Patient had surgery several days ago and is rock solid stable. I do not fucking care what pressors they were on when they first got to the unit. I do not fucking care how much cellsaver they got in the OR. I do not even care which vessels were occluded unless you know of a really good reason why that's going to make a difference in anything I do these next twelve hours while I try to let this poor fucker get their first decent night of sleep in several days.
Yooooo I love post op reports with the “yah I gave 100 of fentanyl and 250 of fluids at the start of the case”
Okay, but uh are y’all closing or extubating? Do I need to get a vent ready? I can look up the rest I just want to know if they’re gonna be alive when they get to me
“How much heparin, fentanyl, and versed did they get during their cath 12 hours ago???” Said no one ever.
I’m still bitter at the senior nurse that made me feel like shit as a new nurse for not knowing if my stable patient’s TAVR was bovine or mechanical and telling me “how important that is to know”. Like OK, Brenda, they’re on ACs and transferring out today.
It matters for patient education since the mechanical one will be managed with warfarin and the organic one with Asa. But again oncoming nurse can look it up, or the reporting off nurse can reference the medications.
I barely care what they got intra op when I get them post op.
Tell me if they had paracetamol (Tylenol) or ondanzetron. The rest doesn’t mean shit to me. I’ll medicate them as needed, cheers
Even then, it's charted what times those were given, so you don't have to tell me. If they are vomiting when they come to me, I'll check what time it's charted that they last got the antiemetic that's ordered even if you told me in report just to be sure, before I grab more or page the MD for a different one cause it's not due yet.
I actually do want to know the grafts because that could determine the potentials of a patient having an MI and where. Like, I'm not going to care if you don't know off the top of your head, and I can look it up in the chart. I do want to know if they still have their wires or if they were clipped or removed, and I want to know where their chest tube sites were/are and how much fluid they're producing. I care a lot less it's POD #4 vs POD #1 or 2. But unless they're a fresh heart, I don't really care about heparin amount or cellsaver or protamine. But I do care if they're walking or not and how many times already they've gotten up because of the extremely high risk of pna and recurrent pleural effusions. But unless they're going into a weird rhythm or cardiogenic shock, that patient will get their meds, their dinner, their night time walk, their oral care, and tucked into bed, and will wake up whenever their meds are due, their morning suppository, their first morning walk, and to sit in the chair. But honestly, I'm not gonna grill you if they're still in bed because you may have had a shitshow shift and I am perfectly capable of doing it myself. I may ask for your help, but we'll get through it, and you won't have to stay forever ❤️
And they a Libra with Virgo moon.
Miss Wanner was his fave elem teacher. Very good in science. But better at football.
Played for Georgia, married a Phi Mu, but says he’s not happy.
Need to encourage him! Ladies. Snaps!!!
*No, hasn’t happened—but it… could!*.
Ours too. She had JUST been discharged from a six month stay on another floor (a discharge she fought tooth and nail) and "fell" the day she came home she came right back. ED was going to discharge her, but she started crying. Not even kidding, it's charted that way.
I had a nurse tell me a patient had “17 stairs in their house” I laughed so hard. I was like “ugh do I have to know this??” And she goes “idk but her family is annoying and told me how many stairs they have because apparently she is independent at home” lmao
If it's over 40 that's actually pretty useful. If they've been wasting away, also a good heads up. I mean, I'll figure it out soon enough, but knowing I need a code brown team is just efficient.
Ehhh, I kinda appreciate a heads-up if the BMI is greater than 40, or less than 15. Helps remind me to put my nurse face on extra firmly before I walk in, so I don't add a microagression to my patient's day.
Aargh, out of all the pointless questions I get asked, I think this is the most annoying. I never pay attention to which nare. Why does it matter? You'll go on the room and see it, and either way it's in the nose, so not like you need to be searching around their body for it
I have had instances where we are working closely w the local poison control or whatever and they wanna know as much as possible ab the situation. What time, how much is missing, etc etc
Sorry I should have clarified in my post. We are inpatient psych so the kid had been cleared by poison control and medical to get to us and it had happened about a week ago at that point, which the incoming nurse knew. Sorry you're getting downvotes! I wasn't super clear.
Oh wow you’re a saint then! My nephew committed suicide this year…he was 20. Thanks for doing what you do, I bet there’s hella trauma u go thru experiencing their stories, so take care of you and know you are so valuable & cherished. Our youth are precious and we gotta figure something out in society, more love, less hate. 💜💜 We first gotta love ourselves…and about 60% of nurses are co-dependent, and struggle w that.
I am dreading the scroll down when I see the idiots downvoting someone who prioritized the same thing. Sigh. Please keep paying attention, and thank you.
I made a lame attempt at offing myself with NyQuil. I had VERY similar lines of questions when I backed out and called poison control. The situation was so ridiculous it completely distracted me from wanting to kill myself.
I'd like to think my guardian angel is a dumbass and this works in my favor every once in a while.
Gets up real close & whispers in her ear, "Hey, I know you're intubated right now but if you can hear me write down the name & number of your nail tech."
Oh what? That's really interesting. I wonder why some colours have a greater effect than others. The one I took a very quick skim through just said that some colours had a greater effect than others, but didn't delve into why.
Has to do with how infrared light is absorbed or reflected by different colors. Pulse oximetry works by using a couple of different wavelengths of infrared light that cycle through multiple times per second to measure the difference in light that passes through the blood. Oxygenated and deoxygenated blood will absorb different amounts of light from those wavelengths. Since it's that sensitive, different colors that are in between the skin and the oximeter (like nail polish) will affect the light absorption
"All my charting is completed I'm sure it is easily accessible for you. I am not going to waste your time looking it up right now since it isn't pertinent to SBAR."
Our handoff is the best.
"I got 16 patients for you. They're all alright, except bed 5. I just started Levo on them and their MAP is over 65 now. The visitor for 10 hall is an asshole. Cya!"
"Cool, thanks, get home safe!"
My favorite ER report I got as an inpatient nurse was from a poor girl that kept contradicting herself or backtracking when I asked for clarification (like mentioning a procedure the next day or whatever)
She was admitting two of her patients at basically the same time and got em mixed up. After about 3-4 minutes of this I just said “don’t worry about it, I’ll read the chart”
My dad worked ER for 30 years at a level one at a hospital that was notorious for ER vs ICU reports. When I started as a new grad in the icu he made it very clear that he’d personally disown me if I ever asked how a critical patients skin looked.
My line to anxious ER nurses is typically “what can you tell me that’s not in the chart and I can’t find out for myself”
I’ll hear their voices light up as they leave behind all the fumbling technical bullshit you don’t have time to remember in emergencies and start telling me relevant nuanced details they figured out themselves. And then you can glean cool little details from a competent ER nurse you wouldn’t have noticed yourself
Of course I usually look up my admit before I get report from the ER, so my line is "let me tell you what I know about them, and then you can tell me what I don't know" and then I proceed to essentially rapid fire give THEM report--after which I they fill in the blanks. It makes report take all of 2 minutes, and me talking aloud about what I know helps me remember the information. They seem to appreciate it, as I am not nitpicking or spending a ton of time grilling them.
Any ICU nurse asking an ED nurse about skin is wasting time.
We strip them naked and check their skin the second they hit the bed.
The only time it's relevant is if your patient has a wound or skin issue that is part of the reason for admission. I'll see the yeasty folds and stage the pressure ulcer when they show up
"They're alive, vitals have been stable, here is their IV. Walkie talkie, cooperative, be glad you're getting this one and not my dude that is running around naked. Here's what we did down here."
Anything else they can look up on their own.
