"Hallway admissions" at overcrowded ED, and professional risks of RNs talking to press

  1. Saw this article in Becker's this morning. As I was reading it, I was quite surprised to read this quote:

    Kate Pugh, RN, a Montefiore ER nurse for five years, told the publication that on the busiest days, she typically treats up to 15 patients in the ER at one time.
    "These are sick people," Ms. Pugh said. "Basically you're just running around putting out fires instead of giving quality care. This is not an easy fix. We just don't have space."
    City Councilman Ritchie Torres sent a letter to the New York City Department of Investigation in August, urging the agency to "probe Montefiore's practice of placing Medicaid recipients in crowded hallways that neglect[s] patient care," the report states. However, the prompt failed to change patient care techniques at the hospital.
    Wonder if Miss Kate Pugh still has a job. Why would anyone besides the hospital spokesperson think it would EVER be a good idea to be quoted in the press, particularly about a shortcoming of the facility for which they work?

    'Hallway admissions' abound at overcrowded Montefiore ER, nurses say
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    About klone, MSN, RN Pro

    Joined: Apr '03; Posts: 13,150; Likes: 37,105

    31 Comments

  3. by   JKL33
    Likely due to feeling they have a duty to do so (sort of a misguided whistle-blowing attempt, if you will) or else out of pure fear and frustration.

    Staff nurse should be the last one worried about being fired over this.

    A hallway admission often means equipment stacking up along the corridors, Tucker said, a dangerous obstacle course of walkers, IV stands and oxygen tanks.
    She takes care of 15 patients at a time and the main issue is the obstacle course?

    ETA one more thing:

    "Even though other emergency departments in our community are less busy and have available hospital beds, people come to Montefiore because we provide high-quality, compassionate, and comprehensive care," a hospital spokesman said in a statement.
  4. by   klone
    I know, that last quote was so much BS.

    If I were to whistle-blow, I would definitely do it anonymously.
  5. by   JKL33
    This reminded me of a post (#16) on a thread titled "Inpatient boarders" over in the ED forum - - the poster reports a situation where not only are there multiple admitted patients boarding in the ED, the facility continues to accept inpatient transfers only for those patients to also be boarded in the ED.
  6. by   TriciaJ
    Yes, I would definitely shun the quieter ER and go to the one where I can lie on a gurney in the hallway and share my nurse with 14 other sick people. For the compassionate quality care.
  7. by   klone
    Quote from TriciaJ
    Yes, I would definitely shun the quieter ER and go to the one where I can lie on a gurney in the hallway and share my nurse with 14 other sick people. For the compassionate quality care.


    Their PR rep needs a raise. That was a magnificent attempt at spin.
  8. by   rearviewmirror
    the only times I saw administration worked like their pants were on fire to get ER extra help is when charge decided to call divert. County hospitals did divert all the time... must have some financial negativity if hospital diverts *shrug. Anyway, looks like Ms. Pugh will be out of job anytime now with some bogus reasons that admin makes up.
  9. by   KatieMI
    Quote from TriciaJ
    Yes, I would definitely shun the quieter ER and go to the one where I can lie on a gurney in the hallway and share my nurse with 14 other sick people. For the compassionate quality care.
    ... for "acute constipation" (from the whole article link).

    That has to be an excellent place to finally have that long-awaited bowel movement.
  10. by   Emergent
    Quote from KatieMI
    ... for "acute constipation" (from the whole article link).

    That has to be an excellent place to finally have that long-awaited bowel movement.
    Louis Callazuol poses for a photo in his Bronx home on Monday. Callazuol paid $250 a day under his medical plan for a space on a cot in the hallway when he went into Montefiore earlier this month for a case of acute constipation. (Go Nakamura for New York Daily News)
    That says it all...
  11. by   TriciaJ
    Quote from Emergent
    That says it all...
    Walgreen's has a better deal than that on Fleets.
  12. by   Emergent
    Quote from TriciaJ
    Walgreen's has a better deal than that on Fleets.
    Warm prune juice works too...
  13. by   Luchador
    Quote from klone
    Saw this article in Becker's this morning. As I was reading it, I was quite surprised to read this quote:



    Wonder if Miss Kate Pugh still has a job. Why would anyone besides the hospital spokesperson think it would EVER be a good idea to be quoted in the press, particularly about a shortcoming of the facility for which they work?

