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ICU RN x7 years here. This is hilarious because it's so accurate. ICU and ED nursing are totally different beasts. I know my patient's history, their CT and lab results and their sister's name by the time they roll onto the floor. I often have the luxury of time to go through the chart. My ED colleagues keep a patient alive without knowing a thing about them. Much respect!
You have time to look at the chart? We are getting the admission as a third 99% of the time, mostly I get told they are coming about 5-10 minutes before arrival. I have been able to check their chart about 3 times before they roll up in the last few months.
I had a kidney stone that ended up causing sepsis and they had to go in after the stone so after the procedure I went into kidney failure and ended up in a coma for two weeks and yeah… Y’all knew my whole family. Thank you for what you do. Your peers saved my life.
And the way Ben looked when he was speaking with the ICU nurse. Of course after they got off, they met for decompression liver rounds(drinks at the local watering hole)
LOL! I'm an ER nurse and this cannot be any more true! Down to the tee, even mentioned how they let you give report for 5 mins straight even though they've looked up the patient for the past hour!
I see it all the time. I’m an ICU nurse and usually when I get an unstable like this I tell ER to help me transfer and go because ain’t nobody in that situation got time to nitpick. Now if you’re sending a walkie talkie DKAer on an insulin drip I may ask for a better report 😂
...and then when you think about them having personal lives, kids, marriages, pregnancies, daycare, sick parents, it's all the more heroic - then there was Covid which took us into another galaxy altogether! True heroes with angel wings.
My wife went to the ER years ago and ended up admitted to the ICU. The difference to my own naive civilian eyes, between the two was astonishing. ER was frenetic, high paced, the most basic questions that they needed to do their job. They literally did not care about anything else. Nor should they. ICU was extremely methodical, calm, quiet... asked every question under the sun and some I'm pretty sure they just made up to see if I'd notice. Both serve a completely different function. Thankful to both, but this was utterly hilarious.
My Mom was an ICU nurse for a few decades then moved on to other things in nursing, spent her last decade or so working as a nursing professor. Think I visited her dozens if not hundreds of times there at the ICU while she was working so she could spend some time with us kids on her breaks, but I can recall a few times where she and her coworkers were working frenetic and high speed in one of the rooms, and well yeah. Didn't understand why really until I was older, but it is what it is. I and the other kids that visited our moms there did see the other nurses as kind-of adoptive aunties and they saw us as adopted nieces and nephews, and we later found out a breathe of fresh air/relief from some tough nights/shifts/events that they had. Actually still see a few of them when I home visiting my parents and one of them comes by to say hi to Mom. But yeah, I've known all my life how hard nurses work, and even some of the reason why for the different positions too :)
Icu is the most accurate to textbook nursing. There is rarely stress. Most patients are stable criticals cause ED wouldn’t let an unstable critical be transferred to floor
Same 😂😂 We already briefed a couple of other nurses on what kind of admit we are getting before we even got report and are all ready to go. How dare the ER not clean the patient and check their skin first though?? 😂😂
@@susanboyd6592 Ahaha. Same. If you get metal plates in your mandible I might as well make sure that you wake up not looking like a vampire after dinner, especially before it starts to swell. How on earth do they expect anyone to clean their blood splattered face while looking like a hamster ?
I used to be pediatric ICU nurse, and I’d like to think I wasn’t that crazy to give report. Didn’t realize how crazy some ICU peeps are now that I’m a cath lab nurse calling report to them lol.
Former ICU nurse. It's so true. Lol. He needs to do a skit about the tangles mess of lines the ER send up to the unit and how ICU nurses are OCD about having organized lines.
My brother was an ER nurse for almost a decade before he decided to get into teaching & being a case manager for discharging patients. Anyway, he has OCD when it comes to lines being neat & untangled.
I was just writing a comment about how one of the most awesome nurses I met during my late husband’s cancer journey was temporally “borrowed” from ICU and she chatted away to me while proceeding to fix my husband’s tangled lines. She fixed everyone’s on the floor but was so lovely about it. She was awesome and efficient 😊
My favorite report from an ED nurse EVER started like this - "I'm sending you this human...because we're all out of puppies." LOVED it. ED nursing is so random. I enjoyed my time down there and so appreciate what ED does.
Edit- I can't believe how many likes this got, and my husband's latest echo shows no damage at all to his heart, just the stent. I am still amazed by this miracle. My husband had a heart attack the widowmaker was down for half an hour, 100% block in his artery. He had to be shocked 11x. He was on life support for a week. Then miraculously he survived. Like it never happened. The icu nurses got us thru but the er team and emts gave me my husband back. They didn't give up on him. Nurses are so underrated. They really are my heroes.
