closing floors during summer slow down

Uptoherern, RN · Aug 3, 2005

i'm re posting just to keep my post active. anybody? is my hospital so weird that no one can think of anything to say? ha.

grannynurse FNP student · Aug 3, 2005

i'm re posting just to keep my post active. anybody? is my hospital so weird that no one can think of anything to say? ha.

When I first moved to SW Florida, in 1980, we use to have a slow season. The number of patients would drop between the end of April til October. Not any more. Patients are waiting for beds in the ER. I know, I had to wait four hours the last time I was admitted, last month.

Grannynurse :balloons:

allnurses Guide · Aug 3, 2005

We've had to close our acute "floor" (we are only one story so that sounds so weird to me) just a few times for a few days. We have 14 beds. Our ER has 3 beds. Our L&D has one laboring room but we have the option of two other beds across the hall.

It happens so seldom that most folks love it. It sounds completely different than your experience however. Our hospital would LOVE to have patients to fill up the beds . . . that sounds weird too - not that anyone loves that people get sick.

Sheesh . .. I'm not making alot of sense :rolleyes: . And neither does your hospital's policy.

steph

MQ Edna · Aug 3, 2005

I work in a fairly small community hospital. level II er. Our er has 14 beds, and 5 fast track. we routinely put 2-3 pts inthe hall and have an L & D room that sometimes gets used for pelvics if that room is full. We see anywhere from 70-100 pts per day. We used to slow down in the summer, but for the last two years we really haven't slowed down much, as far as I can tell. The hospital has ICU (?14 beds, I geuss I should know this ) A med/surg/ortho floor and a tele floor that both have approx 28 beds. ok, that's the background, here's the problem. The powers that be (who knows who it is) decided that it made sense to close the med/surg floor during the "slow" season. We were told that it "saves money". What I would like to know is WHERE does it save all this money? One day recently, the 0700 nurses walked into the er only to discover that we were "holding" 12 admissions. :angryfire The patients are mad at the wait for an actual bed, their families are mad and complaining to us, we are mad because we are getting blamed for the waits and having to deal with the complaints. The floor nurses are mad, because they are being called off and having to use vacation time to make up hours (6 or 7 actually quit, that's alot out of their work force) In the ER, they are staffing the "hold" patients with registry nurses..........makes absolutely NO sense! Why would they pay astronomical registry salaries and not open the floor and use their own disgruntled staff? Not to mention, our er was then down to a 3 bed er! Therefore, wait times for patients in the waiting room is increased, leading to their frustration and of course taking it out on the triage nurse! They finally did open the floor to take admits, but as soon as they had discharges from the other floor, they moved those patients back and closed the floor again. The very next day, we were back to holding 6-7 admits again!
I can't believe the mentallity..........where does this save money? Why would they want to "save money" at the expense of everyone's satisfaction and comfort? The er beds are not comfortable, we have no tv's or anemities. They lay there and glare daggers at us. We do what we can. Using so much registry has to offset whatever perceived "saving" that they are doing. When I ask (and I have asked everyone I meet) what the reason behind this is , and WHAT are they saving, not one person can give a reason. Administration brought us ice cream bars yesterday.....none of us had had a chance to go to lunch. The firemen ate the ice cream. Then administration went to a "PR event" at one of the swankiest hotels in the southwest. Well, maybe PR should begin in your own house.
We were hugely relieved yesterday when they (who are they anyway?!) decided to open the other floor up. Out of 8 admissions from 0700, we still had 4 to go when I left at 1900. who knows how long it will remain open.
Any ideas what YOU think "they" are thinking???? Have you ever heard of this before? Even the LAB techs and resp. techs were complaining. dietary was complaining! Housekeeping was complaining because as soon as a bed opened, everyone was on their butts to clean it ASAP for the next pt. I sort of give up. I keep telling patients that I have absolutely NO CONTROL over how long it takes or when it will be for them to get a bed. We have been holding patients over 24 hours.
ridiculous.
your thoughts......................

