[nurse97mommy2000]

New here and I know this may have been asked before. Our ER has recently started "committees". I am on the admissions committee and was wondering if anyone could tell me what your admission process is? Our TAT (turnaround time) is not where it needs to be. Of coarse we have the floor issues with nurses not wanting to take report or not ready, etc... And then there is the SLOW hospitalists. If you could give me a list of how your process works from CC (care complete) to admission I would GREATLY appreciate it. We are even thinking about writing a step by step policy for admissions.

!!!!!!!!!
Stephanie

[grandee3]

Floor nurses not wanting to take report, or not ready?
In our defense, just let me say,we sometimes have things going on and that is mostly why we don't take report when you are ready. We can have up to 6 pts. on the floor. I understand that ER has their own agenda, needing to move pts along to free up a room, and keep things moving but this seems to be a problem everywhere. Another thing, calling report or bringing pts at shift change. This is very hard and I understand that you have shift change also.
One of the hospitals where I worked before Hurricane K
had different shift change hours then the rest of the hospital. That helped a lot.
Sorry, I am not attacking you, just get a little upset when I hear ER nurses say that floor nurses don't want to take report.

[nurse97mommy2000]

And I too wasn't trying to offend anyone either. I worked 8 yrs as a floor nurse, so I have been on both sides of the fence. Where I work we hear comments like "you have held this patient in the ER for 8 hours and now 1 hour before shift change you want to bring the patient up." I truely feel that all nurses need to have orientation in all departments to see what truely goes on. I know it is hard having 6-10 patients, but what some (not all) floor nurses don't realize is that an ER nurse might have anywhere from 10-30 patients in a 12 hour shift to assess, medicate, do proceedures on, clean of incontinence, etc...and lets don't forget document and document again and again. Where as a floor nurse has those 6-10 patients and only those with maybe 1-3 admissions for 12 hours to get all her stuff done.

Just for example: Our facility had a total census in the hospital of 70 on day with about 25-30 total staff members (all floors combined). Well the ER on the same day saw 100 patients with 12 staff members. Most people don't look at the ER nurse in that respect. Our turnover rate of patient's is much greater that the floor nurse and we never know what is coming in our doors where as a floor nurse has time, even if it is 15 minutes, to get ready for their patient.

Again I am not trying to throw any stones at anyone, and I am not saying all nurses are this way either. I think it all boils down to the fact that there is a lack of understanding for nurses that have never truely experienced the other side whether it be ER or floor nursing (the road goes both ways).

Originally I was just making a statement. Sorry.

[grandee3]

You did not offend me in any way. You sound like a very caring and experienced nurse and will be an asset to allnurses.com. This is a wonderful place to be, and I hope I did not scare you off.
We need your input, your suggestions, your shoulder.
Welcome to allnurses! C

[nurse97mommy2000]

I really need help on this topic. Can someone please let me know your process. I would greatly appreciate it. I am meeting with our committee on Saturday am and would like to have some ideas to bring to the committee.

Thanks

[Wendy_RN]

I have worked as a floor nurse also, so I understand both sides. I had a patient admitted to the floor on Tuesday. I called the floor numerous times to attempt to give report. This began before lunch. The RN kept refusing to take report when I called. One of the ER physicians finally stepped in at 3pm and the RN accepted the patient. We don't hold patients in the ER. It only ties up our rooms and keeps other patients waiting to be seen. It seems that everything is about numbers these days and it certainly does not look good when a patient spends several additional hours in the ER waiting to be admitted.

[Miss Mab]

Nurse 97--
Not exactly what you wanted but has your committee had a chance to check out this recent ACEP report? If not specific help, certainly some jumping off/talking points to get started perhaps?

http://www.acep.org/WorkArea/downloa....aspx?id=37960

Good luck!
Also eager to hear from those who DO have a workable system. I know they're out there somewhere!!