That is AMAZING! So happy to hear that! If you and your husband ever want to go back and give the doctors, nurses and paramedics hugs, or just go to say hello, it is incredibly rewarding! It is truly the reason many of us do medicine, for the lives saved like your husband. It’s so wonderful to see someone you’ve saved afterwards! Wishing you and your husband many healthy years ahead!
Oh they just show the tip of the iceberg. They can't tell you the stories that stick with them forever. The crazies that just defy all crazies. That would end up being HIPAA violations as it would be easy for someone to figure out who they are talking about. Some of those intense stories I'll never tell. Some I have waited ten years or more to tell to avoid anyone recognizing the story. Most of these tales are things that happen multiple times every day so the individuals can't be pin pointed. But y'all... it's rough out there on a level muggles will never understand. 😄
As an ER nurse I can attest to this! This is hilarious. I frequently don't know my patient's name, and what I know is their clothes are lying in pieces on the floor, the bp is tanking, someone is doing cpr, someone is intubating, I'm starting the ART line, the room is crowded and the red hat is directing it all like the finest symphony.
I once yelled at some med students for asking me the pt name in front of them. I told them don't ever do that again, this is emergency medicine patients don't have names they have complaints and room numbers. This is 15 chest pain, if you want to know his government name look on his wristband like you just made me do when you put me on the spot
@@naomihatfield3015 Nah, it's literally just the ER and ICU rivalry. It happens at the hospital I work at also, but I wouldn't take it too seriously though. The hospital wouldn't be the same without it's quirks.
just showed this to my wife who is an IMC RN, she said "That's accurate from both ER and ICU, ER doesn't tell you anything and ICU tries to have you do everything for them before you show up... "
@@mma771 That's your perspective. We still have 20 patients in the lobby, no clean beds, multiple admits and transfers, and another double trauma just rolled in. We have things we need to prioritize and something simple and non-life threatening is likely to fall by the wayside so that we can do something that is higher on our priority list. None of us like that we struggle to find the time to do simple things but none of the ER or ICU nurses are sitting around playing cards, either. We're all working hard, well most of us anyway. ♥️
@@scholasticbookfair. It's not the same. Patients in ICU are critical and can be unstable. They need a lot more attention than 80% of the patients in ER. As someone else above said we all do our best, no matter where we work. It's always hard to figure out what is going on in another unit, you tend to see your own struggles only. In ER you want to send the critical patient to ICU asap because you may need this bed for another emergency soon. In the ICU you want to make sure the patient is stable before they're sent to you because if they're not, you can easily spend 1 or 2 hours with them and that would not benefit the patients you already have in charge. Both teams in ER and ICU do their best to ensure the proper funtionning of their respective units, and that's important too !
@@fluffyjun1479 I'm sorry are the code, trauma arrest, cvs and septic gammy that just walked in not unstable? Even most unstable than before you get them that is.
When I was in peds ED I gave report on a transfer that quickly became unstable and when I rung PICU.. no let me get this right.. this one nurse from PICU rang me and heard the rush in my voice, she said “take a breath, you’re doing great, get the patient up here we’ll see you soon”. That PICU nurse was a gem.
*My floor lead:* Hey can you go triage this thing in the lobby? *Me:* Sure, what's wrong with it? *FL:* No idea. *Me:* Cool. Will it try to eat me? *FL:* No idea. *Me:* ...do we know what species it is? *FL:* Nope! *Me:* ...ok then! [pulls on gloves and just goes]
Seriously though, I’ve been in the ICU before. Those nurses are a different breed altogether. Meticulous about being meticulous is how it describe it. Also… don’t try to get out of bed and go to the bathroom on your own there. They don’t like that apparently. 🤷♀️ But in the end they saved my life so we’re cool lol
How funny because in the UK post surgery they absolutely want you to do everything by yourself post op. After my last laparoscopy I had heavy bleeding leftover from the operation and high levels of pain and they still wanted for my to transfer from the gurney to the bed in the ward all by myself. It took a while and I bled everywhere to the nursing staff’s annoyance. When I was suffering from insane pain from the trapped CO2 they advised me to go for a walk, I couldn’t even straighten myself out from foetal position...
As someone who's had 3 ICU stays (one which they didn't expect me to survive), along with stays in the ICU step-down unit, this had me laughing. The ICU nurses can definitely be over the top. I'm appreciative of all they do. I owe my life to them when the doctor failed me.
