Quote from RNPATL
Randy - this is an issue that drives me nuts! Where I work, it never fails that we get 2 or 3 admissions just before end of shift. There is no criteria! It does not matter that we are changing shifts and the oncoming shift will not be in to see the patient for a while. They still bring the admission.
This whole issue is really sad for the patient. The other day, I had run for the entire day. Had about a 7 minute lunch. I was charting and finishing things for my shift when the charge nurse told me and another nurse that we were getting direct admits that were coming through the ED. My shift was over in 15 minutes. I asked the charge nurse if they could hold the patients in ED until the next shift was on the floor and she said no, they were on the way. So, I accepted the patient, made him comfortable, got a set of vital signs and told him the next nurse would be in to see him as soon as she was on the floor. Told him how to use the call light and made sure he had what he needed.
I really hate change of shift admissions. You would think that everyone knows when the shifts change, why send patients at that time?
First off, holding a direct admit in ER until YOUR shift shift changed?! You have got to be kidding! We have shift changes in the ER too and our nurses want to get out in a timely manner too. The main reason for a DIRECT ADMIT is so the patient won't have an ER charge. If they come to the ER then we have to evaluate and treat them. We are not a HOLDING AREA for the floors, we are an EMERGENCY ROOM! Direct admits are NOT an emergency! Why on earth would you have even thought about dumping a direct admit on the ER staff who might have been just as busy or busier than you? I think that was pretty rude of you. I'm glad your charge nurse didn't allow it. :angryfire
Second, as I said, ER has shift change too, and sometimes the patient has been in the ER for hours waiting for tests, waiting for the admit doc to see them while they're still in the ER, waiting to be seen by the ER doc because we're swamped and that patient wasn't necessarily a priority see for the ER doc, so they waited to be seen, waiting for someone to make the decision to admit them, waiting for the supervisor to call with a bed, etc. etc. So, rather than dump that patient on the oncoming shift who hasn't spent the last few hours with this patient, report gets called before the offgoing shift leaves; that way a report gets called by someone who knows the patient and can give a more personal report instead of someone simply reading what is written. :angryfire
In the case of waiting to give report because the floor nurse is in report, do you not have someone covering your patients while you are off the floor taping your report? Or not having any admits during a certain time period?! get real! Do you think we are allowed to tell patients "oh I'm sorry, you can't check in during certain time periods?" :angryfire
I understand your frustration, but don't expect ER, OR, or any other floor to hold a patient until it's "more convenient" for you; that's inappropriate to say the least. The solution I have heard here is to have a dedicated admit nurse whose job it is to go to the floors and do the admit while the nurse who is taking the patient does whatever they need to do.
As for everyone knowing when shift change is? Not necessarily. We have shift change at 7a, 3p, 7p, 11p or various other times when we have staff coming and going so how are we supposed to know when floor change shifts? And as I said, patients don't always come at times when it is "convenient"; remember, they aren't an interruption of our work, they are the reason for it!
Sorry this is so long, but as you might have guessed, you hit a nerve with this. I don't know about other floors transferring patients to M/S but I know the frustration of ER getting patients to the floor and we have our issues from that side of it.
P.S. this isn't intended as a flame, just a response.