All floor nurses... please help me!

Nurses General Nursing

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Specializes in NICU.

Ok floor nurses.. I need to know something. I want to know how your floor handles discharges and admissions. Ok say you have 3 discharges in your group of pts... will your charge nurse slam you with admissions? So say.. you discharge 3 patients.. this leaves you with 2 patients. You pick up an extra pt at 1500 due to a nurse leaving. You already get one direct admission... So now you have 4 pts.. Would you still get the next admit even though you just got one? Or would a nurse who has 5 patients already get the admit??

I'm wondering because.. Today I discharge 3 pts back to back... boom boom boom.... then pick up a pt at 3. then get a direct admission and an ER pt both within 5 minutes of each other... Other nurses who already have 5 pts are sitting around drinking coffee and I'm running like a chicken with my head cut off.. What do ya'lls charge nurses do? I get so sick of this happening all the time!! I just need to know what other floors do..

Tiger

Specializes in Neuro ICU and Med Surg.

When I worked the floor as a charge nurse the nurse with the fewest patients got the first admit. Then the next admit went to someone else. Eventually you would have gotten both of those admits but spaced. Everyone took their turn getting the admits. Hope this helps.

Specializes in Med-Surg/Peds/O.R./Legal/cardiology.

Discuss with your nurse manager as to how to divide this up more evenly in the future. Don't use a complaining tone, though, or point out that the "other nurses were just sitting around". Just explain what happened today and ask "how can we do this more efficiently in the future?"

ebear (WAR EAGLE!!!!!!) :paw: a REAL tiger of AUBURN UNIV.

Specializes in Med/Surg.

On our floor ,the nurse with the fewest pt's would get the 1st admit (unless something critical was going on with one of the current pt) The 2nd pt would go to the next nurse even if she hadn't had a discharge if she just had 5 pt's assigned. ( O n our floor 2 staff have 6 pt and 2 have 7 if we are full.) Sometimes getting two pt's at a time can't be helped but the nurses that are "sitting around drinking coffee" would help. Either go asses and get the history on the ER pt or go draw the labs and start IV ,ect on the direct. Or what ever would help get the new pt's settled. It's team work all the way on our floor. Charge nurse helps out and so does CM when we have lots going on.

Specializes in NICU.

One nurse did write my MAR.. The charge nurse had to go to an ethics meeting during this so she wasn't much help.

Specializes in Med/Surg and Wound Care, PACU.
Ok floor nurses.. I need to know something. I want to know how your floor handles discharges and admissions. Ok say you have 3 discharges in your group of pts... will your charge nurse slam you with admissions? So say.. you discharge 3 patients.. this leaves you with 2 patients. You pick up an extra pt at 1500 due to a nurse leaving. You already get one direct admission... So now you have 4 pts.. Would you still get the next admit even though you just got one? Or would a nurse who has 5 patients already get the admit??

I'm wondering because.. Today I discharge 3 pts back to back... boom boom boom.... then pick up a pt at 3. then get a direct admission and an ER pt both within 5 minutes of each other... Other nurses who already have 5 pts are sitting around drinking coffee and I'm running like a chicken with my head cut off.. What do ya'lls charge nurses do? I get so sick of this happening all the time!! I just need to know what other floors do..

Tiger

what floor are you on, you are lucky

i have usually 7-8 patients during dayshift, and yes if you discharge them you get them back, the beds are still warm

nici

Specializes in NICU.

We have 5-7pts on day shift. We only had 5pts today... would of picked up my 6th at 1500 but I discharged 3. We are renal/respiratory.. Almost all dialysis patients...

Specializes in Utilization Management.

It's quite common on my unit. We're very fast-paced and have a very high patient turnover, so I'm used to it.

We do have an Admissions nurse, so all I would have to do for the ER admit is weigh, assess, take vitals, put the monitor on, and orient them to the room. Takes about 10 minutes, as long as the patient doesn't come with any pressing needs that aren't covered in the orders.

But first, I'd go over to the DA and weigh, start an IV (and draw a "rainbow" of labs for the lab work), assess, vitals, get the monitor on, do the EKG, give the ASA, orient them, and hope that the Admissions nurse can get up to do the rest of the paperwork. The reason is that there's a time limit for any patient admitted to get the initial labs and tests done, and I'm very strict about that.

If no Admit nurse, I'll be in and out of that room doing the papers after the critical stuff is done. Hopefully I'll have a tech to help, but there are only a couple that I'd trust to a direct admit. Anything can happen with those guys and they just make me nervous.

Specializes in RN, BSN, CHDN.

We get admits in order, sometimes you get back to back admissions because you may have the only tele beds if you are the only one discharging. I have offered to take a new admission out of turn if I feel I am quieter than the other RN's. We have an admission nurse too.

Specializes in CMSRN.

My floor has encountered something similiar. I work 7p-7a and by that time we only have nurses. (no charge, no tech etc)

If I had back to back admits due to having discharged pt's, most of the other nurses would help me out. It would be my pt but they may get Hx or vitals or whatever they could. Granted, it is still more work on me but it would not be fair to have 4 pt's while they have 6pt's. (we may never see another admit till morning) We find it doable and even if it seems unfair at the time, we all go through it and if another nurse does not help automatically then we have learned to ask. Generally no one turns down helping unless they are busy. It also helps to know that your other pt's are covered by your co-workers while you are with your new pt.

Our floor has our issues but we pride ourselves on teamwork.

The nurse with the fewest patients almost always gets the admits/transfers up to the point that they are even with the other nurses. However this does not relieve the charge nurse as well as the other nurses of their duties to help you to get all the admit paperwork done on those patients. Often you can take all the admits no problem as long as someone does the admit paperwork for you.

Specializes in Neuro ICU, Neuro/Trauma stepdown.

When I make the assignments for the day shift nurses before I leave in the morning, I have a pretty good idea of who is expected to be discharged that day. I take into acct that if you discharge too many, you'll get back to back admits. However, on my floor the other nurses wouldn't be sitting around and not helping with the admits...be they bloody from the ER or transfers from ICU.

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