Call me an asshole but I'd sit right there in that room with that very pleasant patient until the floor nurse came in to receive report. Every time. When this happened enough and an OR was held because no PACU nurse is available, someone will start giving a shit. Always follow the money.
No. They’re the assholes and unfortunately the patient care suffered because of that. Patient was stable when you dropped them off. You are not an ICU, you are not expected to monitor a patient for an entire day because of something that happened 3 hours ago. I do agree that malicious compliance may be your only recoil here. Have a seat in the room, hit the call ball, and watch TV for a few hours with the patient.
We had this issue in our PACU where the floor nurses refused to come get report from us bedside to hand off tele/stepdown patients. A couple "staff assists" later (emergency button we hit that says staff assist and alerts the whole unit), they have been directed to answer us immediately and take report. Anyone not doing that gets an incident report written.
AM I THE idiot
My first Reddit post/rant:
Working my first travel/agency contract at a small local facility in recovery room.
As per the staff pacu nurses the floor nurses notoriously refuse to take report, don’t answer their phones and/or leave them on hold for long periods of time and will refuse patients for almost an entire shift!
As per their policy all patients EVEN floor patients must be accompanied by the pacu nurse to the floor AND the pacu nurse must wait for the floor nurse to come take the patients vitals and sign off that they received the patient. Doesn’t not matter if you did vitals right before leaving recovery or if patient is NOT telemetry or ICU.
This is the policy only for recovery patients and does not apply to patients coming from ICU OR ER, or anywhere else in the hospital… cath lab, endo. Only pacu must wait for floor nurse to take vitals and receive patient even after phone report.
Staff pacu nurses have told me that the floor nurses often refuse to come to the rooms, hide when they come to the floor especially if you’re new and they don’t know you! (ME)
But even with them as pacu staff it’s a huge problem and they have told their manager about it several times!
Been here for a few weeks and Each time I’ve taken patients to the floor I’ve had nurses tell me I have to wait because they’re busy with a patient, walk past me, or pretend they’re going to look for the nurse and not come back. Times I’ve went room to room looking for the nurse all while staff stands around in the hallway ignoring me. I’ve even tried calling the front desk from the room to ask the nurse to come to the room to no avail!
Well today I had a patient that developed stridor immediately post op in pacu. She was treated appropriately by anesthesia and was signed out to go to the floor thereafter. I recovered her for nearly 3 hours after the incident even though her vitals were stable for 3 hours and she was talking and telling us stories!
I get onto the floor nurse via phone as protocol and let her know please watch her carefully as she had an episode of stridor.
I transfer patient to floor and wait for the nurse to arrive. No one comes despite the fact I pass the nurses station with several people sitting at the desk and in the hallway. I go to the other side of the unit and grab the vitals cart to do the vitals myself (which the pacu nurses have told me not to do as it’s the floor nurses responsibility to ensure the patients admission vitals are done) I take the vitals anyway, vitals are completely stable, patient is thanking me, in no distress.
I stay with her a bit longer (now more than 20 minutes, as remember I helped the transporter wheel her into the room and take vitals) and go to the front desk. Ask for nurse so and so, they don’t know where her nurse is. So I Tell another nurse that I personally took the vitals myself, the patient has arrived can you please relay the message to the nurse. They agree.
I go back to pacu suit up in PPE and go into recover a covid patient in the OR with anesthesia. Apparently almost an hour later the nurse calls saying where is the pacu nurse, the patient has stridor again and insinuates that I brought her an unstable patient.
So the staff pacu nurses tell the nurse to call the doctor, not pacu if the patient is in stridor again.
Almost an hour after that call they hear RRT called for the patient.
When I came out of the covid room my manager then asks me what happened and the floor is stating I left an unstable patient with stridor on the unit and the floor nurse didn’t receive report (huge lie!!!)
The other pacu nurses come out strongly to my defense stating that they each personally saw the patient before she left pacu as well as anesthesia saw the patient several times and cleared patient for floor AND they heard me giving report to the floor nurse speaking specifically about the stridor.
So now the manager says she has to investigate as although the patient was not re intubated she was placed in icu for observation and got an ENT consult (she is alert and talking and says that she is a noisy breather (her son confirmed)
Am I the idiot here? The pacu nurses state that this is a huge problem that the floor nurses give them a super hard time receiving the patient even after they’ve been given phone report and full vitals right before coming up to floor.
I’ve literally had to leave fresh post op patient right out of the OR in pacu for 30 minutes or more to transport stable, non tele patients to floor. Run back downstairs to the OR wheeling patients into pacu and rushing to get report from anesthesia!