    'Hallway admissions' abound at overcrowded Montefiore ER, nurses say
    Whistle blower laws would clearly protect her. Just being quiet, drinking the management Kool-Aid and taking **** when your administration runs a facility in a way that makes it dangerous is not a way to change it. You know that, right?
    Last edit by dianah on Oct 18 : Reason: Terms of Service re: posting profanity
  14. by   Neats
    This hospital is one of the top 50 largest employers in the state of New York. This hospital was founded in 1884. Was known as a hospital for chronic diseases for many decades. The hospital has greater than 85000 inpatient admissions annually. In 2007 it received a 20 million dollar shared grant for arts and social services (donated from Bloomberg). The resident doctors there are usually 3/4th year students and actually run an internship/residency to serve underserved people.

    In 2017 it opened a new outpatient medical complex (nearby) that is a 12 story medical center (same day surgeries available) but alas no inpatient overnight beds. It does however serve some of the most nations poorest communities in the US with their chronic care issues who have traditionally used the hospital as their doctor office...out of necessity, and perhaps not knowing what is available to them as far as healthcare services
    .
    In 2011 Nurses at this hospital agreed to a union settlement related to overstaffing and wages-the nurses received a $750.00 bonus, pay raise of 7.5 percent over a 4-year period. Nurses do not have to pay for their premiums for healthcare. (I would have demanded way more)

    Boarding patients who cannot go home, moved to any area you can place them safely, who are too unstable to be discharged is an issue at a lot of hospitals in the US. Many hospitals fail to make significant changes to ensure a collaborative patient approach is being made across all departments, it usually is the ED calling department looking for a bed.... The days of round discharges should be made from the admit and units should be able to bridge orders based on patient presentation and if anything could have follow-up at an outpatient basis in lieu of staying one more day to get all things completed, the patient should be discharged with appointments already made at the hospital--their new state of the art outpatient medical complex. This way of thinking needs to change for faster patient access.

    I applaud this hospital for taking care of some of the sickest we could ever see in an environment that has such high patient turnover and patient usage of using this hospital as their family provider again maybe out of necessity or not knowing healthcare access. Clearly there is a need for additional inpatient beds but until this happens we need to collect the hard data that "proves" what changes need to occur.

    As an Administrator I do not think this nurse should lose her job because she spoke out this is how change happens. It just needs to be done in a more analytical way so the decision makers have the accurate data to move forward. When you see this rich hospital history I can only imagine the piece meal hospital renovations that has occur over the last 100 years and imagine they do the best they can. I am not siding with Administration nor the nurses...I think instead of reacting to the current day there should be some forward thinking on planner's part as to what really needs to change and if it includes diversions then so be it.

    Lastly about Hospital calling Diversion status: When a hospital calls a diversion status it means the hospital is currently unable to provide care in an emergency-- ambulances are then asked to divert to other hospitals. It does not mean the hospital emergency room is closed, it is notification the current patient load is being exceeded to treat the patient in a timely fashion. The hospital may not refuse care if a patient is brought there (and many of these patient are brought in by cab/family or walk ins). With many hospitals in the past 5 years' diversions have been on the increase some rightfully so some not. Again diversion is mostly related to ambulances and then triage really kicks in. There really is no penalty and the Diversion is usually time limited.

    We can all complain but what we need to do is join together and make some real vocal significant concerns about healthcare changes that are needed, directed to the right people who make those healthcare decisions, in a manner that is "civil" and provide real solutions. We should be able to decide what we need after all we are the ones in the trenches and our history of support has not been a good ride.

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