Blended pediatric/med/surg adult units?

lpnstudentin2010, LPN · Dec 28, 2007

Closest to this I know of in my life is that I am a patient at a childrens hospital (totally dedicated, whole hospital is kids) have been a patient there since I was 4, am now 20 and am still cared for there.

This hospital will not stop caring for you when you become an adult, which I like.

OC_An Khe · Dec 28, 2007

Alot of the community hospitals are doing this. It does make economic sense. Pediatric admissions are in a significant downward trend even more then adult admissions. Additionally with the advent of all childrens hospitals the community hospital can't compete; particularly when a very sick child is involved. The cost involved for the hospital with regard to pediatrics go way beyond just nursing care.

As much as some in the profession deplore the economic side of health care. Health care is still and will always be a business. No matter what form in takes from free market to socialized health care economics will always be a dominant factor.

debthern · Dec 28, 2007

as a peds nurse the problem I see is that children are not little adults and they need to be cared for differently. All the staff needs to be trained in PALS which was not the case at the hospital I used to work at so if there was an emergency the PACU staff which is where I worked were expected to come in and take care of it...

jackson145 · Dec 28, 2007

My hospital shut down their Peds wing many years ago. We just couldn't afford to keep it open for 1-2 admits a week. So far it hasn't caused a problem.

wooh, BSN, RN · Dec 28, 2007

My old hospital thought all you needed to be a competent peds nurse was PALS. So you were good once the kids started coding! But up until that point, ack! If you have some nurses that are actually competent and comfortable with peds, then I could possibly see it being safe to take some minor GI kids. But respiratory kid starts going bad, where do you send them quick? The adult ICU? That's just not good enough IMO.

MrsAmesRN · Dec 29, 2007

We had adults and peds on the med-surg floor in the small community hospital where I used to work. They hired a lot of new grads (I was one of them) who had no peds experience. None of the nurses on the night shift were PALS certified. (None ACLS either--even the charge nurses).

There were nights that I had a sick baby or little child (a lot of GI and resp problems--like asthma, pneumonia) and an adult in isolation for things like C. diff, VRE, and MRSA. I think this is a really bad way to do things, cost-effective or not. But that's just my 2 cents.

P.S. I think this website is great. I have only posted a few times, but I'm on here reading your comments all of the time. You guys are great. Thanks!

ZippyGBR, BSN, RN · Dec 29, 2007

the biggest problem is the child protection issues with nursing Adults and children on the same units .. this has killed any mixed age units virtually stone dead in the UK ...

the exceptions seem to be specific and 'secure' accomodation within specialist units ( e.g. regional burns units and the Spinal injuries units, but also some of the professorial units based in adult acute hospitals) or occaisionally site managers who can't add up and send 15 -17 year olds to our surgicla assessment unit ... which is a paperwork nightmare as there's a handful of use on the unit that are cleared by the trust to work with paeds patients - even though we are Adult branch nurses ( one of the CNs did a years secondment in the endocrine Nurse specialist team and some of us have an ED background so were cleared for that )

withasmilelpn · Dec 29, 2007

We had adults and peds on the med-surg floor in the small community hospital where I used to work. They hired a lot of new grads (I was one of them) who had no peds experience. None of the nurses on the night shift were PALS certified. (None ACLS either--even the charge nurses).
There were nights that I had a sick baby or little child (a lot of GI and resp problems--like asthma, pneumonia) and an adult in isolation for things like C. diff, VRE, and MRSA. I think this is a really bad way to do things, cost-effective or not. But that's just my 2 cents.
P.S. I think this website is great. I have only posted a few times, but I'm on here reading your comments all of the time. You guys are great. Thanks!

This is exactly my fear. My opinion in this case is don't admit them at all, then - it is not safe!

:nono:

RNperdiem, RN · Dec 29, 2007

When my son needed hospitalization, he was transfered to a hospital that had a pediatric department. I felt more secure in a place that had a PICU, peds nurses, a child-life specialist available and rooms set up to accomodate a parent.

MedicalLPN, LPN · Dec 29, 2007

A hospital nearby where I live has combined their Med-surg, PCU, and Peds unit all into one, from what I've heard it's chaotic, with unsafe ratios (1 RN 1 LPN and 1 CNA for a 46 bed unit on night shift). Pediatrics, PCU, and Med-surg are three different animals I couldn't imagine working on a unit like that, but that's just me.

TexasPediRN · Dec 29, 2007

When I was a CNA (and my first RN job) I worked on a blended pedi/med surg floor. This hospital too, was a small community hospital, and although it was a level 1 trauma center, we were not equipped to care for very sick children.

All those kids were flown out to another hospital.

We had the 'easy' cases - GI bugs, rota, RSV, appys, T&A's, etc.

Most of the time, you were lucky to have one pedi patient. The rest were all adults. I only remember one time in almost 2 years that we had about 17 pedi patients, I was shocked. (It was great though b/c I hate adult nursing!)

Now I work at a level 1 pedi trauma center. We get the sickest kids, and all accident victims, etc. I love it.

I could *never* go back to a blended unit..nope..I refuse!