Blocking beds when understaffed

[Nurse Ratched]

Don't laugh - does anyone's facility do that? I left work today having already put in 24 hours this weekend and determined that it wouldn't be 32 (this is just supposed to be a PRN job now...) The oncoming shift was short a nurse. When informed of this by the house supervisor, I inquired whether we would then consider the remaining empty beds on our unit blocked since we had insufficient staff for the patients we already had. Nope.

(And, no - there's no union.) Just curious if anyone's facility allows for that type of contingency planning for short staffing.

[baseline]

We block beds on some occasions, but right now we have patients in "contingency" beds.....meaning waiting rooms, cast rooms etc. Winter in Fla. Snowbirds flocking......

[KaroSnowQueen, RN]

Nope. If admissions tries to book too many beds too close together the individual charge nurse may refuse to take the admission, and then notifies the house supervisor, but close beds because of short staffing? No way!!! But in the end, once we get caught up, we do take the admissions and staffing is not an issue with them. The house does rethink staffing every four hours and see if staff needs to be beefed up or cut back.

[VivaLasViejas, ASN, RN]

Once when I was working at the hospital, I started my 11p-7a shift with one other nurse and six patients. Then bam, bam, bam came the admits---we ended up with NINE new pts. between 2 AM and the end of the shift. And no, they didn't close the unit, and no, they didn't call anyone in to help out. ER even tried to bring up another three pts. at the end of the shift, but our house super said NO WAY, they'd have to wait until days came on duty. That was all the assistance we got. @#**%!!

[NurseAjah]

Our med-surg floors can't block beds, but our ICU's can. In the past, however, our hospital has closed an entire unit due to short staffing and relocated the remaining staff to other floors. It it hard to lose 30 surgical beds in one morning when no one thought to tell the surgeons who did 70 cases that day!

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[karoline]

Over the holidays one wing of a med-surg tele floor was closed due to not enough nursing staff - 18-20 beds. The nurses who worked there were relocated to other areas in the hospital. The ER does go on diversion - closed to ambulances - when beds are extremely tight. Usually the pediatric unit has open beds and they are required to take adult patients if beds are otherwise not available.

[CCL"Babe", BSN, RN]

Yes they block, then if staffing issues continue they close units and send the remaining nurses to other floors.

[mother/babyRN, RN]

Nope, they block beds when the pt has MRSA but otherwise they float us maternity people everywhere and leave OB short, cause after all, there isn't EVER anything going on in maternity....

[ERNurse752, RN]

My hospital will block beds if there aren't enough nurses.

It mostly happens in ICU and PCU...so then the ED gets backed up and we have to go on diversion. It's a vicious cycle.

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

This is from a post that I had done earlier on the same topic.

Post #4

This isn't new. My little hospital does this. Every four hours each unit is required to update the "board" that shows four colors. Green means that the unit can take patients without difficulty related to staffing and acuity. Yellow means that patients can be admitted but staffing and acuity are a factor. Orange means that staffing and acuity are a problem and that few admits can be taken safely. Red means stop and the unit is "Crazy". On the board is other information such as capping. What a unit is capped to and when the capping will be over. The house supervisor is in charge of placing patients appropriately to need and staffing. The charge nurses of each unit play a vital role in capping. Our charge nurses really have no other function than to be the go to person. They still have their own patients as well. The charge nurse figures out staffing and the color board and communicates this to the supervisor. Sometimes shifting of patients has to be done to accomadate needs of incoming patients. But the program works really well.

My unit, a telemetry unit is one of the highest turnover units and also most demanded since only two floor units have the capablity of monitoring heart patients. This weekend we had five nurses which meant that we could essentially go up to 30 patients in the unit. However, we kept our numbers down because the nurse went down to four on Memorial day. The shift coordinator works to keep our admits down with that in mind though we were not officially capped on Sat or Sunday.

Capping prevents you from having to take more patients than safely could be handled. When the whole hosptial is full we are placed on Cardiac and Trauma bypass.

It is easier to cap on the weekends than it is on the weekdays though due to administration being around.

[Tweety, BSN, RN]

We call them "unstaffed" beds. Supervisors and ER manager still tries to get us to open them. But we have to dig our heels in when we are short staffed.

Most of the time they work with us when the beds are unstaffed. But we best be busy when they make rounds. Heaven forbid we are on break when they come by.

[kaycee]

Most of the code red status all over the city in my neck of the woods is due to not enough staff. There are plenty of beds but no one to care for pt's put in them. My hospital will block beds or refuse admissions to the floors because there isn't enough staff but will pile them high in the ER. Doesn't seem to matter that the ER only has so many nurses and pt's keep coming. That is one of my biggest beefs!

[Nurse Ratched, RN]

I appreciate all the responses. Nice to know that it is done in places - you'd have thought I was speaking a foreign language the way the question to the house supervisor was greeted.