s fault, and things can still be okay.
at the end of the day, blaming anyone doesn’t REALLY help the patient. we are all in this together, and we are better off as a team rather than competitors.
sorry for the rant. i just chimed in because geena asked. not just me specifically, but i’m one of the med-surg nurses.

Hear, hear. I couldn’t have said it better.
Comment by Nurse Bear — July 23, 2007 @ 4:05 pm
And people say they are afraid to go to nationalized healthcare because our current system is oh-so-wonderful, they are afraid there will be problems with a healthcare system in which everyone is actually insured. Oh yea, the are afraid there will be waiting times. Well, if there are no current waiting times, then why does it take a YEAR for a child to get a sleep study and AT LEAST 6 MONTHS to get an appointment with neurology???
Comment by Lisa — July 23, 2007 @ 6:53 pm
Thanks for chiming in, May
Good post!
Comment by geena — July 23, 2007 @ 7:14 pm
Things take time.
Comment by shrimplate — July 23, 2007 @ 10:36 pm
Another great post May! In this day and age society seems to focus on two things: 1) results, 2) who to blame when we don’t achieve results. The easy way out is to CYA and blame the person next to you. It takes someone with a lot of strength and courage to step back and look at the whole picture before making a judgement instead of falling into the CYA trap.
Comment by PD Warrior — July 24, 2007 @ 4:44 am
Moving around in the health care world (from unit to unit) does so much for helping you understand the stress each area has to deal with. To an outsider every area looks so easy - until you try to do it - do it well. Why is it that we advocate for our patients and families and work extra on committees but don’t give each other the same support…? An age old question that I have been asking for my 200 years of being a nurse.
Comment by Dancer — July 24, 2007 @ 8:37 pm
Hmmm… I guess it’s not really anyone’s fault there. Things are sometimes out of our hand to control. Maybe ER nurses have a lot to think about or just more stressed out? Hehe I dunno
Comment by Ferdz — July 24, 2007 @ 11:43 pm
Must be ER/Floor Tension Month!
Comment by beajerry — July 25, 2007 @ 8:21 am
Great post!
I worked ER registration/OP (now called patient access)for 20 years. Then with down sizing they also had us doing admissions and SDS among so many other things.
I loved my job because I was right in the mix with the ER staff and considered them my department more than PT Access. I did 3-11s and worked solo.
Anyway - I feel like I have seen it all. I have seen how stressed every department gets - ER/LAB/X-Ray/Respiratory/the floors - med/surg/ICU/the kitchen/housekeeping, etc.
For me the stress was when everyone wanted everything at once and really yesterday. I hated that the last few years our system was set up so that the ER staff would be held up if we didn’t generate a chart number for them and then if the system went down AND I couldn’t get systems on the phone..well suffice it to know I was ready to go out the door and get a job spraying perfume at the mall, etc. anything that seemed non thinking and non stressful! I understand now with their new system it is not that way anymore so that is great.
I have seen and appreciate each department’s stress when it is a hellacious shift. Ours is a small hospital and uniquely like family. Doctors that also work in the big city hospitals said they have never seen a hospital pull together like ours did. It is a little different than when I started out but we do pull together. Tempers flare, personalities clash but it usually settles down.
I am most familiar with ER and so I KNOW how they get slammed with things and beds back up and no one gets time to eat or even pee. I have seen their frustration when they can’t get a patient into a room or get the labs or whatever necessary. Or worse when things are going south on patients and they have a CPR in progress rolling in the door and yet they get the job done doing what the need to do. (different hospital but one of my friends used to work in OB and one night the Doc was so pissed off at lab that he sent a dirty diaper to them in a tube.) I have walked out the door with the floor nurses 2 hours after our shifts were over who didn’t get to leave on time because they were so backed up and still had to finish charting etc.
I can’t speak for other departments and slackers but in the ER they would just have to kill that staff person, dispose of the body and bring in someone who will work their ass off. But it is a small hospital and no place to hide if you don’t want to work.
I have been at dinner and heard the floor nurses complain about certain nurses/aides feeling that they don’t pull their weight for whatever reason, or that they will stay in one area when they should have been working with more patients.