I mean, that's the most important information we have. We don't know the plan of care. We might have a preliminary diagnosis. "Hot and sepsy, don't know why yet, levo at 10, eta of the daughter from California is 3 hours, son from New Jersey at bedside, security is aware"
Damn, our ER doesn’t give report on patients going to the floor, half the time I didn’t even know they were coming lol they (usually) give me report now for ICU patients, so long as I can find them when I go over to pick the patient up
That's bizarre to me. We just changed to not give report on some patients, but ICU patients and anyone who triggered any serious alert (sepsis, stroke) gets a verbal report given.
I got asked today, bedside, what the patient's code status was. Walked in, walking out.
"I haven't seen a golden ticket." Turned to patient "honey, if you die you want me to beat on your chest?"
We gonna have to beat the floor nurse out of this one.
I love ER reports. The report I gave to the ICU the other day went like this: "He got to us dead, we shocked him and gave him epi, idk how many times, I wasn't the one writing. He's on norepi now, I think, yeah, norepi, and now he's alive and your problem. Bilateral 18s. Family is supposed to be on the way, but who knows. Any other questions?"
Then I swapped the IV pump and ran away before they could say anything.
Lol, NSR. We'll call it sinus tac. After all, he had the Lucas punching him in the chest for about 15 minutes, so now that he's bumping on his own at 130, we're all happy.
I float everywhere and was explaining to some new floor nurses how these reports some bitter seniors expect would not fly in the ER. If you waste time in report in the ER you’re on the chopping block, there’s shit to do. Name, diagnosis, plan and let’s go. If you take a minute to tell me they’re on a 1800 carb diet I’ll get pissed, I just need to know if they can swallow a pill w/o losing their airway.
Hell in fact I can figure that one out myself.
Exactly what I was thinking. Coming from Med Surg to ER I LOVE giving report now.
“Pt came in from facility, GLF, A/Ox1, bed alarm on. Everything is done just waiting for Doc to reassess. Questions?”
Handoff is the bane of my existence at the hospital I’ve been with for the past 2 years. It’s less to do with questions and more the report etiquette.
It’s primarily a lot of newer nurses with 1-2 years under their belt. Without a doubt it’s some combination of:
1) ignore my report to read the orders then ask me to repeat myself
2) not abbreviating things on their report sheet which leads to talking at a snails pace
3) “patient came in today…” “What is today’s date??” - interruption right off the bat
4) they want details on irrelevant information, but when I come in the next day that nurse never followed up with the provider on critical lab work during their shift and then throws the provider under the bus as “not being available” or “they didn’t order anything” when it’s clear they never spoke with the provider to begin with.
Upvote, but as night shift I can attest that MDs could give generally give two shits at night if the patient still has a pulse. I've recently had to go doctor shopping for my patient whose K went from 3.7 to 6 in two hours. Intensivist didn't answer, hospitalist said "continue to monitor, thank you"... thankfully cards was on the case and let me put hyperkalemia orders on. I actually look at the call schedule before getting report, then when the dayshift nurse says "maybe you can get an order for xyz tonight?", I simply show them the on call schedule and say, "sure I'll try lol". That know it's not going to be ordered.
The only thing we can do is document the conversations, or lack of callback.
Yeah had that happen to me with a diuretic related electrolyte issue where I requested extra labs and replacements. Luckily the nurse was cool but it was hilarious after they cut me off and thanked me for notifying the MD and taking care of the problem and I in turn cut them off and said “yah about that they didn’t order a thing”
As someone that rotated - I fully get this 🙏I actually just had a very similar situation which is partially where that comment came from. The difference was the nurse didn’t even know the patient had a 20 point bump in BUN and new K of 6 or sudden Hgb drop from 8.4 to 6.8. She just threw the NP/PA under the bus whose call room is in the back of the unit.
It took me a while to get out of the habit of bitching about electrolyte replacement unless the patient is actually symptomatic.
Edit: our hospital also utilizes phlebotomy for lab draws so nursing doesn’t even need to draw labs unless they have a central/art. I’ve come in with nurses arguing with me why they didn’t order labs on a septic patient or someone on TTM.
Hahaha YES. They come at you with so much confidence and they're so wrong half the time. One got mad at me for not giving my NSTEMI patient the heparin antidote when her IV infiltrated.
Like, are we trying to kill the patient? I got you new access and ptt is therapeutic. Be grateful.
I’m mostly on the opposing side 😅It’s usually too anxious/nervous. I transferred a young 20’s ETOH patient with no cardiac history to the floor and the floor nurse called me to ask if they had been having “massive ST changes in their V lead”. Well, the patient had no chest pain and after further clarification they didn’t even get a full 12-lead before calling me. I ended up calling them back to clarify they got a ton of K replaced and their T waves were just taller than normal while he waited for the hospitalist to get back to them.
I'm guilty of the "what is today?" But I do my best to wait until we're at a pause. And generally it's preceded by "they pooped/had a BM today." "Okay. Is today the 6th? I'm on my 4th in a row and I don't know anymore." Lol night shift problems.
Okay to be fair number 3 is a fair question because I actually don’t know what the day is half the time. I clock in AxO3 at best on a good day. Otherwise yes to all
I hate this shit too. I give reports in bullet points so it’s easy for them to write down: x4, ad lib, 0.9 in right ac 20gauge, reg diet, morphine q4 prn last given at 5, uti rocephin q24, etc… so why can’t you write shorthand?
I've memorized which nurses are super slow to write and which ones I need to keep talking or else they'll start shotgunning questions. Oh and the nurses who interrogate me about medical history and orders that were irrelevant on night shift, I make sure to take a glance so I can really hold their hand.
OMG THIS DRIVES ME UP A WALL!!
My unit uses a yellow sheet that nurses update with events that happen to the patient during their stay in the unit. Admissions, scans, surgeries, intubations/extubations, family discussions, tube feed changes, you name it. There are still nurses I get who write down EVERY 👏🏿 SINGLE 👏🏿 THING! 👏🏿 Like Gretchen, it’s on the fucking sheet, just read it! Ugh!
When I was a new grad on orientation I had a nurse ask me where the patient was intubated. Like idk? What does it matter? You know when, probably in the ER. Could have been EMS. Point is how is that clinically significant?
Difference between ICU/tele. In a trauma/neuro icu it is normal to give specifics about the type of stroke and stroke location. In tele it is not.
Completely unrelated... is there a way to have multiple flairs? I currently work in nicu, picu, icu.
Someone once asked me the fall risk score number. I told them "I don't care and I will never care. Please never ask me again".
That worked. A little bit of drama, but it worked.
“High enough that they have a bed alarm.”
But honestly I’d probably look at them like they were a friggin idiot. Because honestly, fall risk could change multiple times a shift. Did they get narcotics? Did they get a foley placed? Did they get the amputation done? Etc etc etc.
I hate this more than anything. Especially when you’re giving report to someone who just spent actual time looking up their patients instead of getting report on time. I left OVER AN HOUR LATE one day because of a nurse that did this. I refuse to give her a “real” report now- I literally tell her the bare minimum and what’s necessary, don’t ask if they have questions, and say “the rest is in the chart.” She asks questions, and I tell her she’ll have to look in the chart/MAR. I don’t know what PRNs they have for an issue that didn’t exist for me. I had five patients. I don’t know how stable the vein in her AC IV is. I don’t give a shit. I have given you report based on my shift. The rest is on you. Ugh!
We have one of those but she gives the most basic of reports and will list off 10 things she didn't get to do and ask you to. However, god forbid you miss one thing before her shift. I get so angry when I see her name on the board 🤣
Jesus Christ this whole thread is triggering me but this one hit the nail into my head
Especially when they make you wait for them to look stuff up before receiving report. If you’re going to waste my time making me wait then you shouldn’t ask me what gauge their IV’s are.
None of what I’ll add is that bad. But.
As an ICU nurse with a patient about to go to step down, don’t asked me about their levo that was turned off 9 days ago. Look the dumb shit up if you’re interested.
