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

[PickMePlze]

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?

[rn undisclosed name]

It is the same where I am at. I got an admit at 6:30 pm yesterday and actually didn't mind BECAUSE I was working the 3pm - 11pm shift (I normally work 7am-7pm). When I get an admission 95% of the time it is at change of shift. How freaking ironic. Yes, I don't appreciate it at all. I know that ER claims they don't hold patients, etc. but I'm not a believer. Maybe at their hospital they don't but I'm sure the ones who claim this aren't at my hospital. Also, 95% of the time I am told a patient is on the way up and they will maybe be there an hour later. If it's going to take that long I would like to know.

No, they don't have to wait for the docs to come from the clinic because our ER docs do all the orders and admissions, etc. Depending on which doctor is working the ER depends on how many admissions we get. Certain docs are notorious for admitting everyone. The docs who do rounds (attending and specialists) tell the ER docs not to admit certain patients and lo and behold they admit them anyways. These docs also round at other hospitals and they say this doesn't happen at other hospitals it's only this particular group of ER docs who admit. We received a pt the other day. The family couldn't pick him up so they sent him up to a telemetry floor (of all places) so we could babysit him. He had no criteria to be admitted and was told by the primary and consult to not admit. As soon as he got to the floor he was discharged as soon as his family could get him. How freaking inappropriate is that? Why did they send him up at change of shift? Oh because that is when this attending was no longer on call and it would be a different doctor who wouldn't know what was going on.

We do have an admission nurse in the ER. I'm not sure of the exact hours but she does fill out the admission assessment which is a huge help and makes me not mind the admissions later in the day. I wish they had another nurse who did those too for other times of the day. It would save the nurses up on the floor a ton of time.

I am not lumping ER nurses into this statement but on one particular day this week all this occurred with our admissions. A patient came up with no IV site (this is a tele floor and this is hospital policy) and no the patient was not a hard stick, another admission came up and the patient was filthy (quite obvious they had been laying in their own stool for hours), and the 3rd admission did not have their admission stuff done (the admission nurse was working this day) on the patient we needed to babysit and the patients old chart was in the ER and they did not bring it up with them and wouldn't bring it when we called so we could get some history on the patient. The patient had a previous head injury and couldn't give us a good history.

It is unfortunate that this happens. I have had things said to me in the past about how the ER doesn't hold patients and shouldn't have to hold patients because it is change of shift etc. Well when I am told I am getting a patient I shouldn't have to wait an hour or longer after I have already received report. I can understand this happening occassionally but not the majority of the time.

[PANurseRN1]

No, and we shouldn't have to hold pts in the ED because the floors have so many "no fly zones" when you can't call report, in addition to the game of "catch me if you can" during the times when you actually can call report. Not to mention that rarely does anyone ever offer to help when I get the pt upstairs. OB/Womens' Health is the worst offender for this; heck, they don't even acknowledge you when you come, half the time the room isn't set up, and then they expect you to stop and repeat the report that you just gave 15 minutes ago.

I'm sorry, but it cuts both ways.

[dazey71]

If I get an admit after 6, I go in, peek at them, and if they are stable, thats about it. I'm too busy trying to get out on time to worry about a new patient. I'm grateful that we have a charge nurse that helps out with late admits.