Abandoned Patients?

Specialties MICU

Published

How does your units deal with having no PN and you have to take your pt to IR, CT, MRI,et?

Your other pt is left in the unit to be watched over by another RN who already has 2 critical pts, or 1 with a new unstable admit?

Who cares for your pt?

I recently returned to my unit after 2 hrs in IR, to find NO RN's near (W/I sight of pt or pt's monitor). IV alarming amiodarone gtt occluded, HR 110's. When I left HR in 80's.

This is a trend in my unit.

RN's walking around as if they are charge, not watching their pts. Large 23 bed unit. Going to staff meetings at 0715 or 1515 and leaving their pt's. Or, my favorite, going to breakfast and lunch and leaving their pt's.

Over half of staff new grads with less than 2 yrs experence hired right out of school.

It's not safe. When I try to explain this to management I get, I know, I know.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

From reading these stories it seems to me that we need a lot more malpractice lawsuits! I have often been tempted to keep a little black book of events. Including who was there, what happened with times and dates. Then use the book to give a "word to the wise" to family member that maybe they should talk to a lawyer.

You want to know why your family member had a bad outcome? Well it so happens that last night they were left uncared for, for 2 hours while their nurse left to unit to take her other patient to IR.

My hospital has a resource nurse who is an ICU RN. She will either take your patient, or stay and care for your other patient while you make the road trip.

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From reading these stories it seems to me that we need a lot more malpractice lawsuits! I have often been tempted to keep a little black book of events. Including who was there, what happened with times and dates. Then use the book to give a "word to the wise" to family member that maybe they should talk to a lawyer.

You want to know why your family member had a bad outcome? Well it so happens that last night they were left uncared for, for 2 hours while their nurse left to unit to take her other patient to IR.

My hospital has a resource nurse who is an ICU RN. She will either take your patient, or stay and care for your other patient while you make the road trip.

I'm sure she can be in two places at once. There's never ever two sick patients that have to travel at the same time, right?

Close the thread folks, problem has been solved!

;)

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Specializes in Emergency, ICU.
*** In that case who is taking care of the patient? Do your residents and PAs actually know how to run vents IV pumps and all the other equipment an ICU patient may be on? I would be VERY uncomfortable leaving a critical patient with a PA or resident, in fact I have always refused to do it.[/quote']

What?!? Of course they do! They're ICU PAs and residents. And RT goes too if needed. I guess we have a bigger team -- teaching hospital.

I would feel very insecure leaving my second patient on the floor knowing my colleagues have their 2 to handle.

If a patient leaves the floor in competent hands, that's fine with me. I am not the only person capable of taking care of them - in fact, I would never want to be. It is also a doctor's job to handle an unstable patient. At least in my ICU.

Sent from my iPhone using allnurses.com

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I'm sure she can be in two places at once. There's never ever two sick patients that have to travel at the same time, right?

Close the thread folks, problem has been solved!

;)

*** Two would be pretty unusual. In that case the charge, who does not have patients, could also make the trip or care for your other patient left behind.

Besides even if that were not the case wouldn't it be better that no patient was left unattended to the vast majority of the time, rather than unattended patient being a common problem as other posts had described?

A resource nurse IS a good solution to the problem, a common solution used by the more advanced hospitals all over the country. Just because there may be unusual times when the resource nurse is not a 100% solution is no reason to ignore a good idea.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
What?!? Of course they do! They're ICU PAs and residents. And RT goes too if needed. I guess we have a bigger team -- teaching hospital.

*** Amazing! I would not trust any of my critical patients to a resident, or to an attending for that matter. Maybe a few of the PAs, but not many of them.

We are a large teaching hospital too. Other than an MDA I have never seen a physician touch an IV pump, and very rarely a vent. Of course I don't allow anyone else to touch my equipment but no way are our docs trained on it.

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Specializes in Emergency, ICU.
*** Amazing! I would not trust any of my critical patients to a resident or to an attending for that matter. Maybe a few of the PAs, but not many of them. We are a large teaching hospital too. Other than an MDA I have never seen a physician touch an IV pump, and very rarely a vent. Of course I don't allow anyone else to touch my equipment but no way are our docs trained on it.[/quote']

Ok. You go girl!