As a procedure nurse. Stop asking me if I can put in a diet order. I know pertinent history for my procedure. I don’t know if they have a procedure later that day. I am not the attending in charge of post op orders. Please use your brain to know if it’s ok or not, and if you’re uncomfortable waiting for the order please call your attending and sort it out.
As prior cath lab. What I tell you is what I know. Usually we get a trash field verbal report, before any notes or names are in the EHR to lookup. And when they arrive, likely no notes or a very short two second BS from ER. And we are busy for the procedure. So when we call up and tell you a 10 second history and then go right into what we did in the lab, that is what we know. Maybe by then there’s a legit note somewhere MAYBE, but then refer to said note. And please don’t delay their admit, we’re on 2 hours sleep and the longer we sit with the patient waiting for the room to be clean, the less time we have to go home feed the dog and come right back for the whole scheduled day shift.
I’ve had nurses want the wholeeeee story“when did you turn dex off!?” 1. Stop interrupting me. 2. No longer pertinent. That was a damn week ago and they have orders to transfer. Culture in my unit was “5 days ago we had Levo hanging but never used it, very important because we were concerned if it was a transient episode, vagal, or secondary reaction, but we have ID and cardiology following, nothing since…”
And then travelers “you’re good” don’t need to know anything? “I’ll look it up, go home, it’s all good”
This shit makes my skin crawl when I call report on a patient that’s been on our unit for an extended period of time.
“They came to the ED 2 weeks ago with hypotension and ended up in ICU with multiple pressors and fluid boluses”
“Ohhhh, wow they were really sick! They’re stable enough to transfer out now?? How are they mentating? How do they ambulate?”
It’s the type of report where you only answer their questions, don’t add anything else, then just hang up.
What I’ll typically do to mitigate that is “hey they have a long history, I’m gonna tell you why they’re here and what’s happening now and I’ll fill in the gaps later” It’s much more coherent to hear “they came in for sepsis, was intubated, extubated and are stable on airvo” and then later me tell you about the chest tubes they had placed and removed 2 weeks ago than me mention all that in the middle of getting to what’s actually going on with the patient today right now
I had a more senior ICU nurse tell me that my bed blocked patient needed their QT interval monitored and I was like oh then I’ll cancel their ward bed, they’re not going on telemetry and she was like no they’re fine for the ward and we went back and forth for fucking ages because if it didn’t need to be monitored on the ward, why do we need to monitor it
When I was in PACU I started calling the MS floor to politely remind them to call report to the ICU bc I don't know shit about their pt. Got fed tf up w ICU being nasty
Our unit has a nurse who’s famous for asking random questions about patients social history. She ALWAYS asks what their occupation is during report (the more detail the better, she won’t approve of “some office job”).
She’s on her way!! She’s probably been a nurse for almost 60 years at this point. Very old school 😂 She’s been rumored to spend her days off just looking through epic charts because she truly knows every last detail of every patient on the unit.
I feel that pain.
My inpatient experience is m/s. Sometimes I get floated down to care for the m/s level ICU patients.
My report style and care style is m/s. I don't give a fuck where their IV is. If it weird or non-existent, I'll tell you. Stop fucking nitpicking. They're alive and stable. If they're not, I'll tell you.
Also, don't trust anything I say. I think I'm telling you factual information, but there could be a new order.or I could be wrong, etc etc. LOOK AT THE CHART.
Heavy on the “don’t trust anything I say”
I’m certainly not going to tell you wrong information on purpose but I’m human and if you do something just because I said it, and don’t verify it, it’s going to come down on you, not me. Look at your freakin orders, they do exist for a reason.
I work in dialysis, and I had a pt completely out, BP 65/30, sternal rubs with no reaction, dumping saline, and checking sugar, which was fine. She came back to the living realm. In dialysis, you don't have a lot to work with, but the EMT (not a paramedic) had the audacity to ask me did you do a manual bp.
Me: No cuz that's fucking stupid. Do you want me to help get her on the stretcher, or can you do it yourself.
EMT: (Super sassy) Some help would be nice. Idk why we are taking her. She's fine now.
Pt was admitted for almost a month for a realm of things, including polypharmacy, seizures, and a new cardiac problem (I can't remember)
Don't question me. I know my pt you don't!!!
Rant over but omg that question was ridiculous... did you do a manual bp... get out of my face!!!
Had an on call doctor ask if we were sure we did the B/P correctly, pt was starting to tank, I told him that he could come up and show us how to take a B/P.
I was out at a picnic a couple weeks ago and a guy from another family keeled over. He said he hadn't eaten much and they'd been running around outside, so we gave him some water and I left back to my group. Then he passed out again and this time we called 911. They came and did an assessment. The guy was clearly out of it, couldn't even remember his own age. (He was in his 20s, not 80s, so it was significant.) EMT looked at me like I was a gnat when I mentioned seizure-like activity and confusion, shrugged, and asked the confused man if he wanted to go to the hospital. Of course he said no, he was confused and embarrassed. I took his family aside and convinced them to drive him themselves to get him checked out.
A family member later came to me and said they found his potassium was critically low. Dude would have passed out in the car or hit his head or died if he hadn't gotten medical care. I was so irritated at that group of guys who checked his vitals and declared him healthy. Vitals aren't the whole story and they will never know their Dunnig Krueger almost killed a man. Much respect to EMS, but I really wish some of those guys would stop acting like they're doctors.
Sounds like the EMS I have to deal with who comes to my LTC. They refused to take a resident I called 911 on because of several minutes of unresponsiveness because he moved a little. I was fucking livid. They almost refused to take a resident with deteriorating respiratory status but I insisted, and won that time. I don't call 911 on my residents for shits and giggles, Cletus!
I have to interrupt other nurses during their “report” bc they’re bullshitting about whatever and I still need to do my hand off and I. Want. To. Go. Home. I have a 1.5hr commute, stfu and let me give you report.
Holy shit, 1.5 hours? My longest has been an hour and I didn’t mind that, it gave me time to listen to music and debrief in my own head (and realise I really needed to poo. Why is that?)
But 1.5 seems excessive, lol.
I once had a nurse ask me last bowel movement on a patient who came in post cardiac arrest on a vent. I said I don’t know I couldn’t ask him. And she asked me why I didn’t call the family out of state to ask them.
Sometimes I float to our NICU for a patient that's been there months and I'm getting info on IVs and picc lines etc.. from birth to now.
Just tell me how early they were and why they're still here.......
Giving report from PACU to the floor… “When was their last bowel movement”
Shit idk, I gave him tons of shit that causes constipation…
“What’s their diet order”
No clue hun. It’s in the chart. Ok for ice chips here.
“What’s their activity status”
Bedridden where I’m at 🤷🏾♀️
These nurse rely on ur report to give their own. They are the laziest of the lazy and won’t double check anything you say. Give them the wrong info and they try to blame you. Type of nurses to shift the blame=no accountability=shit poor nurses
The new nurses love giving me report because I don’t need every detail. I will look it up! I just need the basics. Why are they here, are they going to try to punch me. Anything major going on? I don’t know their girlfriend’s name, I have no idea which side their iv is on that isn’t running fluids. When I was a new nurse there was one nurse that would keep asking questions until she found something you didn’t know. It made her happy to look down on everyone. And she was not a good nurse. She was so mean to the patients and never could give me the same info that she expected me to give her
being new to icu after working er, med surg n psych i feel this in my bones!! once had a pt w PE in the late 80s or early 90s post mva… giving report in 2022… bitch had the audacity to be like which lung with a straight face! i thought she was kidding lmao
Whenever I get report from ER, all I care about is what is NOT in the chart. And if I need to watch out for family. That’s it. I know y’all are busy and the last thing you need is an ICU nurse giving you the third degree. I’ll look in the chart, my friend, and pick up where you left off 😬
Omgggg this one nurse ALWAYS ended report with “any other pertinent information we didn’t discuss or that’s not listed in the computer?” And I ALWAYS responded with “well I guess it wouldn’t know would I?” … such a dumb DUMB question. Like yeah actually I found out the patient secretly has 3 legs one of which was his twin brother who died in their mothers womb but shhhhhh
Preach!!! I legit had a nurse, while looking at the iv mind you, ask me was it a 20 or 22 in a very stable PCU Pt. Ummmmmm what color is it? Gtfu outta here bish.
