Direct Admits - page 3
I am just curious.............................. Do your facilities allow patients to be admitted as a Direct Admit, meaning they are admitted Directly from the Doctor's office or even sometimes... Read More
Jan 4, '03Occupation: ICU RN Joined: May '99; Posts: 299; Likes: 35I worked med/surg many moons ago and ICU far more recently. Got direct admits in both places. Sometimes it was OK, sometimes it was a dangerous fiasco.
If someone is sick enough to be admitted to the hospital, they should be seen by a doctor before they get to the floor. If they are sick and go to the doc's office, I have no problem with him sending them over as a direct admit without a trip to the ER. IF and ONLY IF he sends orders with the patient. (Or faxes them, whatever.) You can't have an inpatient with no MD orders or assessment, period. Too much liability for the nurse and more importantly, too risky for the patient. (If they are stable enough to wait 8 hours for treatment until the doc comes in, they could have done that at home or in the office.)
No patient should be an inpatient without being seen by a doc to make sure that a) what the patient SAYS is wrong is really the problem and that b) the patient is placed in the appropriate unit.
If the docs are sending patients from their offices to the floors without orders, that's something for the floor manager to address with the doc. If the patient is sent from home to the hospital without ever seeing a doc, then they should go to the ER to be seen to protect the patient and the nurse. If the ER docs feel they are being abused, let them take it up with the PCP's.
There will be occasional exceptions that might be OK- cancer pain management, an obvious exacerbation of a known chronic condition with a known treatment... But in general, I think we shouldn't accept patients into beds until they are seen by someone.