Then their is Patient Access. It would seem that we only push the papers but in reality it was so much more because we were the first ones to see the patients, not only do our work but juggle phones from all departments and outside world, handle families, friends, squads, police, paramedics, etc and get blankets, ice and be the liaison between staff, patients and families, etc.
Personally speaking - on the bad nites - the kind of nite where I knew the staff would not take kindly to the extra requests coming from patients and families, etc or conversely when patients and families wouldn’t be pleased with staff not able to attend to them right away - I always found ways to soften the questions or responses to help keep things going smoothly. By nature I am a peacemaker and so I think I was pretty good at that. Some people come in like a bull in a china shop and oh boy!
Sorry so long. You stirred up some memories.
I will be going back to work soon and am thinking of going to a larger hospital in our system or a different but busier community hospital and I was toying with maybe trying out working as a unit secretary for ER or med/surg, etc. I am wondering if it will be interesting and how the stress compares to patient access work? I just want to be around medical staff, patients and work to be interesting which it usually is when patients are involved because it’s almost always different.
I have been out of work for almost 15 mos and am feeling a bit shy about going back into the work force but I know this too shall pass.
I hope it is alright that I blogroll you.
Comment by SeaSpray — July 25, 2007 @ 9:37 am
Nicely said. As specific as it is to floor and ER nurses, the thought transcends to everyone, assuming.
I liked the flow of this.
Have a great night, May!
Comment by Veronica — July 25, 2007 @ 9:29 pm
i have to clear this up…. You’re talking about the situation in the US right? hehe
Comment by Rygel — July 26, 2007 @ 8:53 am
Couldn’t have said it better myself. Thanks for the post.
Comment by Julia — July 26, 2007 @ 5:00 pm
Excellent post! I love what you said about us all “being in this together” and that teamwork is the answer. I used to have a boss who would absolutely lose her mind whenever someone would call in sick. I mean, she would rant and rave about it so loud and long that it was distracting and created a terrible mood among the staff–which only added more negativity to the woes of being shortstaffed due to the absent nurse. I never said it out loud to her but I always wanted to ask her to just chill—because sure, there’s problems that come up in this job—but we can all help each other and get the job done.
Comment by The Bohemian Road Nurse — July 26, 2007 @ 5:32 pm
Well said! You are a nurse I would like to work with.
Comment by Beth — July 27, 2007 @ 1:25 pm
We are all in this together and when things don’t go well it’s everyone’s fault. There is so much to do, pointing fingers at each other shouldn’t make the list.
That isn’t to say we shouldn’t look for solutions to issues, but great problem solvers waste no time on blame.
Onehealthpro
Comment by Judy — July 27, 2007 @ 4:18 pm
Thanks for the blogroll!
Comment by SeaSpray — July 28, 2007 @ 6:33 pm
may - excellent post, as usual!
i’m sorry to say it is no different in the operating room. people point fingers at each other all the time. nurses vs. surgeons, anesthesia vs. surgeons, staff vs. housekeeping, and the list goes on and on. but when when you get the right combination of people - people who believe in TEAMWORK - it is like a symphony!
Comment by unsinkablemb — July 31, 2007 @ 4:47 pm
You want teamwork? One of my first jobs was in LTC. An alzheimers unit with 48 residents. I worked the same unit with an LPN and the same 4-5 CNAs for about a year, and we worked very well together. For Christmas I bought everyone, including our unit secretary a hang around your neck Bic pen, no big deal, but it solidified our “team” and it was an inexpensive way to make my floor work even better as a team. Much to my suprise, about a month later, the administration, who apparently discouraged teamwork split us all up. How stupid are they???
Comment by Ellen — August 8, 2007 @ 3:37 pm
Wonderfully written. I think you read my mind.
Comment by Ali — August 17, 2007 @ 9:30 pm
I understand you, sometimes we come with a low level of medical services, but remember please - not all the doctors are good and the same with patients.
Comment by Ambulance nurse — February 21, 2008 @ 9:06 am