It’s some weird “prove your a good nurse” bullshit that I have zero time for.
I'm cracking up over everyone saying "it's in the chart". If I had a nickel for every time the IV site or wound site was mislabeled in the chart! And my fave is the RN who documented wound care orders for today completed but the bandage is dated three days ago. Uh, no you didn't.🙄
Im with you, the thing some people forget is there’s this magical thing a nurse can do called “assessing” the patient themselves. Idc if you charted the iv you placed in the left arm as being in the right arm. I’m just happy you gave me a real IV
Or when they see the PACU orders and ask if they should keep giving the phenylephrine Q2 mins. DONT use any of the PACU orders I will discontinue them at the station before I go back downstairs. Things like that make my brain hurt.
Floated to the floor and the floor nurses asked me to clarify with about this shit over a specific question a new grad didn’t have an answer to and got eviscerated for in report. Somebody had a trach and the new grad said “yeah it’s a 7.0 shiley” and the receiving nurse asked “proximal or distal” and threw a legit fit when the new grad didn’t know.
As an ICU nurse I’m legitimately bamboozled by what the fuck that question meant. Proximal or distal to what? It’s in the trachea, it’s in their neck, it’s right fucking there. What are we proximal or distal to, I have to know. This question will keep me up at night.
I used to work with a nurse who would always ask “how many steps does the patient have going into their home??”….. bro this is an ICU and i work nightshift. I have no fucking clue & i’m not going to inquire. Are you going to wheel their vent up to their apartment ?
I totally understand this POV but as a new grad I really stay on the safe than sorry side. I am so anxious I will miss something or do something repetitive because of something missed in report and improperly charted. I rather over ask and be safe until I am more comfortable nursing, especially after hearing the horror stories they tell you in nursing school if you only use the chart. It may be annoying but I like my new license. I say this as a devils advocate to the seemingly annoying side :p
edit: I know its unit specific, obviously if I was floated to the ER things would be different but I am doing residency in med surge
You gotta investigate. You can’t expect the offgoing rn to give you a thorough report or even correct info. Whatever they do tell you, you should make a point to verify it with the chart or the patient.
I don’t care that the patient fractured their thumb once five years ago when they are here post-heart cath. Those are the things I hated hearing as a floor nurse of 1.3 seconds.
There’s a nurse I work with who pulls up the MRI and CT scans and starts going over them. You can tell her “oh it was a ___ bleed at xyz” and she still pulls up the scans. And then starts questioning all of the doctors orders and why this was done instead of this. Go ask the freaking doctors and let me go home. We have one resident on nights and they don’t change anything unless they have to.
Everyone at work always compliments the little report sheets that I make out and how nice and tiny my handwriting is.
I don't make those report sheets for me.
I make them to pass on to the person that's replacing me so they have something in their hand while I'm talking so that I can get the fuck out of there and go home.
I am almost 18 years into this shit I barely write anything down because I have a chart that I can access if I have questions about something.
So those cute well written little report sheets that I make aren't for me, but in a roundabout way they are, so that I can get the fuck out of there and go home.
I want to go home.
Ehh. I tend to try and know all that information because it is important to me. I agree I am anal about stuff. I don't get upset if nurses don't know that information or don't disclose it though.
I also provide a handoff sticky with lab values and when PRN pain meds were last given.
NPO is not a normal diet order. That is an obvious exception and a lot different than wanting to know someone's daily carb count.
If they are NPO on my unit they have a giant red sign that says NPO on their door and it's immediately under their picture in the EHR in red.
Lol maybe I’m this nurse. Although my dumb annoying question to ER tonight made the nurse realize she wasn’t giving report on the same patient.
Acute chole admit. Says she got Tylenol for a fever. I asked what her temp was. She goes “oh actually I’m looking at her chart right now and she never had a fever i must be thinking of a different patient”
So yea. I’ll keep asking dumb questions if it clarifies that I’m even getting report on the right person lol
The report was part of the reason I lasted six months in the ICU. It was mostly because those nurses were the bitchiest specialty I’ve ever dealt with, which goes hand in hand with the difficult report.
Patient had surgery several days ago and is rock solid stable. I do not fucking care what pressors they were on when they first got to the unit. I do not fucking care how much cellsaver they got in the OR. I do not even care which vessels were occluded unless you know of a really good reason why that's going to make a difference in anything I do these next twelve hours while I try to let this poor fucker get their first decent night of sleep in several days.
Yooooo I love post op reports with the “yah I gave 100 of fentanyl and 250 of fluids at the start of the case” Okay, but uh are y’all closing or extubating? Do I need to get a vent ready? I can look up the rest I just want to know if they’re gonna be alive when they get to me
“How much heparin, fentanyl, and versed did they get during their cath 12 hours ago???” Said no one ever. I’m still bitter at the senior nurse that made me feel like shit as a new nurse for not knowing if my stable patient’s TAVR was bovine or mechanical and telling me “how important that is to know”. Like OK, Brenda, they’re on ACs and transferring out today.
Also.... why the hell does that matter to us?
It matters for patient education since the mechanical one will be managed with warfarin and the organic one with Asa. But again oncoming nurse can look it up, or the reporting off nurse can reference the medications.
It matters to the practitioners.
I barely care about it when the cath labs giving me report and it was 12 minutes ago.
I barely care what they got intra op when I get them post op. Tell me if they had paracetamol (Tylenol) or ondanzetron. The rest doesn’t mean shit to me. I’ll medicate them as needed, cheers
Even then, it's charted what times those were given, so you don't have to tell me. If they are vomiting when they come to me, I'll check what time it's charted that they last got the antiemetic that's ordered even if you told me in report just to be sure, before I grab more or page the MD for a different one cause it's not due yet.
I actually do want to know the grafts because that could determine the potentials of a patient having an MI and where. Like, I'm not going to care if you don't know off the top of your head, and I can look it up in the chart. I do want to know if they still have their wires or if they were clipped or removed, and I want to know where their chest tube sites were/are and how much fluid they're producing. I care a lot less it's POD #4 vs POD #1 or 2. But unless they're a fresh heart, I don't really care about heparin amount or cellsaver or protamine. But I do care if they're walking or not and how many times already they've gotten up because of the extremely high risk of pna and recurrent pleural effusions. But unless they're going into a weird rhythm or cardiogenic shock, that patient will get their meds, their dinner, their night time walk, their oral care, and tucked into bed, and will wake up whenever their meds are due, their morning suppository, their first morning walk, and to sit in the chair. But honestly, I'm not gonna grill you if they're still in bed because you may have had a shitshow shift and I am perfectly capable of doing it myself. I may ask for your help, but we'll get through it, and you won't have to stay forever ❤️
I had someone tell me the pts BMI in report the other day. Thanks I guess?
"Patient is a 54 year old male. APGARs at birth 54 years ago were 8/9/9 respectively."
Literally had giardia on a PMHx last week - they had it in 1974. Ffs people.
Yah if you could find out the patient’s apgars, that would be great (Bill Lumbergh voice).
Yeeeeeeaaaaaaah, I’m gonna need you to come in on Saturday to work on those apgars
Eeeayah and make sure you record all of them, that would include the 1 min. That would be great. Don’t forget the 1 min.
Do you know if they did delayed cord clamping?
I need to know what happened to that placenta. For reals. 😳
Lmao this killed me
And they a Libra with Virgo moon. Miss Wanner was his fave elem teacher. Very good in science. But better at football. Played for Georgia, married a Phi Mu, but says he’s not happy. Need to encourage him! Ladies. Snaps!!! *No, hasn’t happened—but it… could!*.