I actually work in a farily large facility (15 floor units) 5 ICU's, large LandD and large ER......Last week they shut down the Women's Surgical/Post Partum floor, and my floor had such a low census with such a high number of scheduled employees (they just hired 15 nurses from india) so we are TOTALLY overstaffed....I had 3 paychecks in a row with under 400.00 on them, and one nurse only had 16 hrs for the entire MONTH! The nurses from India who are just off orientation all had 100+ hours!!! Still trying to figure that one out! Also, my hospital is weird about cancelling and floating LVN's before RN's whether the RN's are float pool or not....yet they put no restrictions on LVN's duties (we do all IV pushes and cardiac drips, etc)...this is why I'm going back to get my RN ASAP!

pickledpepperRN · Aug 3, 2005

I work registry sometimes. I was told that this hospital had been canceling ICU and med-surg nurses for the night shift when the ER was full.

Then they made the ER nurses care for all the patients. With empty rooms upstairs. With RNs and LVNs at home. At least one of them got a registry shift after being called off.

Why! I don't know. BUT your hospital is not the only one.

They reported their hospital the the DHS with the dates and staffing logs. The hospital was cited and had to write a written plan to staff safely and within the law.

We are fortunate to have ratios in California. Didn't I see here on ALLNURSES.COM that you have ICU ratios in Arizona?

Then the ICU patients need the same care whether they are in the ED or the ICU.

Look up your state hospital licensing laws or regulations. Probably what they are doing is not even legal.

Seems like your may be another situation the public needs to know about.

suzanne4, RN · Aug 3, 2005

This was the norm for years in Arizona.........................but for the last few years at least, there is no longer a slow season, especially in any ER......

Patients are now waiting until they are really sick to go to see a doctor and they are all getting admitted.

Perhaps a little discussion with the finance person would clear things up.

Is your hospital part of a chain or independent?

ERERER · Aug 4, 2005

I know what you mean about holding patients in the ER. we are in the same boat...... LOTS of empty beds upstairs, nurses sent home. I have been an ER nurse for almost 20 years. Long ago I lost the concept of time. Time for meds, time for meals, time for accuchecks, time for a bath, etc. You know how it is in the ER, you just do things. There aren't any routine duties.... Invariably things are missed on the holding patients. And, if our secretary isn't on guard, "AM" labs, and all that stuff is missed too. If I wanted to work the floors, I would work the floors. It just doesn't make sense. It does, however, make me laugh when families won't leave until the pt goes "upstairs", as if they are in a hostile environment and need protection!! It is beyond me why administration does this, I have worked many ER's, and this is a problem everywhere. It also makes me laugh when the house supv says that ICU nurses can only take 2 patients, PCU nurses can only take 4. Tells me that as I am holding 2 vented patients, a couple of cardiacs, and anything else that comes in the door????

Nurse Ratched, RN · Aug 4, 2005

Our facility occasionally decides it's a good idea to briefly close down one of our psych units for staffing reasons. Problem is, the reason we have several units is that different groups of patients have different needs and it screws up the milieu to squish them all together.

Then when you get a patient who absolutely CAN'T be in with the other units, you have to open it anyway and bring in staff at the higher on-call pay rate. Don't see it saving money either.

Uptoherern, RN · Aug 6, 2005

geez.....when they opened it back up, we all had hope because they said they had rooms they could renovate on the other floor. "they" said that the floor would stay open. Well..............here it is 3 days later and our first admission of the day had to wait to go upstairs. reason? moving patients to the tele floor and shutting down the medical floor. can't believe we all fell for it.

btw, we are a chain (gang). :chuckle not an independant hospital.

SWFlorida · Aug 8, 2005

I learned years ago the way to get the hospital admins attention is to write up the unit your working on as "unsafe staffing" and work under protest. This way you are not abandoning your post however you will not be held responsible for care under these conditions. Make a LOT of copies and send to all admins and of course to risk management. Amazing how they can suddenly start staffing better. Hospitals will squeeze nurses as long as they "get away with it" If accidents happen they blame the nurses, saying they werent aware of the problem. This excuse goes away once they are written up..... :uhoh3: