ccu

[hagrid]

I work on a 16 bed CCU. Our census has become quite low over the last few months and we are getting patients that don't really belong in on an intensive care unit because we will be the only floor that has monitoring. With the common use of lytics and caths,our patients are not as sick as they were years ago. Are we the only CCU experiencing this and if not what steps are being taken by your hospital to preserve the intensive care beds? Are you combining your medical ICU with the CCU? And another question regarding nurse to patient ratio. Do you have any policies as to how many and what types of patients a nurse can are for on an intensive care unit?

[nimbex, RN]

you are lucky to have lasted theis long...

About 3-4 years ago, my CCU started taking ICU overflow. At that time the literature and discussions I came across indicated MANY hospitals acrosss the country were merging thier CCU's and MICU's.

Chest pain clinics are part of the reason.. We have one in our ER. From the door, MI's go straight to the cath lab, then plasty and if needed right to the OR.

Unless it's a cardiac arrest, We get ALL our MI's post proceedure,,, and they have to be fairly ill to get into CCU. OUr step down takes plasty patients and uncomplicated MI's.

So due to the chest pain clinic and step down with changing DRG's of those dreaded insurance companies, we get anything that comes through the door.

We're the only unit that takes thrombolytics and IABP (except cardiac surg. takes IABP too). Get very few of them latelyl

[nimbex, RN]

Oh, forgot to say, we have admit discharge criteria... the poor tree that died for that useless piece of paper. The doc's don't have to follow it, and don't wate your time calling administration to say that they don't meet admit criteria.

I've had everything from a fresh post op C-scetion to a GI bleed to a fresh post op AAA.

Our sister unit, the Cardiac Surgery unit, once the cream of the crop, now takes anything that comes in the door to keep the beds full.

Haven't you heard..... A nurse is a nurse is a nurse

Sorry for the tone..... this is the one thing that boils my blood pressure in record time. Hey, if I was having "the BIG ONE", I would not want to be in MICU with my nurse saying "why are those ST alarms going off?" "Your chest is supposed to hurt honey, you've had a heart attack"..

:( Attitude readjustment:stone :stone :stone :