I work in a 12 bed Neuro ICU (we also take MICU overflow) and there is a debate on having to have the patient on or off of the monitor in 2 situations.
Situation 1. Pt has transfer order to move to regular nonmonitored floor, AAT, VS Q shift, medlock, etc... The hospital doesn't have any available beds to move the pt to and the pt stays in our unit for a couple of days. My hospital policy states that we may go off of the MDs transfer orders at that point.
Some RNs are keeping the pt on the monitor, stating that they are still in the ICU (although they are not charged for an ICU bed at this point). What does your hospital do? What do you do as the RN?
Situation 2. Pt is DNR/DNI and is now made "comfort care only" or "pallative care". All labs, procedures and meds are cancelled with the exception of morphine, ativan and robinol. Consults have signed off. Pt is going to be extubated and is expected to pass quickly. Do you leave the pt hooked up to the monitor, bp cuff, pulse ox, pressure cables, etc.? Or do you try to eliminate as much as you can, making the pt seem more like themselves (for the family)? What do you do? Does your hospital actually have a policy addressing this?
I would appreciate any insight.