med/surg/peds unit

Reabock · Sep 21, 2001

+6

We do it that way at our facility, but we are a small rural hospital with not a lot of peds admissions. After a 9 million + dollar expansion of the hospital, which in fact lowered our beds, we combined Peds with Med Surg. We basically have a Med surg unit that used to be 2 units, think of an H type configuration, with a 6 bed ICU in the middle of the H.( separate unit)

There is also a neuropsych unit, OB, and Same Day Surgery. Guess what, that means all med surg admits come to one unit!!! :eek:

Anyway, back to the subject, I do not like having a combined unit, but then again I am one of the 3 Peds nurses on 3-11 and I'm not a real big kid person, got roped into it unwillingly. We usually only have 0-2 kids at any one time, unless its RSV season, and yes, we have already had one confirmed case on 9/10/01. we usually also have 3-5 other adult pts. We do get charge pay when doing Peds and supposedly are totally responsible for all our own pts, calling Docs, taking off orders, etc. I personally think if we can't do Peds properly and safely, we should not do it at all but then we are the Only hospital in a 40 mile radius. I guess I just do not adjust to change well, and after 25 years in the same facility, I can remember the good old days when it really was fun to come to work and we had good benefits, etc. Whine, whine

P_RN, ADN, RN · Sep 22, 2001

For a short while about 10 years ago our unit was turned into an adult ortho/trauma.....ortho peds unit. Well the peds orthos didn't want to leave the Children's Hospital upstairs so we ended up with 15 beds for peds med/surg. The front hall was adults/ the back hall was peds. 2 parallel halls with the nurses station in the center.

Personally I am an "old" baby type person. But we all had to rotate especially because Children's hospital doesn't use LPNs. We had to use their charting, their medication setups, their equipment. It meant 2 different budgets and 2 different department numbers.

There were many weeks when OUR peds was full to overflowing (cause the peds surgeons just ate up all the attention we gave them) and CH would be virtually empty.

Common sense prevailed after awhile and the kiddies moved back upstairs and finally this ORTHO nurse got to work ortho again.

KellyandtheBoys · Sep 22, 2001

I've worked on one. It was pretty difficult (for me, anyway). It was hard to go from a peds. focus to a med./surg. focus. We usually kept the med./ surg. patients in one area. And the patients we had weren't too difficult. Lap. Chole., Lap. Appy, asthmatics, that sort of thing. And usually we took care of adults OR children in any given night. It was difficult when we got more complicated med. Surg patient and had to combine adult and children patients in the same assignment.

OC_An Khe · Sep 22, 2001

This seems to be the way of the world, especially in smaller community hospitals. The key to this combination is flexibility and assurring that the acuity mix doesn't get out of hand. It should be the Peds RN decision on how many/acuity of adlut patients she takes when she has acutely ill peds patent(s).

smurfynurse · Oct 3, 2001

I work on a unit like that. Personally, I enjoy kids but I don't feel comfortable taking care of them in the hospital. I'm a recent new grad and although I've had the Peds nursing class in school, I just don't feel quite skilled enough yet to be mixing adult nursing care in with peds nursing care. I mean, there are so many differences between the two types of nursing care. Kids are not just miniature adults and for the sake of the kids I think they are too precious to get less than the most knowledgeable PEDS nurse taking care of them. But then that's just my opinion. Also, on the unit where I work we also have patients on telemetry, post surgical, isolation, etc, etc. There is no rhyme or reason to how the rooms are assigned to patients (except for private and semi-private rooms) and there is no rhyme or reason as to pt assignments. We just get a set of room numbers next to one another. We might have a person with chest pain r/o MI, along with a baby w/ RSV, a post abdominal surgery, and a couple more pts in addition to all of that. Don't ask how it makes, I'm still trying to figure that one out myself. But what can I say, it's a relatively small rural hospital.

deespoohbear · Oct 4, 2001

Our small hospital has both med/surg and peds on one floor. I enjoy having peds patients because usually my patients are over 70. We keep the peds patients in the private rooms if they are available, or in the semi-private rooms and just leave it private. We have had RSV kids, pneumonia, dehydration, appys, and whatever else comes along. The only time the peds really scare me is when it is a tiny baby and their airway is crappy. Then I get a little nervous. I usually get that kid shipped to a larger facility PDQ. Our peds patients are spoiled when they come because we don't have a lot of kids usually. We have had an RSV case this year too. Amazing isn't, it? This combinatins seems to work out okay for us. Our hospital just doesn't have enough peds patients to warrant a separate peds unit. We also recover outpatient suregeries and do outpatient blood therapy. We are the general dump station for the hospital. If no other department wants it, give it to med/surg!!!