Delay in transfer to floor

[bebbercorn]

How detailed do you all get in your notes about charting delays in getting pts to the floor. E.g., when you are meeting resistance due to the admitting team, or floor concerns, do you put that in writing in the pt chart or make it an internal report?

[bebbercorn]

Very similar to what turnforthenurse, BSN posted.

I usually make a nurses note in the actual chart (not the comment section on the board. While it is useful to convey certain information, it is not a permanent part of the chart). Why? To avoid a butt-chewing from MY manager.

Once a bed is assigned, I have less than 15 minutes to call report - or my manager is on my case about why I haven't called report. So whenever I call report, I write down the exact words in quotes as to why I was unable to give report: "Attempted to call report x 1. Was told by secretary the RN is in an isolation room. Was told RN will call back." etc.

We too recently went on this new system of "Room assignment to pt. in room in 60 minutes or less". Now, if the RN can't take report, someone else is supposed to - either a "buddy" or the asst. manager or manager.

If I keep getting persistent push-back from giving report, my asst. manager or manager gets involved. And believe me, if/when that happens, it is mostly out of my control - my charge nurse asks me what's taking so long and if the problem is not my end, they get involved.

cheers,

We have been (like everyone else) trying to maximize throughput through the ED. My manager has encouraged us to write her with situations where we can't get the patients up. The debate is whether to write internal incident reports, email the manager directly (which usually goes nowhere), or in the patients chart (which makes me a bit nervous because of legality issues later...)

In my hospital, thank god, the floor nurses are super receptive to getting patients and rarely give me a hard time about sending patients up.

[FlyMurse, BSN, RN]

I chart a note, because the rule is we have 60 minutes to get them up and that time goes fast...

Must be nice! They want us to get them up within 30 mins from the time the bed is assigned and I even heard someone say they're pushing for 20 mins. Unrealistic! Even if I drop everything I'm doing with my other pt's, I still have to call report (which we know can take the 30 mins in and of itself), do a belongings list, copy whatever's in the chart that needs to go up, then take them up and transfer them.

Re: what to do if the RN can't take report

I believe our policy is to try once, then take them up and let them read the chart or give report to charge. I'll usually try my best to give the nurse report because I've been on the other side and it sucks getting "dumped" on. We do mandate a verbal report for ICU pt's.

[PacoUSA, BSN, RN]

I used to work @ a hospital in NY on a travel assignment where the ER would fax SBAR to the unit and that was it. The patient would come up in about an hour. No phone calls, no phone tag, nothing. The SBARs were pretty concise enough that you rarely had to call ER with questions. And the MD's notes already in the computer so you already had a full picture of the patient when they came up. I LOVED it! Maybe it is because I am not much of a phone person anyway ....

[RainMom]

I used to work @ a hospital in NY on a travel assignment where the ER would fax SBAR to the unit and that was it. The patient would come up in about an hour. No phone calls, no phone tag, nothing. The SBARs were pretty concise enough that you rarely had to call ER with questions. And the MD's notes already in the computer so you already had a full picture of the patient when they came up. I LOVED it! Maybe it is because I am not much of a phone person anyway ....

This is how it works at my hospital. The only phone call is to tell the floor the sbar is being sent so they see the fax right away.