Census dreadfully low at our hospital, anyone else???

Nurses General Nursing

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For about 3 weeks now our census ha been realy low. Not just our floor, but the whole hospital. Nurses are getting called off or sent home mid shift daily. It's frustrating. They have some staffing matrix that they talk bout, but none of the nurses have ever seen it. They call off the CNA's and unit secretary at a certain number. Then of course the nurses have to stay in ratio, so once we get to where there is one too many nurses, they send a nurse home. Yesterday was horrid. We started with 14 patients and discharged 5 then ended up somehow with 20 by the end of the shift (Our floor can take 30) but they literally slammed us. PACU patients started coming up at 2pm and there were only 2 nurses who could really take admits. Me and an RN. The RN got the ER admits (I am an LVN and cant do the admit assessment) and I got 3 PACU patients, within 3 hours of eachother. I was hanging blood/FFP on 2 of my patients that were on the floor already, and as luck would have it, both of their IV's went bad. One before the transfusion of FFP and the other in the middle of the unit of PRBC's. This patient was waiting to go home after his unit. In the midst of all this they decided to send our CNA"s home and our secretary home. So we had only nurses and a charge with PACU patients coming. It was crazy. The manager was on the phone with staffing and talking about how they haven't met their "quota" for the staffing matrix in a while! Geez! What about SAFE patient care!!!

Specializes in Community, OB, Nursery.

We tend to hover at 110-115% capacity....so anyone needing hours, I know where to find them. ;)

We've been having a problem with low census at our hospital too. I find myself hoping to get new admits so that I will have my hours on my paycheck. Then I realize what I'm thinking, I'm wanting people to be sick our hurt so that I will have money. It's very frustrating. I don't think that a hospital should ever low census their nursing staff, if they have to low census someone maybe the other workers at the hospital that are not directly involved in patient care. I realize that I'm not involved in the overseeing of the facility and so maybe I don't understand how everything works. :twocents:

Specializes in ER.

Not in the ER! Seems like we are busting at the seams lately. Plus I keep getting more and more calls to come in. I think people are not going to their PCP's and waiting till they can't take it anymore. Or they don't have insurance. Hence their flocking to the ER! Little do they know that the $75-150 they may pay for an non-insured office visit pales in comparison to the multi-thousand dollar ER bill that will be arriving. Oh well. Job security.

Specializes in Acute Care/ LTC.

i heard today that one of the hospital here is down 150 beds...

I think it's just the seasonal thing. School's just out, people are travelling. We all know people avoid getting sick when it's "inconvenient." Add in that surgeons are taking vacations now that their kids are out of school, so not as many elective surgeries.

Spend a few years paying attention, and you'll be able to predict census patterns. They'll vary by floor as weather and such makes makes a difference with different conditions. But it really does get pretty predictable when census will be down.

Have to agree though, why is it always nursing staff that pays the price for low census? And if we have to "make do" when the hospital is bursting at the seams and work extra hard with not enough staff, then why can't the budget "make do" when the census is low and let us have a few easy days to balance out the understaffing we usually deal with?

Specializes in Extreme generalist.

Hey our hospital finally has a patient- after none in AC for days! There were a few ER pts. They can't reduce nurses though. One for LTC, one for AC/SNF/ER. More if needed but never less.

Specializes in Cath Lab, OR, CPHN/SN, ER.
Not in the ER! Seems like we are busting at the seams lately. Plus I keep getting more and more calls to come in. I think people are not going to their PCP's and waiting till they can't take it anymore. Or they don't have insurance. Hence their flocking to the ER! Little do they know that the $75-150 they may pay for an non-insured office visit pales in comparison to the multi-thousand dollar ER bill that will be arriving. Oh well. Job security.

Ding ding ding!!! We have a winner!!!

That is a big problem. As people are losing their jobs, they're losing their insurance. They're not able to go to their primary doctor because they either can't afford it or else their PMD won't see them since they don't have insurance. It's two extremes- they either come to the ER for anything or wait until they are on their death bed before coming in.

I know that's a totally other debate and subject, but it does contribute. People aren't having elective surgeries anymore because of insurance, not being able to miss time from work or other money problems.

Specializes in Acute Care/ LTC.
Ding ding ding!!! We have a winner!!!

That is a big problem. As people are losing their jobs, they're losing their insurance. They're not able to go to their primary doctor because they either can't afford it or else their PMD won't see them since they don't have insurance. It's two extremes- they either come to the ER for anything or wait until they are on their death bed before coming in.

I know that's a totally other debate and subject, but it does contribute. People aren't having elective surgeries anymore because of insurance, not being able to miss time from work or other money problems.

that is what i was trying to relate to in another post when i said that "health care is messed up" (about going to ER for non-emergancies)..at least you understand what i meant...people who go to the ER usually have a copay but testing etc is covered in many cases in relation to the ER . if you go to the PCP..not only is there a visit copay , but lab work copay or pay out of pocket, or xrays or other testing that people can't afford to pay for. so they either avoid going until they can't take it anymore..etc etc...

Specializes in ER/Trauma.
Not in the ER! Seems like we are busting at the seams lately. Plus I keep getting more and more calls to come in.
You can say that again.

We have not slowed down at all from the winter. Just yesterday I walked into work at 1100 hrs and there were 19 "holds" (pts. who have been admitted to the hospital but are hanging out in the ED because there are no beds available). NINETEEN!!! Psych, Tele, ICU, Med-Surg, Stroke... you name it, we were holding 'em down here. Close to 40% of our ED bed capacity was being occupied by admitted patients - which meant that triage and bed flow was a complete disaster all day long.

We've been getting slammed like crazy. Last month, census for our (community hospital) ED crossed over 6750 patients ... in one month alone! We've shattered all previous volume records.

I've been consistently working over 44+ hours/week! I was supposed to work 1100 - 1900 yesterday but ended up staying till 2230 to help out because we were so busy (crashing patients left right and center).

And it was my day off!!! :eek:

I mean, it's freaking JUNE; not FEBRUARY! :uhoh3: WTH people??!! LOL

My manager is already begging me to come in on Sunday - he's bribing me by promising me over-time wages for a regular shift. He's desperate but as much as I'd love that cash, I'm heading outta town for the weekend :)

cheers,

no low census down here in gods waiting room....plenty of orifs...knee's...copd exsacerbation...non-compliant diabetics...etoh..and the list goes on. btw..has anyone noticed a sharp increase in the weight of patient's charts lately? i counted 12 out of 32 patients on my m/s floor last night with hospital stays exceeding 3+ weeks.

Specializes in LTC, Med/Surg, Peds, ICU, Tele.

I'm hoping for low census this morning, waiting, waiting, waiting...

Specializes in ER, IICU, PCU, PACU, EMS.

I got cancelled yesterday due to low census and have been floated more in the last few weeks than I have in years!

No ICU patients are causing the ICU RNs to come into the PCU and bump us into other areas. I don't know how that is fair, but it's happening!

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