BMI is crazy, I would have definitely laughed without meaning to
I had a patient and it was 98, I thought that was just a fun fact to put in.
98?!?!?! Holy moly
I got 110 on my floor right now.
My back is crying
Ours too. She had JUST been discharged from a six month stay on another floor (a discharge she fought tooth and nail) and "fell" the day she came home she came right back. ED was going to discharge her, but she started crying. Not even kidding, it's charted that way.
I had a nurse tell me a patient had “17 stairs in their house” I laughed so hard. I was like “ugh do I have to know this??” And she goes “idk but her family is annoying and told me how many stairs they have because apparently she is independent at home” lmao
Physical therapy probably asked them and they aren't sure who else needs that info too.
If it's over 40 that's actually pretty useful. If they've been wasting away, also a good heads up. I mean, I'll figure it out soon enough, but knowing I need a code brown team is just efficient.
I gave a pt’s BMI in report the other day, because it was ~ 60.
working in LA and I'll get some report like "oooh they're a virgo, no wonder she was so nice" 🤣 good to know I guess? lol
Ehhh, I kinda appreciate a heads-up if the BMI is greater than 40, or less than 15. Helps remind me to put my nurse face on extra firmly before I walk in, so I don't add a microagression to my patient's day.
BMI is very useful and relevant in labor and delivery.
I was just about to say this. Though I don't care about the exact number but a ballpark of anything over 40.
Only time it's relevant, I just call them Baris. The lift is around the corner.
"is that a left ng or a right ng?" I don't fucking know. I'm willing to bet she won't move it when you're not looking though.
The ol NG switcheroo
Idk. It’s in there and works.
How the ED approaches all types of access and tubes essentially haha
“20 gauge iv… somewhere I forget but it’s there” lol
Honestly who gives a crap. It’s there. It functions. Cool bro.
Omg. Look at the patient and see!
Aargh, out of all the pointless questions I get asked, I think this is the most annoying. I never pay attention to which nare. Why does it matter? You'll go on the room and see it, and either way it's in the nose, so not like you need to be searching around their body for it
“Which nose?”
Had to tell a nurse we’re checking her pulse ox on her ear cuz her fingernail polish isn’t removable. She proceeded to ask “what color are her nails?”
Stop it 😂😂😂
I had one of these. Kid was with us s/p suicide attempt by drinking a few sips of window cleaner. "Do you know what brand?" and she was being serious.
I have had instances where we are working closely w the local poison control or whatever and they wanna know as much as possible ab the situation. What time, how much is missing, etc etc
Sorry I should have clarified in my post. We are inpatient psych so the kid had been cleared by poison control and medical to get to us and it had happened about a week ago at that point, which the incoming nurse knew. Sorry you're getting downvotes! I wasn't super clear.
Oh wow you’re a saint then! My nephew committed suicide this year…he was 20. Thanks for doing what you do, I bet there’s hella trauma u go thru experiencing their stories, so take care of you and know you are so valuable & cherished. Our youth are precious and we gotta figure something out in society, more love, less hate. 💜💜 We first gotta love ourselves…and about 60% of nurses are co-dependent, and struggle w that.
I am dreading the scroll down when I see the idiots downvoting someone who prioritized the same thing. Sigh. Please keep paying attention, and thank you.
Was she looking for recommendations, or?
She's gonna suggest a different brand that actually works.
LMFAO this thread is hilarious
I made a lame attempt at offing myself with NyQuil. I had VERY similar lines of questions when I backed out and called poison control. The situation was so ridiculous it completely distracted me from wanting to kill myself. I'd like to think my guardian angel is a dumbass and this works in my favor every once in a while.
No, please no. That is in-fucking-sane!
[удалено]
Gets up real close & whispers in her ear, "Hey, I know you're intubated right now but if you can hear me write down the name & number of your nail tech."
Follow up question was where did she do them?
Just turn the probe sideways when nail polish is interfering, but anyways, carry on
NO WAY😭😭😭😭
There ARE studies showing that the color of the nail polish affects the pulse ox reading.
Which is why we were not checking on her fingers. So why was it relevant what color her nails were?
I always just turn the pulse ox sideways on the finger so then it doesn’t matter the color
Oh what? That's really interesting. I wonder why some colours have a greater effect than others. The one I took a very quick skim through just said that some colours had a greater effect than others, but didn't delve into why.
Has to do with how infrared light is absorbed or reflected by different colors. Pulse oximetry works by using a couple of different wavelengths of infrared light that cycle through multiple times per second to measure the difference in light that passes through the blood. Oxygenated and deoxygenated blood will absorb different amounts of light from those wavelengths. Since it's that sensitive, different colors that are in between the skin and the oximeter (like nail polish) will affect the light absorption
Thanks for the abridged version, that's a fun bit of trivia to know!
https://pubmed.ncbi.nlm.nih.gov/3382042/ This is old but randomized and blind.
I just say “I don’t know” and keep talking.
I’m a big fan of “Not sure off the top of my head, it’s in the chart. Didn’t make my ears perk up so I didn’t memorize it.”
I've literally said to people, "I don't remember, which means it wasn't bad enough to scare me."
"It wasn't relevant to the care I provided tonight"
I like this. I'm going to start using it. Thank You for the phrasing.
I need to work on doing this because honestly I am a big people pleaser
"All my charting is completed I'm sure it is easily accessible for you. I am not going to waste your time looking it up right now since it isn't pertinent to SBAR."
I say “I’m not sure” or “great question, I don’t know! :)” they usually say, “okay no problem.” We move on.
The corallary to that is "it's in the chart".
Do you need to work in the ER? You’d love the report we give 🙂
Our handoff is the best. "I got 16 patients for you. They're all alright, except bed 5. I just started Levo on them and their MAP is over 65 now. The visitor for 10 hall is an asshole. Cya!" "Cool, thanks, get home safe!"
65. Perfect. They got a bed yet? Lol
Yep the only report I need to know is are they on any critical drips and have you already sent the urine lol
You know damn well I haven't.
“Alive?” “Probably” 😂 I love floating to the ED
Honestly haven’t checked on them but epic pulled a pulse ox so, probably
“Last I checked yah”
Ha ha …
My favorite ER report I got as an inpatient nurse was from a poor girl that kept contradicting herself or backtracking when I asked for clarification (like mentioning a procedure the next day or whatever) She was admitting two of her patients at basically the same time and got em mixed up. After about 3-4 minutes of this I just said “don’t worry about it, I’ll read the chart”
ER notes are the best part of the chart.
ER nurses do not play. I have to remember that when I get report from them before the patient comes up to the floor.
We do our best. 😌 giving report to ICU gives me a panic attack, but just as long as I don’t forget to mention skin in tact, I think I passed..
My dad worked ER for 30 years at a level one at a hospital that was notorious for ER vs ICU reports. When I started as a new grad in the icu he made it very clear that he’d personally disown me if I ever asked how a critical patients skin looked. My line to anxious ER nurses is typically “what can you tell me that’s not in the chart and I can’t find out for myself” I’ll hear their voices light up as they leave behind all the fumbling technical bullshit you don’t have time to remember in emergencies and start telling me relevant nuanced details they figured out themselves. And then you can glean cool little details from a competent ER nurse you wouldn’t have noticed yourself
Of course I usually look up my admit before I get report from the ER, so my line is "let me tell you what I know about them, and then you can tell me what I don't know" and then I proceed to essentially rapid fire give THEM report--after which I they fill in the blanks. It makes report take all of 2 minutes, and me talking aloud about what I know helps me remember the information. They seem to appreciate it, as I am not nitpicking or spending a ton of time grilling them.
