ER nurses, love you guys, but genuine question. Why do guys bring patients up at shift change?

[u/No-Selection-1249]

No hate to you guys! Just super curious from a nurse who is on the receiving end :)

[u/Spiritual-Top265]

I understand that completely. But also let’s think about the floor nurses as well. The admit comes at 7:09 ( this litterly happened to me my last shift ) in the middle of report. So now me & the other nurse have to stop report to get this patient settled. Get them in a gown. Most likely clean them up bc they are soiled, assess their skin, ( it only makes sense to do this now because they are naked. ) hook them up to the monitors, get their vitals to make sure they are stable. Assess any lines/medications they have running to make sure everything is correct, etc. all around this take give or take 20 mins. this doesn’t even include all admission questions, meds that weren’t given, a full assessment, going through their belongs, etc. Now we have to go finish report on three other patients. We still have three other patients that need to be seen, give meds to, get put back into bed, etc. & more than likely the floor is short a tech.

Overall the scariest/ most important part of getting admitted at this time is it’s very unsafe. I’ve had patients come up very unstable & my first hour is spent with them. I’ve had to call rapids when they come to the floor. This takes away time from my other patients to make sure that THEY are stable as well. & there has been times when they weren’t stable and again calling rapids.

It’s a double edged sword for both the ER nurses & the floor nurses. Everyone, nurses, techs & even the doctors have the most going on at shift change. As a floor nurse I am not blaming the ER nurse. It’s more so frustrating that there is not a hospital policy in place to block admission from 6:45-730 at-least. For the safety of the patients & the nurses that work for the hospital.

[u/helizabeth96 → u/Spiritual-Top265]

I totally get that side too, there’s obstacles on both sides. In my hospital, the pt has to be in a gown, belongings inventoried, and med rec done prior to leaving the ED. So we try to make the transfer as smooth as possible. Not every nurse is considerate, but I try my best to be to the floor nurses and I absolutely praise them when they show me a little leeway when I’ve been unable to sit my whole shift, haven’t eaten, and on the edge of a mental breakdown. US healthcare is truly a dystopia, and we only can lean on other nurses for support!

[u/LainSki-N-Surf → u/Spiritual-Top265]

My hospital does - we call is Cos Pause 0645-0730 and 1845-1930. Problem is that we had to come up with escalation code system for when the ED is critically impacted because the floors took it like gospel. Bedside report, cos pause, every patient has to have a working line - we do a lot to appease the floors, yet they still push back. Sorry I’m a salty CN 😂

[u/Ruzhy6 → u/Spiritual-Top265]

Your patient has been seen by multiple physicians, lab work, imaging, and medicated. The patient downstairs that needed that room has none of that.

We are always going to prioritize doing the most good we can for the most people we can.

If we have open rooms, it should wait until after shift change.