We've just been informed by our new er manager (an rn), that our LWBS numbers are too high. (Left Without Being Seen). Meaning the patients are not wanting to wait (sometimes 2-3 hours, not bad considering county hospital sometimes has 18 hr waits!), or they decided they aren't really that sick, or have gotten an appt with their dr...........whatever the reason. So she has put out a memo stating that "this WILL change!" We (the triage nurse), are to "go out in the lobby and check on patients" ............and do what, we wonder? Chain them to the chairs so they won't leave???? She then proceeds to write that "if I notice trends among certain nurses, these will be documented, and there will be Verbal Warnings!" (Like what comes after verbal warnings?) Some of our nurses seem to be stuck at triage every shift. Some, like myself, hardly ever do triage. I don't know why. How the hell are we supposed to keep people from leaving the waiting room? :angryfire We are all somewhat pi##ed off about this. I mean, if people are waiting........that means that we are FULL! and FULL means that sometimes we have people sitting in the hall in chairs, not even in a bed (because they are all FULL!) Good grief
We already have a policy implemented that we are to do vitals every 2 hours, on every patient (minimum) whether they are in the lobby or in the er. When someone leaves with out being seen, we are now to write up an incident report.......believe it or not....... with the reason they left. Hello, they don't always tell us they are leaving. Besides, if it is so busy, that I cannot get people into the back........how much time do you think I have to write up incident reports???? Aargh :angryfire
Just a long vent...........anybody else EVER had this happen? I mean, jeez, if they are well enough to leave, they probably didn't need to be in the er in the first place. and if they were really, really ill, the triage nurse would've found SOMEPLACE to put them in the er. Not back in the waiting room.
the way i see it, emergent they get back. if they come in smiling, eatin' tater chips and sippin' mountain dew, they can wait. if they leave, they didn't need to be there in the 1st place. our hospital has established county urgent cares (4), that treat less acuity walkins. when we have a high census in the hospital, holding 15-30 patients in the ed waiting for a hospital bed, i send them to the uc's (after initial assessment, and rate low on acuity) if they're willing, or they can wait 3-6 hours, i give them the option. i have full approval of charge nurse and nurse manager when doing that. hate it for those who get plastered b/c they couldn't get the uri back within 30 minutes.
Last edit by Carotid on Feb 29, '04