Sent from my iPhone using allnurses.com

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Specializes in Trauma/Tele/Surgery/SICU.

Not all of us are lucky enough to work on units with resource nurses and I have NEVER worked anywhere where charge does not get a full patient load. Most of our charges are stuck in their own rooms with their fresh CABG patients. It can get mighty thin when you throw in a couple stat CT runs and code/rapid calls.

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Specializes in Pediatric/Adolescent, Med-Surg.
Not all of us are lucky enough to work on units with resource nurses and I have NEVER worked anywhere where charge does not get a full patient load. Most of our charges are stuck in their own rooms with their fresh CABG patients. It can get mighty thin when you throw in a couple stat CT runs and code/rapid calls.

Not having a free charge in ICU just sounds unsafe. What if you need an extra hand for a decompensating pt or a code on the floors? I have floated to ICU's that would give charge a full assignment and not have a resource nurse and I found those to be unsafe places to work. When you expect nursing to stretch themselves thinner it is just a recipe for disaster, especially when you throw critically ill pts into the mix.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Not all of us are lucky enough to work on units with resource nurses and I have NEVER worked anywhere where charge does not get a full patient load. Most of our charges are stuck in their own rooms with their fresh CABG patients. It can get mighty thin when you throw in a couple stat CT runs and code/rapid calls.

*** Luck doesn't have a darn thing to do with it. I don't work in a great hospital where I have good benefits and pay, am treated fairly, and most importantly embraces EBP on accident.

I spend months searching, calling, emailing and researching. Found what I wanted and got a job there.

In your shoes I would try to introduce your unit and hospital to evidenced based practice ASAP before (more?) patients are harmed.

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Specializes in Trauma/Tele/Surgery/SICU.
Not having a free charge in ICU just sounds unsafe. What if you need an extra hand for a decompensating pt or a code on the floors? I have floated to ICU's that would give charge a full assignment and not have a resource nurse and I found those to be unsafe places to work. When you expect nursing to stretch themselves thinner it is just a recipe for disaster, especially when you throw critically ill pts into the mix.

A decompensating patient or code on the floor is handled by whoever has the time to help/respond. If no one volunteers it is on the charge. I do feel it is unsafe at times. Luckily I have some awesome coworkers who help out as much as possible, but yes, overall I feel my unit is not safe. I have picked up a contingent position in another hospital system and I cannot believe the difference. Doctors on the unit AT ALL TIMES and not first years either. Charge nurses with no patients, resource nurses, and patient transport. I feel much better in these ICU's.

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Specializes in Trauma/Tele/Surgery/SICU.
*** Luck doesn't have a darn thing to do with it. I don't work in a great hospital where I have good benefits and pay, am treated fairly, and most importantly embraces EBP on accident.

I spend months searching, calling, emailing and researching. Found what I wanted and got a job there.

In your shoes I would try to introduce your unit and hospital to evidenced based practice ASAP before (more?) patients are harmed.

A group of us have tried to implement change and we have been successful in some respects, but staffing remains an issue. It is quite disheartening. I have been looking for some time now but in my area many hospitals are the same. Got an offer from a level 1 with an excellent reputation among nurses but then they rescinded due to budget and cancelled the opening. Broke my heart. I am still searching for my home. I am really hoping to get an offer of a full time job from the system I am working contingent at right now.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
A group of us have tried to implement change and we have been successful in some respects, but staffing remains an issue. It is quite disheartening. I have been looking for some time now but in my area many hospitals are the same. Got an offer from a level 1 with an excellent reputation among nurses but then they rescinded due to budget and cancelled the opening. Broke my heart. I am still searching for my home. I am really hoping to get an offer of a full time job from the system I am working contingent at right now.

*** Well I applaud your efforts to improve a dangerous situation. It was quite a shock to me to realize the differenced between states, and hospitals in states. Certain things became obvious to me when I was researching. Some states just suck to be a nurse in. Florida leads that pack. Some states are quite behind the times. I know that when I did travel assignments in Arizona and Minnesota I felt like I was taking a step back in time.

Obviously there are going to be exceptions, good hospitals in old fashioned states, and poor hospitals in more advanced states.

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