Covid and Non-Covid on Same Floor?

[P IV]

I decided to travel again in January. I’m not sure if the facility I chose had a good system down or what, but, even though I wasn’t told I was gonna work COVID, that’s where I ended up. That’s fine. It wasn’t the start or climax of the pandemic and I honestly had no complaints. I worked COVID patients and COVID patients only. That’s where I was assigned and the need was there.

I am on my second assignment and of course this has started again. This particular facility was a hot spot before and of course is now. What I don’t understand is putting COVID patients on the same floors as non COVID patients. I don’t know why, but this feels much more stressful. I thought this large facility, which is the only for this hotspot would do differently.

I don’t mind floating between COVID and non COVID floors, but to be taking care of the different sets of patients, many of the non COVID being elderly or immunocompromised. 

Is this common elsewhere?

[T-Bird78]

I was pulled from my office location to work in one of our larger hospitals within my healthcare system early this year. I’ve never worked in a hospital so it was a first for me!  I was told it’d be non-COVID pts only. They were wrong. Every floor, every unit had COVID pts. The unit I was on had med-surg, postop, telemetry, and COVID pts. They hung the door caddy on the outside of the COVID rooms and we had to glove/gown/mask/face shield/glove for those rooms. I asked about a non-COVID unit but was told there were too many COVID pts and each floor had COVID pts. 

[OUxPhys, BSN, RN]

On the covid floor at my hospital the nurses take care of covid and non-covid pts. Eventually it will be like that. 

[P IV]

11 minutes ago, OUxPhys said:

On the covid floor at my hospital the nurses take care of covid and non-covid pts. Eventually it will be like that. 

Eventually is fine, but that’s during stabilized times in my opinion

[SmilingBluEyes]

11 minutes ago, P IV said:

Eventually is fine, but that’s during stabilized times in my opinion

I agree. But what else to do with COVID patients? There are so many now that dedicating floors to them has become just about impossible.

[JBMmom, MSN, NP]

Since day 1 we have had COVID and non-COVID patients in our critical care unit and throughout the hospital. We have only one floor that doesn't take COVID patients because they do joint replacement surgeries and have specific requirements for their patient population. We have not had many instances of in-hospital transmission, but it has happened. 

 Very early on there was an assignment in critical care that had a patient on neutropenic precautions with the same nurse assigned to a COVID patient. I changed that assignment, but got push back from my manager who said "as long as you have proper PPE it's okay". Well, if I were the family member of the cancer patient with a compromised immune system, I would NOT be happy to know the same nurse was also treating a COVID patient at the same time. It's happened again over the past year and a half, but we haven't had any trouble with transmission in the unit as far as we know. Unfortunately, there was a patient on the cancer floor that they tested who was initially negative, but came up positive a few days into their hospitalization. That person and the staff did infect about a dozen other patients, mostly cancer patients, and a few died. Very sad. 

[SmilingBluEyes]

13 hours ago, JBMmom said:

Since day 1 we have had COVID and non-COVID patients in our critical care unit and throughout the hospital. We have only one floor that doesn't take COVID patients because they do joint replacement surgeries and have specific requirements for their patient population. We have not had many instances of in-hospital transmission, but it has happened. 

 Very early on there was an assignment in critical care that had a patient on neutropenic precautions with the same nurse assigned to a COVID patient. I changed that assignment, but got push back from my manager who said "as long as you have proper PPE it's okay". Well, if I were the family member of the cancer patient with a compromised immune system, I would NOT be happy to know the same nurse was also treating a COVID patient at the same time. It's happened again over the past year and a half, but we haven't had any trouble with transmission in the unit as far as we know. Unfortunately, there was a patient on the cancer floor that they tested who was initially negative, but came up positive a few days into their hospitalization. That person and the staff did infect about a dozen other patients, mostly cancer patients, and a few died. Very sad. 

Wonder how long before these surgeries are cancelled and the whole floor is dedicated to COVID patients? I bet not too long.

[NurseLy, BSN, RN]

We mix covid and not in our units.

If symptomatic covid and receiving treatment we keep them between two units. We do have non covid patients mixed in the same units depending on the bed needs at the time.

Positive covid patients who are not requiring covid treatment but are there for a speciality issue - cardio, neuro, etc. get placed on those specialty floors. 
 

Right or wrong I am not sure, our health system says as long as we are using our isolation precautions the patients neighboring covid patients are at no greater risk.

While patient safety comes first of course, an entire unit of isolation patients is hard on the nursing staff staffing it. 6 isolation patients is a heavy load ?  
 

[Charlcie, BSN, RN]

I've worked with it both ways. Currently our ICU has both. I agree it seems way more stressful from a nursing standpoint and not very responsible in general given the high transmission rate. 

[P IV]

3 hours ago, NurseLy said:

We mix covid and not in our units.

If symptomatic covid and receiving treatment we keep them between two units. We do have non covid patients mixed in the same units depending on the bed needs at the time.

Positive covid patients who are not requiring covid treatment but are there for a speciality issue - cardio, neuro, etc. get placed on those specialty floors. 
 

Right or wrong I am not sure, our health system says as long as we are using our isolation precautions the patients neighboring covid patients are at no greater risk.

While patient safety comes first of course, an entire unit of isolation patients is hard on the nursing staff staffing it. 6 isolation patients is a heavy load ?  
 

How do you have a positive covid patient that doesn’t require treatment? Why are they in a bed? Serious questions 

3 hours ago, NurseLy said:

We mix covid and not in our units.

If symptomatic covid and receiving treatment we keep them between two units. We do have non covid patients mixed in the same units depending on the bed needs at the time.

Positive covid patients who are not requiring covid treatment but are there for a speciality issue - cardio, neuro, etc. get placed on those specialty floors. 
 

Right or wrong I am not sure, our health system says as long as we are using our isolation precautions the patients neighboring covid patients are at no greater risk.

While patient safety comes first of course, an entire unit of isolation patients is hard on the nursing staff staffing it. 6 isolation patients is a heavy load ?  
 

Actually in my opinion, 6 isolation patients with the same diagnosis were easier for me. Having 2-3 covid patients then 2-3 very sick non covid patients to me is too much. 

[NurseLy, BSN, RN]

8 hours ago, P IV said:

How do you have a positive covid patient that doesn’t require treatment? Why are they in a bed? Serious questions 

Actually in my opinion, 6 isolation patients with the same diagnosis were easier for me. Having 2-3 covid patients then 2-3 very sick non covid patients to me is too much. 

I believe we are still testing all patients. So people come in with other complaints — ie chest pain… but they incidentally test positive. If they have no covid symptoms we still place them in isolation but on other floors based on where they will receive the best care. Cardiac patients go to our cardiac floor versus a general medical floor. 

[NurseKatie08, MSN]

Our med surg units do mix COVID & non-COVID patients, however my unit (transplant) and the hematology/oncology unit are excluded from having COVID patients. If someone tests positive, they get transferred to another unit. I've floated to units where there are COVID patients but they do not get assigned to floats from the two 'clean' units.