Admits after 6:00 pm? Does your hospital do this?

Nurses General Nursing

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I'm a new grad and I've been working where I am for almost a year. I work 7-7 days. One of my main reasons I'm throwing in the towel on this job is be because of the 6:00 admits, ER, or some other department wanting to call report and transfer patients in the same hour that we have to give report to the night nurse. The floor I work on is already a zoo, and by the end of the day I AM DOG TIRED AND READY TO GO HOME. I get sooo pissed off, this is driving me insane. Im spending my days off looking for another job. Many a nights I don't get home till 9 pm because of this crap.

I can't understand why they wait till after 6:00 pm. Am I missing something here?

This is why there are two (or three) shifts. Babies/patients come when they come - whatever point in the shift that may be. If I get an admit at the end of my shift, I tell the oncoming RN in report what I have done and what still needs to be done. On the other side, if I am coming in to work and one of my babies just came through the doors within the hour, I consider the baby to be my admit and take over where the prior shift left off.

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Specializes in Neuro/Med-Surg/Oncology.

We get them @ 06:00 a lot. What I wind up doing is telling the pt. I'll be their nurse for the next ___ minutes until my shift's over, do a quick assessment, get them settled, and then try to address the things that are most pertinent. (Bloodwork(lab is usually on the floor anyway for morning blood draws and it winds up saving them a trip back after they've just left), abx it they're septic or neutropenic, etc.) Stats. Everything else can wait. If I have time, I try to get the admission paperwork started, but I certainly don't stay late to do it.

What ticks me off is when a pt gets to the floor after 18:00 and the nurse giving him to me has not even looked at the patient or his orders. I mean, it's one thing if they literally just got to the floor in the last 15 minutes. But if the pt's been on the floor for an hour, you should be able to give me a heads-up. Do I expect everything to be done? No, but if there's something stat, please do it or tell me if you didn't get to it so that I'm not caught like deer in the headlights or finding it later when I do my chart checks.

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Specializes in Emergency Dept.

At our hospital if there is an admit that is ready to go up from the ER (or close to it), the nurse tries to get them up before they leave rather than leaving the work for the next nurse. Now, the complications for the floors is, they work 7-7, the ER staff switches shifts 6-6, ergo, the number of admits at 6pm. To help lighten this load alittle though, if a nurse recieves a patient with less than one hour in their shift, they are expected to get the patient's vitals and a very basic assessment done, then the next shift does the full profile, etc.

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OP - U can't be serious?!? U might as well get out of nursing & find yourself a nice 9-5 job because there is no where that you will go where pt's don't arrive at change of shift! That's just crazy! Guess what, pt's code at change of shift too! R u gonna try and make them wait until their fresh new nurse arrive

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Specializes in pedi, pedi psych,dd, school ,home health.

I have to agree with the posters who say that nuring is a 24 hour job. I have worked in many different facilities and settings. EVEN in Home Health you get issues that come up before the end of your shift.....even admits . perhaps the 7a-7p shift is the issue for you not the admits. maybe finding an 8 hour a day job would work better for your family.

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Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

We all get patients at shift change- it's just a fact of life. Cooperation between everyone involved is key. I got one at shift change from recovery yesterday. As rough as my day was though, the recovery nurse who sent me the patient had a day that was 10 times worse than mine. She had had to hold the patient in the RR since 10 that morning, due to a lack of CC beds. When she called to give me report, I could hear the other RR nurses coding another patient. She was the on call nurse for the night, and was looking at a 24 hr shift when all was said and done, due to surgery back-ups r/t RR holds r/t no beds to admit to.

I didn't give her flack, and she didn't give me flack for having to wait a few minutes while the room was being cleaned. The oncoming nurses also didn't give me flack. We got the patient set up, did a quick assessment and bedside report, and passed the pt on to night shift.

While it's not an ideal situation, if everybody works together as a team, things can go much more smoothly.

