I'm just curious what other's do. Do you do weekend and evening admissions on a regular basis? If you do, does your oncall nurse do it? And what kind of a census population is the oncall nurse serving? Do you have an oncall admission staff?
I'm just asking because this is continually an issue for us. We do it now and then, but generally only when it is well planned in advance and unavoidable. Its just too great a burden for the limited oncall staff. If they are tied up for hours dealing with an admission then other patient's who are needing support can't get the timely service THEY need. I had to refuse 2 cases yesterday because they wanted to send people home from the hospital on the weekend that we had no previous contact about who were already at death's door. Everytime we DO accept one it ends up being a frustrating mess for everybody because invariably the hospital staff in ill-informed and they are sent home without appropriate orders or communication and our staff spends hours spinning their wheels trying to get things in place. :angryfire And then when looking back in the physician's notes, I can't tell you how many times I will see that there was mention of hospice consideration as much as 3 days prior!
Sorry for the rant, but it just really makes me burn, because in the end it is the patient and family who suffer, and aren't they already suffering enough already? I think they deserve a well planned, calm, and orderly discharge.