@@sjfrench8034Thanks, After I came off life support (due to doctor error), I ended up with a diagnosis of colon cancer. I've been battling for 3 1/2 years now (first stage 3, now stage 4), but all things considered, I'm doing well. On indefinite chemo and facing my fourth surgery, but hanging in there.
I know what you're going/went through. I have type 1 neurofibromatosis, mastocytosis and type 1 diabetes. I won the genetics jackpot lol. To say I have spent some time in the ICU is an understatement. I have always loved the fact that the ICU nurses are always more on top of things than the ICU doctors.
I've been an ICU nurse since 1990 and this is spot on. This is exactly how report between the Emergency room and ICU staff is. It made me laugh because I can remember me asking the same questions and ER nurse saying the same things.😂😂
I remember my late husband went into septic shock on Christmas Eve (turned out a cancer tumour in his liver had burst). The doctors prepared me for the worst. He made it through the night but was barely hanging on when I visited him the next day. ICU doctor was called down to assess whether not to transfer him. The dr calmly and silently looked at my husband and checked a few subtle things. Then shook his head and left. I said to my father-in-law, who was also in the room, that that was one doctor you WANT to be rejected by. I knew then my hubby would make it. Which he did. Though sadly he passed a few months later in palliative care. One of the best nurses we had too was one borrowed from ICU. She proceeded to re-cable the whole floor because everyone was so shabbily connected to things. She explained that in ICU everything must be just so. She was lovely (not rude about it at all) and efficient.
ER nurse was my second choice of career after paramedic. I didn't want to only treat a specific system or disease, I wanted to be able to do hands on maneuvers to keep them okay until they can get to the place they really need to go
Same here. Emt though. "Play" & learn so that your skills increase Do what you can for the patient and then hand over to the experts - Austen and Ben. They have to deal with ICU. Phew. Ironically I was admitted to resus nearly 2 weeks ago, ended up with tubes everywhere, ventilated for 5 days, recovered in ICU and am now waiting to go home. Thank you both ED and ICU nurses. Oh and my own colleagues of course.
Ah gosh I don’t want to do ER Medicine. I’m more of the “thinks deeply while balancing electrolyte levels, ECGs, scans, etc) guy so I want Internal Medicine. Altho of course IM has its emergencies too and the residents also rotate in the ER… after ER residents stabilize them of course.
Ed nurse here. I had an incubated boarder that was finally airlifted after about a day. I was also juggling two other high turnover ed beds. I only had the intubated dude for 4 hours. Just kept him sedated and vitals stable. Barely had time to look at the charts. My passdown to the airlift crew and my passdown cal to the icu was shit and I felt bad. I even got a couple condescending looks from the helicopter nurses. But you know what? I kept everyone alive and stayed afloat. That's all you can do sometimes and if people have no empathy or understanding, that's their problem to fix, not mine!
This is so spot on! I’ve worked in both the ER as well as ICU and the “getting/giving” report battles were epic. I can’t tell you the countless number of times that as soon as an ICU nurse finds out they’re getting a patient from the ER, they’re going over that patients chart with a fine tooth comb, and yes the top questions are “ How does the patients skin look ?” And “Are you going to replace x, before you bring them up?” Lol!
As an ICU nurse, I take umbrance, I never trusted ER to check the skin. And yes I had the bed, drips, ultrasound, etc already in the room because I had perused the chart...
Loool we have a 1:6 ratio in my ED, we have time to get ABC's, a basic pain coverage and sources of infection sorted and then we get them the hell outta there.
The part about "You already know more than I ever could about this patient" is sooooo true lmao! I work on med surg currently and when ED calls I don't make them suffer. There's one guy down there that basically knows he can just text me "pt on the way, text me if you have any questions" ... I expect a good Christmas gift from him. haha
I never would have expected ED to do a Braden assessment! Their job is to keep patients alive enough to get to OR or ICU. Maybe a nursing home patient would get that attention in ED, but even then, being alive takes precedence! Never heard an ICU nurse ask that when I was a clerk there…but then, we didn’t start using the Braden scale on the floor until mid- to late 1990s!
Im ICU and love the friendly rivalry with ED. When I started, I had this idea that ICU would be slower pace most of the time - compared with the constant pace in ED. However, most shifts see us trying to complete an unending number of tasks, with the goal being to not let the patient get worse during our shift. Sometimes we can give the patient back in a better condition than they were, but thats not always the case. Anyways, I think the two specialties are equally challenging and rewarding in their own ways. I'm never trying to give ER nurses a hard time and know that their mission is different than ours.
