Hallway beds on the floor/overcrowding

[cardinalRN]

My hospital is about to start a new program that will place 2 hallway beds on each floor to help relieve the number of ER holds. The patients that are placed in these beds will have to be ambulatory since they will have to walk to the visitor bathrooms, as they will not have their own. They will simply be at the end of the hallway, with a curtain.

The hospital recently opened a new floor which is supposed to be ICU step down, but because of the amount of patients holding in the ER, it is currently being used to house the ER hold patients...and is full every day. The opening of this floor for its intended purpose has already been delayed for 2 months because of this. There are days/nights when we are holding 30+ patients that are waiting for beds. They end up being held in PACU and essentially any "closet" administration can find to stick them in. Nurses are pulled from the floors to take care of them, which leaves the floors short-staffed. And this happens EVERY night (I'm a night-shifter). I've asked why we don't transfer patients to other facilities, and the answer I received was 1) there aren't any beds available within 200 miles, and 2) that would mean a higher level of care which the patient doesn't qualify for. I don't know if this is true or not.

The hospital states that there have been studies done that show patient satisfaction is higher with the hallway beds. People feel they are getting better care on the floor, rather than being kept in the ER. I looked online...and sure enough, there are studies that show that. I'm just embarrassed, honestly. We already have hallway beds in the ER, but having them on the floor just seems crazy to me. A patient, a bed, and a curtain! I don't even know how we'll have room for a bedside table! And what about when family visits?

Has anyone had experience with this? Does your hospital do this? I'd love to hear from others on this issue.

[Nurse SMS, MSN, RN]

My hospital doesn't do this. I am glad we don't. It sounds like a HIPAA and infection prevention nightmare.

[MrChicagoRN, RN]

So, are these observation beds, or considered real beds? How long are they in hall beds?

You really have that many patients that are ambulatory, don't need call lights, yet need hospitalization?

Unless your facility is in an area severely under capacity for beds, it makes me wonder if this is increasing surge capacity or a way to routinely do business. I wonder if they are doing enough to shorten LOS and facilitate discharges in order to open up beds.

[NicuGal, MSN, RN]

TJC will have a lot to say, I would think. Is there monitoring, a call light?

[Rose_Queen, BSN, MSN, RN]

We don't do hallway beds. However, when there are only X number of beds available and X number of patients waiting in the ER, designated single occupancy rooms become double occupancy rooms. Fortunately, these are rooms that were previous doubles, so although tight, they aren't impossible to move in. It does suck for the patient that was enjoying the private room, but unless there is a reason they have to have one, they aren't guaranteed one.

[applewhitern, BSN, RN]

Many, many, many years ago, I was placed in a hallway bed when I was in labor with my first child. Apparently every woman in the state decided to go into labor that night. After I finally got a room, the woman in the bed next to me (semi-private room back then) got a dose of some pain medication and promptly coded. Back to the hallway I went! I wasn't a nurse then, so you can imagine how embarrassing it was to be 21 years old, in labor in the hallway.

[dudette10, MSN, RN]

I'm not schooled on diversion, but I know it's a big deal. However, does your hospital EVER go on diversion? Sticking patients wherever you can find space sounds like a nightmare. How does one staff for that, considering that most grids are based on available beds?

[applewhitern, BSN, RN]

Not every hospital uses The Joint Commission for accreditation; mine does not.

[Guttercat, ASN, RN]

Did anyone else read this post and think, "Really? Really???"

[NicuGal, MSN, RN]

If not TJC them the health department... We got slammed when they were in our department and we were doubling up kids in bedspaces and transport monitors...we got cited for going over our bed capacity and had 24 hours to find some of those kids somewhere else to go. I would be not happy to be parked in the hall, that is for

Sure!

[MunoRN, RN]

Exceeding the number of licensed beds is a Health department violation, which is much worse than a JC violation.

[OCNRN63, RN]

​This is a lawsuit waiting to happen.