Ever feel like the med/surg unit is the hospital dumping ground?

[deespoohbear]

I was wondering if any other med/surg nurses feel like their departments are the hospital "dumping grounds?" In our small hospital, our M/S floor basically gets what the other departments refuse to take. Besides are regular inpatient med/surg patients, are department also does the outpatient blood transfusions and outpatient surgeries. We also get patients from the doctors' offices who come for IV replacement therapy if the ER decides they are too busy to deal with them. We get Hospice Respite Care patients. We get hyperemeisis graviderium patients because OB doesn't want them. They say they are "infectious." So, now the latest thing is ICU has decided they are tired of doing their 3 patients who come in weekly for Primacor infusions and are trying to give them to Med/Surg. The really aggravating part to this is that sometimes are 4 bed ICU has 2 nurses for 7a-7p, plus their nurse manager. Med/Surg usually only has 3 nurses for 21-24 patients. The ICU manager contacted the hospital DON. Now there is an inservice scheduled for Med/Surg are taking care of these Primacor patients. I know taking care of them is that difficult (they all 3 have infusaports), it is just the idea. The nurses on M/S have absolutely no say in what kind of patients we get. Heck, we even get suicide watch patients who are on every 15 minute checks. Yeah, right. I would hope our DON would look out for us for once, but I have this sinking feeling that our department is going to be stuck with these patients also. Thanks for letting me vent.

[Sunstblush3]

wow... ok.. Im on a medicine unit.. we have 10 cardiac beds.. and believe me We were supposed to be considered a dialysis unit but we have suicide pts, cardiac patients, heck i had a patient that was brought to be admitted to my floor.. took one look at him and called a code.. thinking maybe he should have been sent to ICU?? :smiling: Im glad to see Im not the only one frustrated with the inadequacy of perhaps our admittin folks.. maybe they dont really know where these patients belong.. and where I work some of our patients are in a hallway for more than 24 hrs before gettin lucky enough to find a bed anywhere in the hospital.. well my hats off to all my fellow nurses that are pullin their hair out over things like this.. just think.. that is what makes us that much more special.. :) great to be a nurse.. better to have someone to vent of the pitfalls.. !!!!

[BBFRN, BSN, PhD]

ummm, I work on a Trauma Med/Surg floor, so the people that get dumped on us (with the exception of Burn Unit overflow) are usually way easier to manage than our usual patients, so I have no problem taking them- usually. I'm going to have a full load anyway, might as well throw in a couple of DNR's. lol

[deespoohbear]

Sometimes the DNR's are the patients who require more support emotionally. And their families can be a real trip too. I believe there is a fine line between comfort measures and heroic measures sometimes. At least if my patient is a full code, I know what to do for them if they start going south. The DNR's can be a little more tricky as for what they need. Just my .02.

[preciousnurse]

I work on a 32 bed step down unit and know that it is sometimes a dumping ground. Women's Care cannot take a patient because they are infectious ,however they may only have one patient. I have had ICU nurses however keep patients when they know that are med-surg floor is busy. It depends a lot on the type of hospital you work in. I work in a small community hospital where everybody knows everybody. The key is to working together and not so much a separate units! i know it is frustrating, but it is sometimes the reality>

[renerian, BSN, RN]

LOL the oncology unit which did BMTs I used to work on would always get called to put a pneumonia patient in with an immunocomprised host...........always had to fight with admitting............we got alot of stuff that was not oncology but when an onc patient was in the hospital the docs would demand the patient come to the unit and others would then be sent elsewhere.........then that receiving unit felt like they were getting dumped on.......

renerian

[EmieRn]

I feel like that all the time. Just yesterday, we got three admissions from the hours of 1A.m. and 3 A.M. At the small hospital where I work we have one RN, one LPN and one aide for up to 15 pts/ We don't split the pts. up so the RN gets all the admissions, no secretary so we have to put the chart together, do the admission and take off the orders.VERY time consuming, especially with about 40 papers to an admission. All the pts. come from the ER, they do not help at all with anything! If something happens though in the ER we are also expected to go back and help. (2 RNs back there for 5 beds, but alot of nights they have no pts. back there). Its too much work fo one RN on the floor to handle, anywhere from 1-15 pts to take care, admissions to do and help in ER if they are busy. Can we say early burnout and bad management

[NiteNurseRN]

Deespoobear,

YES, YES, Yeeesssss, I feel that Med/Surg is the dumping ground. I got an admit from a NSG home that was passed on to me (hello, is it gonna be a bad night or what???) with decubs, bleeding out in his urine (f/c bag is full of kidney bean red/brown urine), H&H in the toilet, plus stroked out.

Meanwhile, the unit clerk/tele moniter is playing on the internet all nite, so the Dr's orders are full of mistakes which we nurses have to fix in our 24 hr chart checks.

I had a pt. fall because most every one on the unit was busy with a near code that was rushed to the ICU. My boss ended up mad at me because I was still there with 6 untouched-white-as-the-virgin-snow charts.

P.S. Deespoobear, Your cute, red barn looks like it has 2 bombs on top of the roof (don't get maD)

[BadBird, BSN, RN]

As a ICU nurse I do feel that the MS nurses are dumped on, which is why I am not a MS nurse. God bless all of you, I don't know how you manage. I have found that the types of MS patients are the hardest to care for, call bells on constantly, confused, combative, constantly incontinent. Visiting hours are also longer so you have to deal with many families. Because I realize this I always make sure when I transfer a patient that the bath is done, all orders taken off, meds reordered if not in their bin so the nurse will have them. I know those are small things but I do try to help both for the patient and the nurse. I just can't believe the ratio of patients to nurses in MS, it it truly awful. Many thanks to all you MS nurses out there.

[deespoohbear]

NiteNurseRN-I won't get mad about the comment about the things looking like bombs on my barn. Not sure what those are suppose to be. Sure don't have anything like that on our barns here at our place. I don't think my boss would have the guts to say something to me about my untouched charts if I would have had the kind of night you had. If my pt is circling the drain, their physical well being comes first, the paperwork can wait. That chart will still be there...

BadBird-Thank you for your kind comments. I don't regret the time I have spent in Med/Surg for I feel it has given me a solid foundation and a wide knowledge base. I am currently in the process of cross training in our ICU. We are building a new facility soon, and the ICU will be enlarged and require more nurses. I have already expressed my interest and desire to transfer to ICU whenever possible.

I can't believe this thread is still getting comments after a year!! Wow!!!

[miphillli]

I can't believe we still face the same problems in '04 that you wrote about in '02...good old med-surg....we still get adm. dx. of constipation....some things never change.

[VivaLasViejas, ASN, RN]

I can't believe we still face the same problems in '04 that you wrote about in '02...good old med-surg....we still get adm. dx. of constipation....some things never change.

At least your doctors call it plain ol' 'constipation' instead of dressing it up in the term OBSTIPATION so it sounds better to the insurance company!! :rotfl:

[Thunderwolf, MSN, RN]

In med-surg, you see it all. This is so true. And if you're a new grad, it is baptism by fire. Even a seasoned nurse has his/her days. Team work is so important. If you work as an individual, you run the risk of burning out or burning out others.