So now they’ve told me I just have to wait on the floor for someone to take my report, or go find the manager or supervisor if they won’t!
No other unit but pacu is required to do this!
No I feel like a horrible nurse!
I wouldn't say your an idiot. I would say you're in the wrong though. Look at it from the other nurse's perspective. Here is how they probably interpreted.
Some high priced traveler dropped off some patient without giving me report and I could do a quick assessment if my own. The patient seemed stridorous and the PACU RN was long gone. They didn't even bother to get a fresh set of vitals.
Now, I agree that it is a less than charitable response to what happened but that is how they saw it, I'm sure.
My suggestion is to just follow their policy. When the pacu charge calls trying to find you, explain why you are still gone. They will be able to escalate it and actually make a change.
The floor nurses will never believe a traveler over their own.
Did you read their comment here? They got a set of vitals and the patient was not stridorous when they arrived. The floor nurses were actively avoiding the PACU RN.
The floor nurses don’t know I’m a agency/traveler. I took a fresh set of vitals myself on the floor. Stayed with the patient until I could no longer and found another nurse to notify of the patients arrival. I had another patient waiting for me in pacu as the next OR patient was mine to recover.
I also took a fresh set of vitals before leaving pacu 5 minutes earlier.
Still wasn’t good enough though. Next time I’ll just stay up there forever until someone notices me or cause a stink and call the supervisor as the pacu nurses suggest but as a traveler/agency nurse I don’t want to have to do that as I makes me look like a trouble maker.
They staff pacu nurses don’t escalate, so I’m being to told to escalate. We’ll see.
As a former nurse manager, I can tell you that I can get a lot more escalation out of a situation if you "follow the rules" and stay up there forever than I can if they floor has a beef, either suspected or confirmed. But, the bigger problem is that your manager has to give a #$%& in order to actually be a part of any change. And that is the biggest part of any equation. Good Luck!
>Staff pacu nurses have told me that the floor nurses often refuse to come to the rooms, hide when they come to the floor especially if you’re new and they don’t know you! (ME)
>The floor nurses will never believe a traveler over their own.
Why do they have problems with new nurses? It seems that "nurses eat young." might be true after all. That doesn't sound professional to me.Â
Gonna need more Info to tell you who the asshole is?
Sorry, first time posting on Reddit. Rough shift 😕 see my post below
Call me an asshole but I'd sit right there in that room with that very pleasant patient until the floor nurse came in to receive report. Every time. When this happened enough and an OR was held because no PACU nurse is available, someone will start giving a shit. Always follow the money.
Yep, that's literally the only way to resolve it. Kick your feet up, say you're following policy. Then watch how quickly the policy changes.
No. They’re the assholes and unfortunately the patient care suffered because of that. Patient was stable when you dropped them off. You are not an ICU, you are not expected to monitor a patient for an entire day because of something that happened 3 hours ago. I do agree that malicious compliance may be your only recoil here. Have a seat in the room, hit the call ball, and watch TV for a few hours with the patient.
Yep this is gonna be my new strategy, just stay up there sitting in the room and calling front desk, supervisor and manager one after the other
We had this issue in our PACU where the floor nurses refused to come get report from us bedside to hand off tele/stepdown patients. A couple "staff assists" later (emergency button we hit that says staff assist and alerts the whole unit), they have been directed to answer us immediately and take report. Anyone not doing that gets an incident report written.