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We ROUTINELY get our admits between 5PM and 7PM. And unfortunately, people tend to code and/or die around shift change, too.

I suggested to our manager that we have an admit nurse who works from 2 to 9PM, since that is when the bulk of our admits occur. She gave me a look like, "What planet are you from?"

I thought it was a great idea. We could even take turns doing one admit shift every few weeks, or something like that. Admit nurse would do all the paperwork, start IV, get fluids running, get orders, etc. Then turn pt over to the regular shift nurse, who could, during this time, actually be performing real patient care for his/her other patients. Oh well, they made fun of Thomas Edison, too. ;)

Oldiebutgoodie

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We actually have a house-wide admission team. They are present from 0700 to 2300 Monday through Friday. They will admit patients that arrived on the floor from 0400 until 1900 or so (just depends on how many nurses on duty and how many in line to be admitted) They don't do unit admissions. They take care of all paperwork, the initial assessment, start IV (if not already done), go through orders, and then give report on what's been done to the pt's primary RN. It's a good system and works great.

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Specializes in Rural Health.

Here is another perspective from an ER nurse. I don't even pay attention to the clock. When I have a patient that is ready to be transfered, either in house or out, they go. I make sure that there are no pending orders that I can take care of before they leave and that is it. We have a small ER, 8 beds, and I can't hold patients because of timing issues. I also have no idea what time hospitals change shifts, we transfer out to 8+ other facilities. I bet I transfer out at least 2 patients a week that fall smack dab in the middle of shift change....I can't help it. Nursing is 24/7.

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I'm well aware its a 24 hour job but I'm not a freaking robot, either. Nurses need to eat sleep and rest just like everybody else. I can't be allowed this then I need to move on, which is what I intend to do.

Maybe a job as a school nurse or for an MDs office is for you. In a hospital, you are always going to have admits at all hours, whether or not it's convenient for you. I work 1500 to 2300. Last night I got an admission at 2230. You know what? I started the admission, gave report, did the narc count and the RN coming on at 2300 finished my admission. This is called teamwork...maybe your unit you work in doesn't work as a team. Maybe you are not a team player.

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We actually have a house-wide admission team. They are present from 0700 to 2300 Monday through Friday. They will admit patients that arrived on the floor from 0400 until 1900 or so (just depends on how many nurses on duty and how many in line to be admitted) They don't do unit admissions. They take care of all paperwork, the initial assessment, start IV (if not already done), go through orders, and then give report on what's been done to the pt's primary RN. It's a good system and works great.

You obviously work for an enlightened hospital! I don't.

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Specializes in Critical care/coronary care.
Maybe a job as a school nurse or for an MDs office is for you. In a hospital, you are always going to have admits at all hours, whether or not it's convenient for you. I work 1500 to 2300. Last night I got an admission at 2230. You know what? I started the admission, gave report, did the narc count and the RN coming on at 2300 finished my admission. This is called teamwork...maybe your unit you work in doesn't work as a team. Maybe you are not a team player.

This seems a bit harsh. I completely agree that nursing is a 24 hour job, but the OP is not on for 24 hrs! I don't mind having work left for me if an admit just came through the doors. It is teamwork. As long as you settle the pt, do vitals, make sure they're stable, what more can they expect? Putting in 2 hours of OT a day is not healthy. I think you guys should have an understanding on your ward.

I came on the other day, and the night nurse was very frazzled (kinda new), her pt went into rapid a fib (and was trying to crawl out of bed), and she was doubled (in ICU) with another sicky. She was very concerned because she didn't give her 0600 Abx (it was 0730). So she was going to go get them and give them. That is the culture her previous ward was. I told her to go home, I'm here for 8 hours, and proceeded to start my day, with a couple extra things on the list. I could not in good conscience expect her to do everything! Anyways, to the OP, is there communication on your ward, any committees you can bring this up to? Best of luck.

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