Bed assignment

Been there,done that, ASN, RN · Dec 1, 2018

Amen.

The name of the game is clean out the ER. I was charge for many years with a patient assignment.... no matter what was going on, if there was an open bed , the ER patient is coming on up.

The only answer is advocate for safe staffing.

**CalicoKitty, BSN, MSN, RN** · Dec 1, 2018

Some of the nurses in the ER may have 7 patients, including 2 ICU patients. Getting those patients upstairs is a priority. If you can't take report at some point, can you see if anyone else can (charge nurse or anyone else). I think I've found that I don't really need much report since i can just scan through their chart. The thing that makes or breaks units is teamwork. But it can be really hard when everyone is drowning.

martymoose, BSN, RN · Dec 1, 2018

Yes especially when they are sending up unstable people.b/p 240 systolic? Ok.rapid a fib he 185 ,perfectly ok for a hallway bed, real safe pushing meds on them

I've got it. There is no good solution.i know id be pissed if my family member was treated like this.

Daisy4RN · Dec 1, 2018

Yes, things have certainly changed and not for the better. I remember when I first started as Charge, I was able to tell ER or other floor that the nurse wasn't ready yet, give them a valid reason, and that was the end of it (unless someone was constantly abusing it). Gone are the days. Seems the higher ups and JC etc dont really care too much about pt safety.

Daisy4RN · Dec 1, 2018

Some of the nurses in the ER may have 7 patients, including 2 ICU patients. Getting those patients upstairs is a priority. If you can't take report at some point, can you see if anyone else can (charge nurse or anyone else). I think I've found that I don't really need much report since i can just scan through their chart. The thing that makes or breaks units is teamwork. But it can be really hard when everyone is drowning.

I think everyone is just way too busy all the time, nonstop!

Sour Lemon · Dec 1, 2018

Yep. Different departments fight with each other when nobody is actually at fault expect for the people who decide how to staff those departments.

Been there,done that, ASN, RN · Dec 1, 2018

Yes especially when they are sending up unstable people.b/p 240 systolic? Ok.rapid a fib he 185 ,perfectly ok for a hallway bed, real safe pushing meds on them
I've got it. There is no good solution.i know id be pissed if my family member was treated like this.

Now that's a different story. The purpose of ER is to treat and stabilize. Does your management get the drift?

cleback · Dec 1, 2018

Sad state of affairs.

LM NY · Dec 2, 2018

As crazy as this sounds, I actually felt better reading your post. I thought my hospital was the only that was like that. All they see is an empty bed, not knowing anything that has already occurred on that unit. Just recently a patient was sent up from the ED to my med-surg unit and arrived during morning huddle/change of shift with a BP of 70's/40's. Like WHHAAATT!!!! It quickly turned into an RRT then a stat intubation. My hat goes off to ED nurses, but come on. That patient's BP was low for awhile. They gave one bolus, brought it up to 90's/60's which they made sure they documented and gave during the report and sent the patient right up. Ugh! No one is perfect and no facility is either, but OMG please stop it with the unsafe practices. Don't even get me started about how often we are short staff.

JKL33 · Dec 2, 2018

My hat goes off to ED nurses, but come on. That patient's BP was low for awhile. They gave one bolus, brought it up to 90's/60's which they made sure they documented and gave during the report and sent the patient right up. Ugh!

You're not offending any ED nurses. I'm sure they put someone at least as sick in the bed they managed to clear out...

No one is perfect and no facility is either, but OMG please stop it with the unsafe practices. Don't even get me started about how often we are short staff.

However, you might be offending the safety people. They are working harder than any of us on making things appear to be safe.

sallyrnrrt, ADN, RN · Dec 2, 2018

Yes especially when they are sending up unstable people.b/p 240 systolic? Ok.rapid a fib he 185 ,perfectly ok for a hallway bed, real safe pushing meds on them
I've got it. There is no good solution.i know id be pissed if my family member was treated like this.

The description of ER nurse with multiple patient load in addition to two other patients that were successful codes on ventilators, needing icu bed.......one of those patients I had for 2 days in ER.....finally got her bed.....in icu