Is anyone else's ICU more like LTAC? - page 2

Just curious what other regions/ hospital systems are experiencing.... I am an ICU nurse at a Midwestern hospital (community size roughly 250k) and we are the main hospital system in the city -... Read More

  1. by   LovingLife123
    I see it often. Most of the time, it's because family is very unaccepting of the diagnosis/prognosis and others it's waiting game trying to find somewhere outside of the ICU to place a patient. I find there are not enough LTAC facilities around that will take vents. The wait can be long.
  2. by   gonzo1
    All of the above.
  3. by   Cvepo
    We have an 18-bed intermediate care unit in the hospital where I work that is usually has like 10 chronic, stable vents. The problem is, our hospital does not allow even stable vents on med/surg or tele (kinda stupid, I think). So the stable vents stay in stepdown until one of the few vent nursing homes has a free bed or they end up on trach collar. The rest of the stable ICU patients get stuck in limbo, where they are too stable for ICU but too heavy for a floor. We had a trach'd vascular patient who was a fail to wean in our SICU who waited so long for a stepdown bed on our intermediate unit, that we actually ended up weaning him on our unit (decannulated and everything) and just sent him to the inpatient surgical floor!

    I see this less in Surgical ICU than I did when I worked in MICU. MICUs tend to have this problem from what I have gathered because of all the respiratory failure.
  4. by   Lennonninja
    I work in a MICU and it often feels like an LTACH and it frustrates me to no end. We see all of the same stuff people have already mentioned, but our stepdown unit can't take even the most stable of long term trach vents, the ones where family takes care of the trach vent at home! And we have had a big problem these last few years where a patient is accepted to whatever place, but then they refuse to accept the bed because they don't want to leave the hospital. We had one patient do this to us for FOUR MONTHS this winter. The patient just wanted to stay with us for the patient ratio and the narcotics, they refused every other aspect of care. It was HORRIBLE.
    Last edit by Lennonninja on May 8