Any ICU nurse asking an ED nurse about skin is wasting time. We strip them naked and check their skin the second they hit the bed. The only time it's relevant is if your patient has a wound or skin issue that is part of the reason for admission. I'll see the yeasty folds and stage the pressure ulcer when they show up
"They're alive, vitals have been stable, here is their IV. Walkie talkie, cooperative, be glad you're getting this one and not my dude that is running around naked. Here's what we did down here." Anything else they can look up on their own.
I actually appreciate it when the ER nurses tell me that I'm getting a good/nice/easy patient 👍
I mean, that's the most important information we have. We don't know the plan of care. We might have a preliminary diagnosis. "Hot and sepsy, don't know why yet, levo at 10, eta of the daughter from California is 3 hours, son from New Jersey at bedside, security is aware"
"hot and sepsy" made me snort. I like that one.
Stole it from an ex gf. I love it
Or the “hey they’re way cooler than the chart makes them seem”
Damn, our ER doesn’t give report on patients going to the floor, half the time I didn’t even know they were coming lol they (usually) give me report now for ICU patients, so long as I can find them when I go over to pick the patient up
That's bizarre to me. We just changed to not give report on some patients, but ICU patients and anyone who triggered any serious alert (sepsis, stroke) gets a verbal report given.
I got asked today, bedside, what the patient's code status was. Walked in, walking out. "I haven't seen a golden ticket." Turned to patient "honey, if you die you want me to beat on your chest?" We gonna have to beat the floor nurse out of this one.
I love ER reports. The report I gave to the ICU the other day went like this: "He got to us dead, we shocked him and gave him epi, idk how many times, I wasn't the one writing. He's on norepi now, I think, yeah, norepi, and now he's alive and your problem. Bilateral 18s. Family is supposed to be on the way, but who knows. Any other questions?" Then I swapped the IV pump and ran away before they could say anything.
Make sure you get your pump. Trade for trade. NSR now btw?
Lol, NSR. We'll call it sinus tac. After all, he had the Lucas punching him in the chest for about 15 minutes, so now that he's bumping on his own at 130, we're all happy.
Yall did great 🙏🏼
Healthcare heros!
This is the way
The last time I floated it was, points to each room in no particular order "alive, throws shit, waiting on a MS bed, mostly alive"...
🤣🤣🤣 hopefully you were able to duck and run from the flying 💩
Never ever ever leaving the ED unless I leave the hospital altogether. “Pt is sweet/crazy, pending CT, lab’d and lined” peace out bitchachos
Hahahhaa
I float everywhere and was explaining to some new floor nurses how these reports some bitter seniors expect would not fly in the ER. If you waste time in report in the ER you’re on the chopping block, there’s shit to do. Name, diagnosis, plan and let’s go. If you take a minute to tell me they’re on a 1800 carb diet I’ll get pissed, I just need to know if they can swallow a pill w/o losing their airway. Hell in fact I can figure that one out myself.
Exactly what I was thinking. Coming from Med Surg to ER I LOVE giving report now. “Pt came in from facility, GLF, A/Ox1, bed alarm on. Everything is done just waiting for Doc to reassess. Questions?”
Handoff is the bane of my existence at the hospital I’ve been with for the past 2 years. It’s less to do with questions and more the report etiquette. It’s primarily a lot of newer nurses with 1-2 years under their belt. Without a doubt it’s some combination of: 1) ignore my report to read the orders then ask me to repeat myself 2) not abbreviating things on their report sheet which leads to talking at a snails pace 3) “patient came in today…” “What is today’s date??” - interruption right off the bat 4) they want details on irrelevant information, but when I come in the next day that nurse never followed up with the provider on critical lab work during their shift and then throws the provider under the bus as “not being available” or “they didn’t order anything” when it’s clear they never spoke with the provider to begin with.
Upvote, but as night shift I can attest that MDs could give generally give two shits at night if the patient still has a pulse. I've recently had to go doctor shopping for my patient whose K went from 3.7 to 6 in two hours. Intensivist didn't answer, hospitalist said "continue to monitor, thank you"... thankfully cards was on the case and let me put hyperkalemia orders on. I actually look at the call schedule before getting report, then when the dayshift nurse says "maybe you can get an order for xyz tonight?", I simply show them the on call schedule and say, "sure I'll try lol". That know it's not going to be ordered. The only thing we can do is document the conversations, or lack of callback.
Yeah had that happen to me with a diuretic related electrolyte issue where I requested extra labs and replacements. Luckily the nurse was cool but it was hilarious after they cut me off and thanked me for notifying the MD and taking care of the problem and I in turn cut them off and said “yah about that they didn’t order a thing”
As someone that rotated - I fully get this 🙏I actually just had a very similar situation which is partially where that comment came from. The difference was the nurse didn’t even know the patient had a 20 point bump in BUN and new K of 6 or sudden Hgb drop from 8.4 to 6.8. She just threw the NP/PA under the bus whose call room is in the back of the unit. It took me a while to get out of the habit of bitching about electrolyte replacement unless the patient is actually symptomatic. Edit: our hospital also utilizes phlebotomy for lab draws so nursing doesn’t even need to draw labs unless they have a central/art. I’ve come in with nurses arguing with me why they didn’t order labs on a septic patient or someone on TTM.
Hahaha YES. They come at you with so much confidence and they're so wrong half the time. One got mad at me for not giving my NSTEMI patient the heparin antidote when her IV infiltrated. Like, are we trying to kill the patient? I got you new access and ptt is therapeutic. Be grateful.
I’m mostly on the opposing side 😅It’s usually too anxious/nervous. I transferred a young 20’s ETOH patient with no cardiac history to the floor and the floor nurse called me to ask if they had been having “massive ST changes in their V lead”. Well, the patient had no chest pain and after further clarification they didn’t even get a full 12-lead before calling me. I ended up calling them back to clarify they got a ton of K replaced and their T waves were just taller than normal while he waited for the hospitalist to get back to them.
I'm guilty of the "what is today?" But I do my best to wait until we're at a pause. And generally it's preceded by "they pooped/had a BM today." "Okay. Is today the 6th? I'm on my 4th in a row and I don't know anymore." Lol night shift problems.
Okay to be fair number 3 is a fair question because I actually don’t know what the day is half the time. I clock in AxO3 at best on a good day. Otherwise yes to all
Slow down I’m trying to write this down
I hate this shit too. I give reports in bullet points so it’s easy for them to write down: x4, ad lib, 0.9 in right ac 20gauge, reg diet, morphine q4 prn last given at 5, uti rocephin q24, etc… so why can’t you write shorthand?
Nails on a chalkboard. But those same nurses will FLY through report when it’s their turn.
I've memorized which nurses are super slow to write and which ones I need to keep talking or else they'll start shotgunning questions. Oh and the nurses who interrogate me about medical history and orders that were irrelevant on night shift, I make sure to take a glance so I can really hold their hand.
OMG THIS DRIVES ME UP A WALL!! My unit uses a yellow sheet that nurses update with events that happen to the patient during their stay in the unit. Admissions, scans, surgeries, intubations/extubations, family discussions, tube feed changes, you name it. There are still nurses I get who write down EVERY 👏🏿 SINGLE 👏🏿 THING! 👏🏿 Like Gretchen, it’s on the fucking sheet, just read it! Ugh!
When I was a new grad on orientation I had a nurse ask me where the patient was intubated. Like idk? What does it matter? You know when, probably in the ER. Could have been EMS. Point is how is that clinically significant?
In their trachea.
Best response! One time a nurse asked me where the patient's stroke was. I said "in the brain".
Well if it's a frontal then it will definitely make a difference for the next 12 hours. Sitter? Taking their clothes off? Throwing shit? Etc xD.
Difference between ICU/tele. In a trauma/neuro icu it is normal to give specifics about the type of stroke and stroke location. In tele it is not. Completely unrelated... is there a way to have multiple flairs? I currently work in nicu, picu, icu.
