No report from ED and patients waiting in the halls.... - page 2

ED is in the middle of construction at my hospital and we all just received a notice from the DON which basically states: ED wait times are too long and too many patients are coming through so...... Read More

  1. by   martymoose
    Quote from nutella
    I wonder if this would be of interest for you :

    http://www.ahrq.gov/sites/default/fi...tflowguide.pdf

    it is from 2011 but is from the Agency for Healthcare Research and Quality (AHRQ)

    .
    Yeah, all I got out of that is that the bottleneck is the " resistance of the nurses" taking on more pts.

    Yup, its all our fault.

  2. by   Kharma711
    Quote from gonzo1
    JC reports state hand off is one of the unsafest times in pt care. For you to get a patient without report first is a gross violation. However, there are a couple of considerations. You have not assumed pt care until you get report. Make sure that you start charting, "report rec'd and pt care assumed at this time" on all your patients. That way when you don't get report you can chart, something like," pt rec'd into stepdown hallway. No report rec'd, pt on portable monitor. Will assume pt care after rec'g report."

    If I were in this situation I would take care of the pt in the hallway, but the chart would reflect that no report was rec'd and pt care not assumed. This may protect you in court as the pt is being taken care of, but you have not assumed care. Since the pt is in the hallway they and their family will be asking all staff for help, and everyone will see what needs to be done and have to be involved in pt care.

    If a pt codes in the hallway this will not be on you, if you follow ACLS quidelines, but rather on the hospital itself.

    This won't last for long as pts and their families are going to be screaming. I would just go along with it for a while and make sure you educate yourself on JC standards of care as far as privacy and hand off and I don't know what else.

    You are a brave soul for staying in such a position, cause I would be running for the doors as soon as my shift was over after having my first hallway pt. I have a feeling this will never actually happen. I have worked a few places where they said this was going to happen and it never has. Too many unanswered questions like how to use bedpan, urinal, hallway crowding and fire codes, no privacy and multiple privacy violations.
    Ha yes a brave soul under a contract for another 13 months... though I am considering a transfer to a different unit...
  3. by   applesxoranges
    We don't really call report at my hospital but the nurses have access to the chart. Even before, we would fax an SBAR sheet. I usually try to give a verbal but some nurses don't like it. We tell them they can look at the chart, they are supposed to look at the chart in that time frame. Then they can ask questions.


    Some frustrations from the ER in the floor looks at the chart is that they were telling us they couldn't tell who admitting doctor was (it is in the admission order) or they want to know where the IVs are (where it is documented?)


    If they are just dumping them in the halls, that is weird. However, there needs to be a balance. Holds in the ER are extremely dangerous and can be the most dangerous periods for patients. ERs are not set up to be the units. You constantly get new patients. I've worked in places where I have had 2 ICU patients plus 3 other patients in the ER. How is that safe?


    I do wonder about the stretcher because usually ERs want their stretchers back. In general, they need to clean the rooms quicker.


    To be honest, a lot of ERs utilize hall beds when their beds are completely full.

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