Abandoned Patients?

Specialties MICU

Published

Specializes in Interventional Cardiology, MICU.

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 Pediatric/Adolescent, Med-Surg.

What if you started documenting who you hand off care to when you go on transport trips. Then you will have a paper trail that you were gone for 2hrs and so and so didn't take care of the pt that was handed off to their care.

The charge nurse but where I work we have 20 beds in the critical care unit. Icu ccu but two charges

Specializes in Critical Care.

We have another RN watch them. This does leave that RN with now an extra patient, and we do the same thing when we go on break. It's certainly not optimal, but given the trend in hospitals these days I don't see that changing, and it's probably good practice for when we'll start taking 3 patients to begin with.

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.

Radiology has an ICU run nurse that takes the patient down to radiology. If the patient really unstable they are 1:1 and usually the nurse will go with. Occasionally one of the PAs or residents goes also.

Specializes in Trauma/Tele/Surgery/SICU.

We have to take our own patients and leave the other one or two with another RN as well. It is hit or miss on my unit as it all depends on who you are near. Some nurses are very conscientious and others not so much. Luckily we have central monitors so everyone on my side of the unit can see everyone elses alarms, but again this is only good if the others respond. We have had a few incidents which have made my blood boil. Example: People just silencing others alarms and not just the nuisance ones, I am talking V-tach, low SPO2 etc. I would rate my coworkers as 50/50. 50% good and 50% "it is not my patient." Can make a run to CT or IR very nerve wracking.

We also have just recently hired in a new crop of 6 new ICU RNS and in my opinion only two of them are worth much. I have tried to counsel them. Our unit is separated into two hallways with 12 beds each. You cannot tell and have no access to the alarms on the other side. Some of the things our new nurses have done: New admit to the unit EVERY SINGLE NURSE on that whole side goes into the room, some to help and some to just gawk, leaving NO ONE on that whole hallway to watch any monitor. Continue to sit and chart while someone is coding. Sit and chart while someones vent is alarming repeatedly. Twice I have found that these were patients who self extubated. One of them was sitting at her computer charting while the patient in the room RIGHT NEXT TO HER was screaming for help. The rest of the nurses on that side were busy with a new unstable admit and she did not even look up to see what was going on. I ended up walking over from my side and found this patient ON THE FLOOR. The scariest thing is that these four act like they have no idea why I am angry. They always say "it wasn't my patient." I have talked to management but as yet no action has been taken.

When I have to travel with a patient I always go and inform my charge and find someone even if they are on the other side of the unit, to ask to watch out for my patient. It has gotten to the point where a group of us have started following each others schedules just so we know that we are working with someone we can trust.

Specializes in Surgery, Trauma, Medicine, Neuro ICU.

It is what it is...sometimes you have to leave your patient. I always try to make sure that I leave my patient as low maintenance as possible. Bags full, calm, comfortable, clean. If the nurse nearest to me isn't my most trusted neighbor I'll ask another nurse or two to keep a "fuzzy ear" out for alarms and make sure they know DNR status. I always make sure my hall leads (36 beds, 2 18 bed halls means we get a team leader and two resource nurses- one for each hall) and team leads know I'm going as well (unless they're going with me). Usually it's okay. I'm super lucky that my unit has AMAZING team work. I've left the unit for 5 hours before (worst. TIPS. ever.) and my patient was charted on, my I&Os were done, my meds were up to date.

It also helps if you're helpful. Lesson I've learned the hard way.

Specializes in Emergency, ICU.

I guess I'm luckier than I thought. My ICU: RN does not leave the unit. If a patient needs to go out, resident or PA must go and stay with the pt.

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What is a PN?

In my surgical ICU of 16 beds, the RN goes with their patient and your "neighbor" watches your patient plus their 2 patients while you are gone. The lead/charge RN might go with you but only if your patient is critical. Usually, this is not a problem as I work with a quality group of nurses. Having a RN from radiology come take your patient or a resource nurse for each hall (as mentioned above by ICUPrincessNurse) sounds like a dream!!!

Specializes in critical care.

We travel with the patient and ask a neighbor to listen out while we are gone. I trust every one of my colleagues on night shift. We are mostly newer nurses with a few "go to" experienced nurses, and the teamwork is incredible. Also, we have a resource nurse (an experienced critical care nurse) who floats through the whole hospital on nights. Theoretically, she could travel with a really unstable patient if needed, but I haven't seen this happen. There has been no need.

Day shift is all experienced nurses, however, and from what I've seen/heard, there is less teamwork.

That's what Fentanyl and Versed are for. Put the patient on auto-pilot, go on your travel and all will be fine.

I'm kidding. Sorta.

We used to have another nurse watch them. I didn't ask certain people because I knew they'd let my patient yank the Foley, go get a pizza downstairs and come back, eat half of it, and then the nurse would maybe notice their leads are off. Maybe. You just need to learn who to ask that is trustworthy.

It's a problem that will never go away. Trying to fight to create a system for having someone watch an "abandoned patient" while you're traveling is just asking for trouble. It won't work. People will not stop being busy with their patients just because there's a policy saying they have to cover your patient and their needs.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I guess I'm luckier than I thought. My ICU: RN does not leave the unit. If a patient needs to go out, resident or PA must go and stay with the pt.

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*** 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.

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