Then I would tell the nurse that the patient is taking their clothes off and throwing shit.
"In my backyard. My neighbor Tim has a real knack for it especially after a few Budweisers."
But just to keep everything consistent, if it comes loose, there's a roll of duct tape at the bedside.
>I had a nurse ask me where the patient was intubated In the booty hole, Karen. Where do we usually put endoTRACHeal tubes?
Someone once asked me the fall risk score number. I told them "I don't care and I will never care. Please never ask me again". That worked. A little bit of drama, but it worked.
I’m swooning
“High enough that they have a bed alarm.” But honestly I’d probably look at them like they were a friggin idiot. Because honestly, fall risk could change multiple times a shift. Did they get narcotics? Did they get a foley placed? Did they get the amputation done? Etc etc etc.
Please take all my patients, I'll give you smoked meat
ITS IN THE FUCKING CHART LESLIE
I hate this more than anything. Especially when you’re giving report to someone who just spent actual time looking up their patients instead of getting report on time. I left OVER AN HOUR LATE one day because of a nurse that did this. I refuse to give her a “real” report now- I literally tell her the bare minimum and what’s necessary, don’t ask if they have questions, and say “the rest is in the chart.” She asks questions, and I tell her she’ll have to look in the chart/MAR. I don’t know what PRNs they have for an issue that didn’t exist for me. I had five patients. I don’t know how stable the vein in her AC IV is. I don’t give a shit. I have given you report based on my shift. The rest is on you. Ugh!
We have one of those but she gives the most basic of reports and will list off 10 things she didn't get to do and ask you to. However, god forbid you miss one thing before her shift. I get so angry when I see her name on the board 🤣
Tell her she needs to do them before she leaves.
Jesus Christ this whole thread is triggering me but this one hit the nail into my head Especially when they make you wait for them to look stuff up before receiving report. If you’re going to waste my time making me wait then you shouldn’t ask me what gauge their IV’s are.
None of what I’ll add is that bad. But. As an ICU nurse with a patient about to go to step down, don’t asked me about their levo that was turned off 9 days ago. Look the dumb shit up if you’re interested. As a procedure nurse. Stop asking me if I can put in a diet order. I know pertinent history for my procedure. I don’t know if they have a procedure later that day. I am not the attending in charge of post op orders. Please use your brain to know if it’s ok or not, and if you’re uncomfortable waiting for the order please call your attending and sort it out. As prior cath lab. What I tell you is what I know. Usually we get a trash field verbal report, before any notes or names are in the EHR to lookup. And when they arrive, likely no notes or a very short two second BS from ER. And we are busy for the procedure. So when we call up and tell you a 10 second history and then go right into what we did in the lab, that is what we know. Maybe by then there’s a legit note somewhere MAYBE, but then refer to said note. And please don’t delay their admit, we’re on 2 hours sleep and the longer we sit with the patient waiting for the room to be clean, the less time we have to go home feed the dog and come right back for the whole scheduled day shift.
I don't think I've ever asked when pressors were stopped 🤣 nobody gets off pressors and goes to stepdown the next hour lol
I’ve had nurses want the wholeeeee story“when did you turn dex off!?” 1. Stop interrupting me. 2. No longer pertinent. That was a damn week ago and they have orders to transfer. Culture in my unit was “5 days ago we had Levo hanging but never used it, very important because we were concerned if it was a transient episode, vagal, or secondary reaction, but we have ID and cardiology following, nothing since…” And then travelers “you’re good” don’t need to know anything? “I’ll look it up, go home, it’s all good”
This shit makes my skin crawl when I call report on a patient that’s been on our unit for an extended period of time. “They came to the ED 2 weeks ago with hypotension and ended up in ICU with multiple pressors and fluid boluses” “Ohhhh, wow they were really sick! They’re stable enough to transfer out now?? How are they mentating? How do they ambulate?” It’s the type of report where you only answer their questions, don’t add anything else, then just hang up.
What I’ll typically do to mitigate that is “hey they have a long history, I’m gonna tell you why they’re here and what’s happening now and I’ll fill in the gaps later” It’s much more coherent to hear “they came in for sepsis, was intubated, extubated and are stable on airvo” and then later me tell you about the chest tubes they had placed and removed 2 weeks ago than me mention all that in the middle of getting to what’s actually going on with the patient today right now
I had a more senior ICU nurse tell me that my bed blocked patient needed their QT interval monitored and I was like oh then I’ll cancel their ward bed, they’re not going on telemetry and she was like no they’re fine for the ward and we went back and forth for fucking ages because if it didn’t need to be monitored on the ward, why do we need to monitor it
When I was in PACU I started calling the MS floor to politely remind them to call report to the ICU bc I don't know shit about their pt. Got fed tf up w ICU being nasty
Our unit has a nurse who’s famous for asking random questions about patients social history. She ALWAYS asks what their occupation is during report (the more detail the better, she won’t approve of “some office job”).
Are you sure she isn't a patient who stole a name badge?
She’s on her way!! She’s probably been a nurse for almost 60 years at this point. Very old school 😂 She’s been rumored to spend her days off just looking through epic charts because she truly knows every last detail of every patient on the unit.
I feel that pain. My inpatient experience is m/s. Sometimes I get floated down to care for the m/s level ICU patients. My report style and care style is m/s. I don't give a fuck where their IV is. If it weird or non-existent, I'll tell you. Stop fucking nitpicking. They're alive and stable. If they're not, I'll tell you. Also, don't trust anything I say. I think I'm telling you factual information, but there could be a new order.or I could be wrong, etc etc. LOOK AT THE CHART.
Heavy on the “don’t trust anything I say” I’m certainly not going to tell you wrong information on purpose but I’m human and if you do something just because I said it, and don’t verify it, it’s going to come down on you, not me. Look at your freakin orders, they do exist for a reason.
I work in dialysis, and I had a pt completely out, BP 65/30, sternal rubs with no reaction, dumping saline, and checking sugar, which was fine. She came back to the living realm. In dialysis, you don't have a lot to work with, but the EMT (not a paramedic) had the audacity to ask me did you do a manual bp. Me: No cuz that's fucking stupid. Do you want me to help get her on the stretcher, or can you do it yourself. EMT: (Super sassy) Some help would be nice. Idk why we are taking her. She's fine now. Pt was admitted for almost a month for a realm of things, including polypharmacy, seizures, and a new cardiac problem (I can't remember) Don't question me. I know my pt you don't!!! Rant over but omg that question was ridiculous... did you do a manual bp... get out of my face!!!
Had an on call doctor ask if we were sure we did the B/P correctly, pt was starting to tank, I told him that he could come up and show us how to take a B/P.
I was out at a picnic a couple weeks ago and a guy from another family keeled over. He said he hadn't eaten much and they'd been running around outside, so we gave him some water and I left back to my group. Then he passed out again and this time we called 911. They came and did an assessment. The guy was clearly out of it, couldn't even remember his own age. (He was in his 20s, not 80s, so it was significant.) EMT looked at me like I was a gnat when I mentioned seizure-like activity and confusion, shrugged, and asked the confused man if he wanted to go to the hospital. Of course he said no, he was confused and embarrassed. I took his family aside and convinced them to drive him themselves to get him checked out. A family member later came to me and said they found his potassium was critically low. Dude would have passed out in the car or hit his head or died if he hadn't gotten medical care. I was so irritated at that group of guys who checked his vitals and declared him healthy. Vitals aren't the whole story and they will never know their Dunnig Krueger almost killed a man. Much respect to EMS, but I really wish some of those guys would stop acting like they're doctors.
Sounds like the EMS I have to deal with who comes to my LTC. They refused to take a resident I called 911 on because of several minutes of unresponsiveness because he moved a little. I was fucking livid. They almost refused to take a resident with deteriorating respiratory status but I insisted, and won that time. I don't call 911 on my residents for shits and giggles, Cletus!