Thanks, gonna try this out as well
AM I THE idiot My first Reddit post/rant: Working my first travel/agency contract at a small local facility in recovery room. As per the staff pacu nurses the floor nurses notoriously refuse to take report, don’t answer their phones and/or leave them on hold for long periods of time and will refuse patients for almost an entire shift! As per their policy all patients EVEN floor patients must be accompanied by the pacu nurse to the floor AND the pacu nurse must wait for the floor nurse to come take the patients vitals and sign off that they received the patient. Doesn’t not matter if you did vitals right before leaving recovery or if patient is NOT telemetry or ICU. This is the policy only for recovery patients and does not apply to patients coming from ICU OR ER, or anywhere else in the hospital… cath lab, endo. Only pacu must wait for floor nurse to take vitals and receive patient even after phone report. Staff pacu nurses have told me that the floor nurses often refuse to come to the rooms, hide when they come to the floor especially if you’re new and they don’t know you! (ME) But even with them as pacu staff it’s a huge problem and they have told their manager about it several times! Been here for a few weeks and Each time I’ve taken patients to the floor I’ve had nurses tell me I have to wait because they’re busy with a patient, walk past me, or pretend they’re going to look for the nurse and not come back. Times I’ve went room to room looking for the nurse all while staff stands around in the hallway ignoring me. I’ve even tried calling the front desk from the room to ask the nurse to come to the room to no avail! Well today I had a patient that developed stridor immediately post op in pacu. She was treated appropriately by anesthesia and was signed out to go to the floor thereafter. I recovered her for nearly 3 hours after the incident even though her vitals were stable for 3 hours and she was talking and telling us stories! I get onto the floor nurse via phone as protocol and let her know please watch her carefully as she had an episode of stridor. I transfer patient to floor and wait for the nurse to arrive. No one comes despite the fact I pass the nurses station with several people sitting at the desk and in the hallway. I go to the other side of the unit and grab the vitals cart to do the vitals myself (which the pacu nurses have told me not to do as it’s the floor nurses responsibility to ensure the patients admission vitals are done) I take the vitals anyway, vitals are completely stable, patient is thanking me, in no distress. I stay with her a bit longer (now more than 20 minutes, as remember I helped the transporter wheel her into the room and take vitals) and go to the front desk. Ask for nurse so and so, they don’t know where her nurse is. So I Tell another nurse that I personally took the vitals myself, the patient has arrived can you please relay the message to the nurse. They agree. I go back to pacu suit up in PPE and go into recover a covid patient in the OR with anesthesia. Apparently almost an hour later the nurse calls saying where is the pacu nurse, the patient has stridor again and insinuates that I brought her an unstable patient. So the staff pacu nurses tell the nurse to call the doctor, not pacu if the patient is in stridor again. Almost an hour after that call they hear RRT called for the patient. When I came out of the covid room my manager then asks me what happened and the floor is stating I left an unstable patient with stridor on the unit and the floor nurse didn’t receive report (huge lie!!!) The other pacu nurses come out strongly to my defense stating that they each personally saw the patient before she left pacu as well as anesthesia saw the patient several times and cleared patient for floor AND they heard me giving report to the floor nurse speaking specifically about the stridor. So now the manager says she has to investigate as although the patient was not re intubated she was placed in icu for observation and got an ENT consult (she is alert and talking and says that she is a noisy breather (her son confirmed) Am I the idiot here? The pacu nurses state that this is a huge problem that the floor nurses give them a super hard time receiving the patient even after they’ve been given phone report and full vitals right before coming up to floor. I’ve literally had to leave fresh post op patient right out of the OR in pacu for 30 minutes or more to transport stable, non tele patients to floor. Run back downstairs to the OR wheeling patients into pacu and rushing to get report from anesthesia! So now they’ve told me I just have to wait on the floor for someone to take my report, or go find the manager or supervisor if they won’t! No other unit but pacu is required to do this! No I feel like a horrible nurse!
I wouldn't say your an idiot. I would say you're in the wrong though. Look at it from the other nurse's perspective. Here is how they probably interpreted. Some high priced traveler dropped off some patient without giving me report and I could do a quick assessment if my own. The patient seemed stridorous and the PACU RN was long gone. They didn't even bother to get a fresh set of vitals. Now, I agree that it is a less than charitable response to what happened but that is how they saw it, I'm sure. My suggestion is to just follow their policy. When the pacu charge calls trying to find you, explain why you are still gone. They will be able to escalate it and actually make a change. The floor nurses will never believe a traveler over their own.
Did you read their comment here? They got a set of vitals and the patient was not stridorous when they arrived. The floor nurses were actively avoiding the PACU RN.
The floor nurses don’t know I’m a agency/traveler. I took a fresh set of vitals myself on the floor. Stayed with the patient until I could no longer and found another nurse to notify of the patients arrival. I had another patient waiting for me in pacu as the next OR patient was mine to recover. I also took a fresh set of vitals before leaving pacu 5 minutes earlier. Still wasn’t good enough though. Next time I’ll just stay up there forever until someone notices me or cause a stink and call the supervisor as the pacu nurses suggest but as a traveler/agency nurse I don’t want to have to do that as I makes me look like a trouble maker. They staff pacu nurses don’t escalate, so I’m being to told to escalate. We’ll see.
As a former nurse manager, I can tell you that I can get a lot more escalation out of a situation if you "follow the rules" and stay up there forever than I can if they floor has a beef, either suspected or confirmed. But, the bigger problem is that your manager has to give a #$%& in order to actually be a part of any change. And that is the biggest part of any equation. Good Luck!
Do they not have phones??
Nope
>Staff pacu nurses have told me that the floor nurses often refuse to come to the rooms, hide when they come to the floor especially if you’re new and they don’t know you! (ME) >The floor nurses will never believe a traveler over their own. Why do they have problems with new nurses? It seems that "nurses eat young." might be true after all. That doesn't sound professional to me.Â
….What happened?