admission nurse in med surg

[returningnurse2006]

I need some advice. I have been the admission nurse for almost 3 months. It was a newly developed position. Mainly my duties are to do the admission assessment, nursing hx, care plan, flow sheet. On a real good day I can get 5 admissions done... lately I have been able to only get 3-4 admissions completed. I come in at 12pm and leave at 6pm. I am hoping someone reading this forum can give me some suggestions complete admissions in more timely manner. Post op pts seem to be the easiest to admit...unless they are having alot of pain...but most of their hx info is already in the chart when they arrive to the floor. The longest admits are usually pts with multiple wounds that need to be measured and photographed and printed. Pts with multiple issues that have alot of info to talk about. I am the only admission nurse that covers approx 90 beds....The staff is very positive about what I do, but I feel bad because I can't help everyone. When I am not busy I help with discharges...blood draws if needed...so far not too many IV starts...chart audits.. I am looking for suggestions on how I should prioritize admissions.... I tend to stay in the halls that have been bombarded with admits..

Thank you for your assist :)

[gospursgo07]

We also have a admit/discharge nurse on our floor. Difference is, she only takes care of the paperwork aspect. The nurse taking that pt does his/her initial assessment as with any other pt, takes care of charting this assessment, and blood work, IV starts, etc. The A/D nurse takes care of locking up belongings, documenting pt's history, allergies, etc. In other words, he/she takes care of the tidious things, while the other nurse is able to focus on getting the pt settled, orders carried out, as well as the other pts. The nurse does not have to spend over an hour simply on paper work. our A/D nurse works 8 hours, 7-3, and is able to get at least 5 admissions and 5 discharges done per day. The rest is passed on, and this is an issue we are currently working on. But for the most part, it has helped the busy day-shift greatly!

[returningnurse2006]

Thank you for your information. How much paperwork does the actual admit/discharge nurse do at your hospital?.... I have been responsible for Nursing history, Nursing flow sheet, Care plan and initial pt teaching. Med Reconcilitation. I let the primary nurse handle med issues, Doctor issues, unless she happens to be on break... and pt needs pain med at the time..I also make an initial nurses note when I receive pt... am I doing too much... I than report any pertinent finding to primary nurse when I am done. When I am limited on time... as in close to my clocking out... I just do pt history, and med reconcilliation and handover assessment to primary nurse or oncoming shift..I don't have much time for discharges.. too busy with admissions in a 6 hour shift. I can really use more nurses input on this. Thank you for your reply.

[gospursgo07]

The A/D nurse takes care of past med hx, med reconciliation, allergy verification, abuse assessment, and orientating pt to the room. She does no assessment, and charts no notes other than the admission flowsheets. These assessments are the duty of the nurse who will be caring for the pt on the floor. She is the first to see the pt after all, and does her initial assessment when the pt arrives to the room. (in total, there is 3 flow sheets on the computer along with 2 papers for the pt to sign regarding belongings and advanced directives). Average time for all of this to be completed is usually between 20-40 min depending on how extensive the hx is.

[returningnurse2006]

Thank you again for your reply. It sounds as though your hospital is computerized which probably helps speed things up a bit. I don't know how swamped your floor nurses are, it seems as though our hospital is clammoring for open beds as soon as a pt is discharged. ED and OR are looking for bed placements. The turn around time on the floor for pts is very fast. So taking away the initial assessment from the primary nurse helps alot in the documentation time for them. Alot of the time they are with me during the assessment so they can see what's going on and they don't have to double my work. They make an initial note if they see the pt before me, and once I am done or before... I tell them anything pertinent.