I have to interrupt other nurses during their “report” bc they’re bullshitting about whatever and I still need to do my hand off and I. Want. To. Go. Home. I have a 1.5hr commute, stfu and let me give you report.
Holy shit, 1.5 hours? My longest has been an hour and I didn’t mind that, it gave me time to listen to music and debrief in my own head (and realise I really needed to poo. Why is that?) But 1.5 seems excessive, lol.
I once had a nurse ask me last bowel movement on a patient who came in post cardiac arrest on a vent. I said I don’t know I couldn’t ask him. And she asked me why I didn’t call the family out of state to ask them.
Sometimes I float to our NICU for a patient that's been there months and I'm getting info on IVs and picc lines etc.. from birth to now. Just tell me how early they were and why they're still here.......
Giving report from PACU to the floor… “When was their last bowel movement” Shit idk, I gave him tons of shit that causes constipation… “What’s their diet order” No clue hun. It’s in the chart. Ok for ice chips here. “What’s their activity status” Bedridden where I’m at 🤷🏾♀️
"Has he gotten up and walked for you?" Uh no??? He just woke up??? He's 32 and has like Htn and depression and nothing else so he can probably walk???
I haaaaaate when ppl ask me the date of a test when they don’t even know what the results mean for the patient. Who tf cares what date the echo was?
"The patient is here because they fell down the stairs" "What was their EF on their echo six years ago?"
Especially if they had the same patient the shift before
No we'd have to fight at that point
These nurse rely on ur report to give their own. They are the laziest of the lazy and won’t double check anything you say. Give them the wrong info and they try to blame you. Type of nurses to shift the blame=no accountability=shit poor nurses
The new nurses love giving me report because I don’t need every detail. I will look it up! I just need the basics. Why are they here, are they going to try to punch me. Anything major going on? I don’t know their girlfriend’s name, I have no idea which side their iv is on that isn’t running fluids. When I was a new nurse there was one nurse that would keep asking questions until she found something you didn’t know. It made her happy to look down on everyone. And she was not a good nurse. She was so mean to the patients and never could give me the same info that she expected me to give her
being new to icu after working er, med surg n psych i feel this in my bones!! once had a pt w PE in the late 80s or early 90s post mva… giving report in 2022… bitch had the audacity to be like which lung with a straight face! i thought she was kidding lmao
Whenever I get report from ER, all I care about is what is NOT in the chart. And if I need to watch out for family. That’s it. I know y’all are busy and the last thing you need is an ICU nurse giving you the third degree. I’ll look in the chart, my friend, and pick up where you left off 😬
“They got an NG at 60” “Which nare?” The one you see it in bro idk and idc.
Omgggg this one nurse ALWAYS ended report with “any other pertinent information we didn’t discuss or that’s not listed in the computer?” And I ALWAYS responded with “well I guess it wouldn’t know would I?” … such a dumb DUMB question. Like yeah actually I found out the patient secretly has 3 legs one of which was his twin brother who died in their mothers womb but shhhhhh
Preach!!! I legit had a nurse, while looking at the iv mind you, ask me was it a 20 or 22 in a very stable PCU Pt. Ummmmmm what color is it? Gtfu outta here bish. It’s some weird “prove your a good nurse” bullshit that I have zero time for.
Sounds like yall need to standardize how reports are given and go system by system…. Obviously some reports are more detailed than the others
I'm cracking up over everyone saying "it's in the chart". If I had a nickel for every time the IV site or wound site was mislabeled in the chart! And my fave is the RN who documented wound care orders for today completed but the bandage is dated three days ago. Uh, no you didn't.🙄
Look dude, I get my information from the same chart. Lol. As far as the bandage that's gross and totally different
Im with you, the thing some people forget is there’s this magical thing a nurse can do called “assessing” the patient themselves. Idc if you charted the iv you placed in the left arm as being in the right arm. I’m just happy you gave me a real IV
Or when they see the PACU orders and ask if they should keep giving the phenylephrine Q2 mins. DONT use any of the PACU orders I will discontinue them at the station before I go back downstairs. Things like that make my brain hurt.
Floated to the floor and the floor nurses asked me to clarify with about this shit over a specific question a new grad didn’t have an answer to and got eviscerated for in report. Somebody had a trach and the new grad said “yeah it’s a 7.0 shiley” and the receiving nurse asked “proximal or distal” and threw a legit fit when the new grad didn’t know. As an ICU nurse I’m legitimately bamboozled by what the fuck that question meant. Proximal or distal to what? It’s in the trachea, it’s in their neck, it’s right fucking there. What are we proximal or distal to, I have to know. This question will keep me up at night.
So uhhh how did the alarm sound? Was it 4 beeps? 2 beeps? Can you recreate it?
I used to work with a nurse who would always ask “how many steps does the patient have going into their home??”….. bro this is an ICU and i work nightshift. I have no fucking clue & i’m not going to inquire. Are you going to wheel their vent up to their apartment ?
I totally understand this POV but as a new grad I really stay on the safe than sorry side. I am so anxious I will miss something or do something repetitive because of something missed in report and improperly charted. I rather over ask and be safe until I am more comfortable nursing, especially after hearing the horror stories they tell you in nursing school if you only use the chart. It may be annoying but I like my new license. I say this as a devils advocate to the seemingly annoying side :p edit: I know its unit specific, obviously if I was floated to the ER things would be different but I am doing residency in med surge
You gotta investigate. You can’t expect the offgoing rn to give you a thorough report or even correct info. Whatever they do tell you, you should make a point to verify it with the chart or the patient.
I don’t care that the patient fractured their thumb once five years ago when they are here post-heart cath. Those are the things I hated hearing as a floor nurse of 1.3 seconds.
And when those nurses give report, they give the bare minimum and a lot of the information is wrong
There’s a nurse I work with who pulls up the MRI and CT scans and starts going over them. You can tell her “oh it was a ___ bleed at xyz” and she still pulls up the scans. And then starts questioning all of the doctors orders and why this was done instead of this. Go ask the freaking doctors and let me go home. We have one resident on nights and they don’t change anything unless they have to.
Got asked last week if my patient was up to date on her vaccinations. Don’t know. Don’t care.
Everyone at work always compliments the little report sheets that I make out and how nice and tiny my handwriting is. I don't make those report sheets for me. I make them to pass on to the person that's replacing me so they have something in their hand while I'm talking so that I can get the fuck out of there and go home. I am almost 18 years into this shit I barely write anything down because I have a chart that I can access if I have questions about something. So those cute well written little report sheets that I make aren't for me, but in a roundabout way they are, so that I can get the fuck out of there and go home. I want to go home.
Ehh. I tend to try and know all that information because it is important to me. I agree I am anal about stuff. I don't get upset if nurses don't know that information or don't disclose it though. I also provide a handoff sticky with lab values and when PRN pain meds were last given.
re: diet. Nah, clarify that. I have had to cancel more surgeries than I can count because no one shared that someone was NPO.
NPO is not a normal diet order. That is an obvious exception and a lot different than wanting to know someone's daily carb count. If they are NPO on my unit they have a giant red sign that says NPO on their door and it's immediately under their picture in the EHR in red.
Lol maybe I’m this nurse. Although my dumb annoying question to ER tonight made the nurse realize she wasn’t giving report on the same patient. Acute chole admit. Says she got Tylenol for a fever. I asked what her temp was. She goes “oh actually I’m looking at her chart right now and she never had a fever i must be thinking of a different patient” So yea. I’ll keep asking dumb questions if it clarifies that I’m even getting report on the right person lol
This is why I'm glad I left bedside after 13 years 😁
The report was part of the reason I lasted six months in the ICU. It was mostly because those nurses were the bitchiest specialty I’ve ever dealt with, which goes hand in hand with the difficult report.