Most admissions you personally had during shift or most your floor had. - page 3
Curious to see how many patient admissions you have had to take and how many admissions in one shift total for everyone. We got slammed the other night with 5 admissions in 4 hours! I got two of... Read More
May 10, '04Alright, I'll acquiesce that my post was a bit flippant. However, I maintain that we should not be expected to exceed safe staffing ratios. Luckily we are fairly well-staffed and have only been in that situation once in the entire time I've worked this unit.
The situation begs the question, though... if beds are not available within the hospital, why not transfer the patient to a lateral level of care for convenience, safety, and maintenance of appropriate ratios in the ER? This rarely happens, in my experience, and not because there are no available beds in local hospitals.
Its all about the bottom line. Sad, but true.
What do you propose is a good solution?
May 10, '04I can't beat some of those record admissions I saw earlier in this thread. I used to work a tele unit that was 53 beds split on two ends of a very long hall. Busy shifts would see up to around 12-16 new patients between ER admits and tranfers out of ICU/CCU. Granted the transfers were generally not that difficult. We were having real space issues right before I left a couple of years due to the closing of another close-by hospital. The ER was suffering very badly, going on divert weekly, holding patients for hours and the waits to be seen were horrible.
I admitted a patient who had been in the ER just at 24 hours, of course he was discharged about 20 hours later, how ironic! Due to this when one would come on, one could sort of predict how many admissions one would have by looking at how many beds were available because rarely did they stop until the beds were filled. Fortunately I worked nights and discharges were rare after 9pm so once we filled a bed, it stayed filled.
May 10, '04I actually had one night where I got 6 admissions all by myself. Surprise, surprise, I couldn't not get them all completely admitted by the end of my shift. Stayed about 45 minutes over to finish the forth one. Night nurse said, " you are going to stay to do the last two arn't you?" I refused, I was getting mentally fried, had to pass the work on to next shift. Sorry but people do it to me all the time.
May 11, '04Quote from tiredfeetEDHMM....Believe it or not ...ER has Staffing ratios too! Not my problem is a frequent attitude throughout the hospital...it is all our problem. We hold everyday in the ED. The other day our little 18 bed ED had 18 holds, 1 ICU 3 Teles and 14 Medsurg pts... I got 15 pts up that day! Bottom line it is not fair to our pts..Our ED docs/PAs do not care for these pts once there admitted unless they crash! Never once seen a Doc put a pt on a bedpan. We have one tech! no Cnas...The problem is when we are too burnt to work OT and the floor floats down!
I recently found out that the hospital loses money on ED Holds. They cannot bill for ICU or Tele (no monitor tech) or medsurg Since the ED is considered Outpatient and a admit is a inpatient...So now that money is a issue..why go over the ed staff ratios 2:1 trauma room, 4:1 reg rooms with holds and lose money....This is all our problem!!!
It is all of our problem I agree. And it isn't quite fair that the floors can say "I'm at my safe ratio, no more admissions" and the ER has to keep the door open and exceed in order to keep the dolllars floating in.
But why should any of us exceed safe ratios for the sake of money. A number is just a number, if I can take more admissions, I will regardless if I'm at my max, if my patients are easy and stable and the ER's jammin' I will help. But my concern is the safety of my patients on the unit, I can't own any economic problems or any problems in the ER. Sorry.
Why should the hospital admit more patients than they can safely handle. It's a big big problem where I work. This winter the would hold up to 20 patients in the ER before admitting defeat and go on divert. I do feel bad for the ER who is slammed, they can't tell the person walking in, or the ambulance pulling up, 'sorry I'm maxed out", while we on the floor can. It's one of the big unjustices. It's very hard to get an ER nurse to feel any kind of sympathy for a floor nurse under those circumstances. Brick wall meets brick wall. Apples and oranges.
May 11, '04Quote from webbiedebbieHi,the highest number of admissions in 20 yrs of being an RGN was when I worked nights on a 28 bed dental/ophthalmic ward, back in 1994 ish. We had 10 admissions from A&E, ranging from acute asthma episodes, possible MI's, suspected CVA's - OD's. There were 3 of us on shift, only 2 trained, worse still, the bed manager, made us admit patients in between patient bed/locker spaces . . .!! We filled in an unsafe form/critical incident form in a.s.a.p and told the bm we weren't taking any more less we had more staff, we were already looking after post op max/fax & dental patients & now cardiac monitors were appearing too! We didn't get extra staff . it was grim .Surprise, surprise the ward got closed down soon after this until better staffing levels could be achievedCurious to see how many patient admissions you have had to take and how many admissions in one shift total for everyone. We got slammed the other night with 5 admissions in 4 hours! I got two of them.
take care Kath
May 11, '04Worst day of my life in the hospital med/surg unit I work on...will never forget, new years eve last year...5 discharges and 5 admits (on our team of 9 patients alone with me and an RN!) in 4-6 hours time, and only 6 licensed staff (usually we should have had 12 licensed) on the entire floor for our 37 patients! Nursing supervisor came to our floor after one of the nurses called her, crying, and said "You should feel lucky...CVPV is down 7 staff!" and walked away! HORRIBLE, HORRIBLE, HORRIBLE! I still think back to that day and get chills! :angryfireLast edit by KacyLynnRN on May 11, '04