I posted about my husband's widowmaker, and I just wanted to thank you for being an ICU nurse. You guys don't just help the patient, you really get the patient's family thru. Those nurses did so much for me, hugged me while I cried, were cheerleaders f optimism, but they listened to me about his ptsd, flashbacks, nightmares, it kept me rom breaking down. Thank you for what you do.
ED/ER nurse here! I'm glad that you and your colleagues see it as friendly rivalry! I think it can for good unison between the two departments if we stop assuming that the other department is underserving of time and understanding. All too often I see this between wards and departments where I work - we're all in it together FFS guys!
Haha! I'm an ICU CNA and I love my nurses, but they are a little ridiculous sometimes I can't tell you how many times I've helped turn a new admit to check their skin and heard the ICU nurses grumble about the ER nurses not giving a skin check in report
@@pahtosh Yep! ICU nurses are fantastic and they know their stuff, but they are also very meticulous. The most Type-A adrenaline junkies you will ever meet 😅
Oiii it is on us if the bedsore is not community acquired... how do we find out if it is community or hospital acquired ? By That skin check on admission... smh
ER nurse here, I love learning about the differences in departments because it helps me to work better with them, to avoid petty disagreements, and to focus on patient care. Every department has different primary focuses, and staff that knows what these are can usually avoid arguments over skin assessments. I've mad respect for ICU nurses, and I do skin assessments of the back and bottom when I can, even if I have to Google the pressure ulcer stage chart. I even stay in the room when I admit my patient to help the floor staff turn them and get them settled
ICU : what's the patient's condition Er: patient is not stable ICU : so you are sending me an unstable patient Er: well if he was stable we wouldn't have put him in the ICU
I’m an ICU nurse and this is way too accurate. I’d like to think I don’t fall into the stereotype. As soon as I get assigned a patient I’m looking them up and following the activity log in their chart. I look my patients up and then when I go down to pick them up and get report it’s just confirming what I already know and writing down anything new. I am about to do a full head to toe assessment anyways so I listen to report and if it’s not going to kill them in the elevator on the way up I’m not even going to ask. I often know the history, injury complex and plan of care just as well as the ER nurse because they are very busy. Perhaps my one pet peeve is getting a patient that hasn’t gotten their COVID screening done. Inevitably they get to the ICU, half our staff is in and out of the room, we get a swab, and then the result comes back positive. If I don’t have a resulted test, I’m wearing PPE and minimizing personnel in the room until I know. Admin complained to me that it is not hospital protocol to isolate preemptively. I tell them that the hospital is screening all patients for a reason and it’s my prerogative to safeguard my own health.
Since when has hospital admin ever had a clue lmao😂. It's the same everywhere, admin vs the real workers. They can be so outta touch. Normally, I just nod my head, say "thank you for your concern" and then continue doing it anyway. I also document everything just in case for leverage.
First, you have a right to safety as much as your patients or anyone else. 2, if they have COVID, it’s going to affect their recovery. Earlier you know, the better the results. lol 3, It’s a pain to get a shift covered when someone is out for a day. What happens when they have to cover your shifts for an extended period of time? 4. And if you don’t make it, where will they find another you? How much money will they lose training someone, and how long will it take? 5. Workman’s Comp. $$$ Temporary or possible permanent disability $$$ lawsuit $$$$$$$. 6. You are doing them a FAVOR, helping them avoid all of these things they overlooked (🙄). While I wish they could have a heart, often you have to put it in terms they understand- inconvenience & MONEY. Good for you for standing your ground! I hope others are able to follow your lead to save themselves and their patients.
@@Priuloch Are you talking about the vaccine? It wouldn't help if you're already positive. You need to get them before you get sick. Or not, as you apparently prefer.
Brief time in both areas during my training so many years ago . . . .laughed my head off with this one! To all you who are in either space - THANK YOU!!!!!!!! Seriously both are invaluable and so different to each other.
ER nurse here. Two very different worlds; I could not tell you how much I respect the brain of the ICU nurse. As I like to say, we stop the plummet from the precipice, ICU hikes them back up to the peak. Both worlds are magic.
Truth!!! As soon as I know I’m getting a patient I immediately deep dive the chart and write out my own personal Cardex and then get the report. Emergency depart nurses love it because I basically tell them what I already know, ask them if they have anything to add to it😂. They’re like “nope we’re good!”
I'm Med-Surg CNA. I hear how ER never gives a good report and that you should never trust what you get. "Patient is alert and oriented, independent" and when they arrive to us, we literally have to help them hands-on because they can't move from the cart. LOL. My brother is a ER Tech and refuted, "well they walked to the bathroom and was able to provide a urine sample no problem!"
