Quote from fergus51
You keep vented patients on med surg? This is exactly why I avoided medsurg like the plague once I finished school. I have never worked in a hospital that had enough ICU beds....
In order to create critical care beds and to get chronic stable vents out of critical care. Our unit has four rooms designated vent rooms. Believe it or not all persons on vents are critical (there are vents in nursing homes and even vents at home, for people like actor Christor Reeves). Anyway, they have to meet strict criteria to come to our floor. The nurses taking care of the patient has to good to a vent class, and 24 hours of precepting in the critical care unit with vented patients.
We've been doing this about six months now and it's working out well. So far we've only had two vents at a time. Our manager is very hesitant about having 3 or 4 vents on the floor. They are never more than a 3:1 assignment, so while they are stable they are not part of a full med-surg assignment.
When we are short staffed, the charge nurse is usually the one assigned the vents. We were going to get a vented patient to our unit today that's been in critical care taking up a critical care bed for the last six months.
I wish we had the budget and staff for a real step down unit. My patient really wasn't crashing and burning, or needing a vent, just hypotensive and needs q1h vital signs checks and I&Os, which can't be done on a med-surg unit. She would have been a perfect candidate for a step-down unit.