Delay in transfer to floor

  1. How detailed do you all get in your notes about charting delays in getting pts to the floor. E.g., when you are meeting resistance due to the admitting team, or floor concerns, do you put that in writing in the pt chart or make it an internal report?
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  2. 15 Comments

  3. by   turnforthenurse
    I just chart something like "attempted to call report, nurse to receive patient busy at this time" and usually the clerk will say "I'll have them call you in 10 minutes" or whatever. I used to work the floor so I understand it can also be very busy there. I remember being arms-length in c.diff and the ER was calling trying to give report. Anyway, I let this slide maybe once. If they don't call back, I will call back and if I still cannot give report, then I will ask to speak to their charge nurse so that I can give report to them. If I am unable to speak to their charge nurse, then I go to either my charge nurse or nurse manager and let them know of the situation.

    Our hospital recently changed policy where if we cannot give a verbal report, we basically tell the clerk to let the receiving nurse know that information is ready in the chart for the nurse to review and we send the patient on up. Of course the receiving nurse can always call down to the ER to talk to the nurse taking care of the patient if they have any additional questions. Our ER is so overcrowded that we try to send the patient up the second their inpatient bed becomes available.
  4. by   bebbercorn
    Thanks for the feedback. My facility usually is pretty good on the side of the floor taking report. Recently I've run into a few issues. I'm at a loss at times as to whether I need to do a patient safety report or keep it within the chart... I just know that if there is an internal report it actually will get looked at. I just prefer to get the issue over with right then and there.
  5. by   amzyRN
    At my hospital all ED reports are now written, even report to ICU. The floor nurse is given a heads up that the report is in and if they have questions they can call back.
  6. by   SquishyRN
    I make an entry into the chart similarly as turnforthenurse. Some units are really good about taking report and calling us back if they were busy, others are notorious for delay tactics. The latter is the pretty much the reason I need all that documentation to account for any delays. Pretty much goes with that saying "If it wasn't charted, it didn't happen."
  7. by   NickiLaughs
    I chart a note, because the rule is we have 60 minutes to get them up and that time goes fast. I'm hoping we transition to written reports like my last hospital because the phone tag game gets ridiculous for everybody.
  8. by   hherrn
    Report attempted. Floor to call back.
    Report attempted. Awaiting room availability.
    Report attempted. Awaiting room clean.
    Report attempted. Receiving RN at lunch.
    Report attempted. No answer.
  9. by   bebbercorn
    Quote from hherrn
    Report attempted. Floor to call back.
    Report attempted. Awaiting room availability.
    Report attempted. Awaiting room clean.
    Report attempted. Receiving RN at lunch.
    Report attempted. No answer.
    Perfect example... do you escalate this when it starts to get ridiculous on the part of the RN upstairs?
  10. by   LadyFree28
    Quote from bebbercorn
    Perfect example... do you escalate this when it starts to get ridiculous on the part of the RN upstairs?
    I let my charge nurse know, and she lets the nursing supervisor know.

    I went through this a few nights ago-pt was getting admitted, got a room before change of shift-tried to give report and couldn't because the floor takes report from 1900-1930; some will take report and then give report to the oncoming nurse-didn't happen this time.

    When I called back, the nurse refuse report because the room wasn't clean; usually people will still take report from me and this was a first. I let my nursing supervisor know-the pt ended up waiting THREE hours to go upstairs! The only blessing was the pt needed an MRI, so they were being scanned for half the wait, by that was so unacceptable-and I let them know it; along with juggling other pts and other pts who are sick waiting to be seen, it was unacceptable. Most situations like this we call an event for delay in care, since there wasn't any, I didn't call one in.
  11. by   Roy Fokker
    Very similar to what turnforthenurse, BSN posted.

    I usually make a nurses note in the actual chart (not the comment section on the board. While it is useful to convey certain information, it is not a permanent part of the chart). Why? To avoid a butt-chewing from MY manager.

    Once a bed is assigned, I have less than 15 minutes to call report - or my manager is on my case about why I haven't called report. So whenever I call report, I write down the exact words in quotes as to why I was unable to give report: "Attempted to call report x 1. Was told by secretary the RN is in an isolation room. Was told RN will call back." etc.

    We too recently went on this new system of "Room assignment to pt. in room in 60 minutes or less". Now, if the RN can't take report, someone else is supposed to - either a "buddy" or the asst. manager or manager.

    If I keep getting persistent push-back from giving report, my asst. manager or manager gets involved. And believe me, if/when that happens, it is mostly out of my control - my charge nurse asks me what's taking so long and if the problem is not my end, they get involved.

    cheers,
  12. by   Kooky Korky
    Quote from bebbercorn
    Perfect example... do you escalate this when it starts to get ridiculous on the part of the RN upstairs?
    What part is ridiculous?
  13. by   bebbercorn
    Quote from Kooky Korky
    What part is ridiculous?
    Certain things are understandable: room not ready, nurse is up to her ears in c. diff, another pt is crashing, etc. Nurse is at lunch, or no one is answering the phone is not a legitimate reason for a patient to wait in the ED.
  14. by   bebbercorn
    Quote from Roy Fokker
    Very similar to what turnforthenurse, BSN posted.

    I usually make a nurses note in the actual chart (not the comment section on the board. While it is useful to convey certain information, it is not a permanent part of the chart). Why? To avoid a butt-chewing from MY manager.

    Once a bed is assigned, I have less than 15 minutes to call report - or my manager is on my case about why I haven't called report. So whenever I call report, I write down the exact words in quotes as to why I was unable to give report: "Attempted to call report x 1. Was told by secretary the RN is in an isolation room. Was told RN will call back." etc.

    We too recently went on this new system of "Room assignment to pt. in room in 60 minutes or less". Now, if the RN can't take report, someone else is supposed to - either a "buddy" or the asst. manager or manager.

    If I keep getting persistent push-back from giving report, my asst. manager or manager gets involved. And believe me, if/when that happens, it is mostly out of my control - my charge nurse asks me what's taking so long and if the problem is not my end, they get involved.

    cheers,
    We have been (like everyone else) trying to maximize throughput through the ED. My manager has encouraged us to write her with situations where we can't get the patients up. The debate is whether to write internal incident reports, email the manager directly (which usually goes nowhere), or in the patients chart (which makes me a bit nervous because of legality issues later...)

    In my hospital, thank god, the floor nurses are super receptive to getting patients and rarely give me a hard time about sending patients up.

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