Can we please get more of this ER vs ICU? Just the idea of ICU trying to thwart Ben but he is always three steps ahead would be a running gag through more of these.
I hate telling my symptoms over and over to different doctors and departments. I’ll remember this. If I end up in ICU I’ll remind them they know my chart better than me😂
Oh my god! This is so true!!!!! I’m an ICU nurse of 6 years and yes! I always know more about the patient than the ER nurse. 😂 And if they tell me something I don’t know, I’m like, “You better document that central line before coming up here.” But also, yes, ER is always frustrated by us asking to non-critical things to be done, like potassium. 😂
Even as a medsurg nurse giving report to an ICU nurse sometimes I would be taken aback by the detailed questions some would ask. I get where they are coming from and to them it can be relevant but if I have 6 other patients that need me I didn’t always know ALL the details of their medical history, especially at the beginning of the shift. Different places require different things.
Oh yeah. I can definitely see this. 6 years in MRI at a level 1 trauma. Although too unstable to go to the ICU wasnt really a thing. I've definitely seen 3 CCRNs, 2 RTs, an attending, a resident, and a CT tech all helping bring an unstable patient from the ER CT to the ICU.
The way Steve developed his characters is so accurate. I really like how he describes ER and ICU nurse report. As a Med-Surg Nurse, we do have the same question when doing report. In my hospital, Braden Scale is important one, too.
Retired RN - trained in the UK and practiced there and in Canada in teaching hospitals. Love this! Brings back a lot of memories, always puts a smile on my face and often, a good laugh. Must be a bit of a shock to some patients and families but what you portray is real and it's a reminder to all of us that hospital staff are people just like them. On a more serious side, I appreciate the teaching/learning platform you bring along with good support of staff, delivered in a good mix with humour. Respect!
Im leaving this comment here so, after a month or maybe a year, when someone like it, I get reminded of this master piece. You are getting better, Steven.
LMAO! This is the most back-handed compliment I've ever seen, but it's funny as heck because I can imagine a woman telling a guy - "That was a masterpiece dear! You're getting better honey!" LOL! HILARIOUS!
Amazingly done as always, love the gradual development of each character and their individual personalities, keep up the amazing work Steveioe👏🏽👏🏽👏🏽👏🏽👏🏽
That tasting blood part though! I once almost touched blood spill in the ward as a little kid with my mom at the hospital, and she gave me one of the most stern lectures of my life! It's a hospital, hundreds of sick people and you never know if they're not HIV positive or some other shit 🙊
As a Emergency Medicine Resident, who also had ICU postings, I can confirm it. This is absolutely what happens in my hospital btw ER department and ICU
This is so funny and true! Us ICU nurses want to read the chart before ER gives report cuz usually it’s the break nurse giving report and not the main nurse. And we want that K covered before coming up!!🤣
But...but...the priority is on getting the critical patient to critical care where the nurse has time to sort em out and get them out of the ER nurse's hair so they can get back to dealing with ER shenanigans like unruly drunks, confused grammy on the floor, and your next icu patient comin in...😬
@@jackiemulholland6 and all the unstable surgical patients that you never see. Medical icu is a vent farm basically . ED is the highest level of care. Not the icu where you turn knobs all day...........
ICU nurse here gotta say as long as the patient is somewhat breathing/intubated, labs were at least drawn so i have an idea whats going on and the ct that was ordered an hr ago that our er has to pass on the way up was done we good:) ill deal with the rest of the things as they come though because with how busy our er is i dunno how they do it
I'm not ICU, I'm medical receiving, but same, Ive got a lot of sympathy for what's theyre up to in ED. My one gripe is when they walked past xray and CT to bring the patient up, but didn't get the scans. Like, i get it, theyre busy down there, but 3 people to pat slide patient three times in an hour, because ED sent up a patient with sepsis ?source, but no CXR, is very frustrating, especially when it takes staff off the floor.
Considering the workload that ER nurses usually deal with, they'll more likely to suceed in ICU compared to an ICU nurse trying to survive in the ER where they will have to deal with 8+ patients and constant admission when they usually only deal with 1-2 pts at a time in the ICU
Been there done that. Got floated to ICU a few times during the pandemic. They only trust me with 2 stable intubated pt. They were doing team nursing and team lead is the ICU nurse watching over 5 pts. 2 vents, 2 HAU pt, and 1 medical step down. My pt desated when the ICU nurse and I turned him for pericare and I pressed the 100% FiO2 button. She complemented how calm and collected I was like I was a new grad. 🤣🤣🤣. Took me a lot of self control to not say anything. I don’t think I can ever work in ICU, too boring.
