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Discussion

Hallway beds?!?!?!?

we have started something at our small town hospital that i wonder how many of you have seen.

we are admitting patients to the hallway. we will be renovating our er in the next year so they will not be able to hold our overflow pts. we are currently renovating our downstairs unit so some beds are not available right now. in light of this we are now putting pts in the hallway. in theory this will happen when we are expecting a discharge and the pt will then be put into that room. however last night we admitted a pt to the hallway at midnight. this poor lady slept in the hall all night. she couldn't sleep because the light above her was on all night long (there is no way to turn it out). to use the restroom, we wheeled her into the nearest female room. she was on o2 which we had to use a portable tank. her call bell was a silver ding bell. we had "privacy screens" up but they didn't afford much at all.

i was just wondering if any one else has seen this? i don't see joint commision being happy or the fire marshall. and we have worked so hard to get our press ganey scores up. we finally succeed in that and then this. :angryfire each hall can hold two hallway beds. this would take our normally 22 bed unit to 24 pts. :bugeyes:and no extra staff is allotted. we are frustrated anyway and this is just making things worse. we are all supposed to be "on the bus" and most of us are feeling that the bus is just running us over. :banghead:

sorry this is so long, but i would appreciate any responses.

thanks

nitenurse02:nurse:

Featured Replies

This actually is pretty routine in my 750 bed Florida hospital, during the busy weeks of the snowbird season.

The problem, I work Oncology - the patient are either neutropenic, septic, vomiting, GI bleeding/diarrhea....which means that they should not be in the hall.

  • Experts

Hallway medicine is a common problem in many urban hospitals. In Canada where health care is a single-payer system with the funding provided by the provincial governments, several election campaigns have been run focusing on hallway medicine, it's such a big problem. In my province the solution is something called "full capacity protocol" meaning that we're now putting stretchers in between the two beds in semi-private rooms with no regard to gender, or putting a second bed into private rooms. Wherever a stretcher can be shoe-horned in, that's were the patient goes. It's created a lot of problems for the health region because nurses are being injured trying to provide care in overcrowded rooms and patients are complaining to the press...

Putting a stretcher in between 2 beds in a semi-private room??? OMG !! What next? I'm speechless.......:uhoh21:

This sounds like a disaster waiting to happen... I could spend all night going into all the "what if's" As a former firefighter a rescue in this type of situation could be a nightmare, probably resulting in fatalities. That's just a worst-case scenario, what about the poor nurses who have to care for all those unhappy patients, crammed in like livestock. Not humane at all.

I would refuse to take a "hallway patient". All nurses should. Hospitals were built to hold a certain capacity. If they want to add to that capacity, then they need to build a new wing. Saying that they will only assign hallway patients when expecting a discharge is just a pretense, as you have already witnessed. This is just another scheme to generate more profit without considering the nurses or the patients. :down:

Is it more acceptable to keep admitted patients on stretchers in hallways in the ER?

Of course we have already had this debate a few weeks ago...hallway medicine

My husband was a hallway pt and it was TERRIBLE! He was 6 days postop Aortic Valve replacement, on O2 and admitted for fluid in the chest/pericardial sack just 24 hrs after discharge. He stayed in the hall 30 hrs, next to the doors where the medics bring in pts, (and the wind was blowing), had to crawl off the gurney twice to find a nurse because his portable O2 tank ran out, didn't have a call button, and missed his meals because "hallway pt's usually don't get them!" And was dehydrated as he had a Hep Lock but there was no where to put a water container! And I thought we lived in the USA, not a third world country. Then when I called to check on him, the hospital said he was not a pt there because hallway pt.'s don't have a room number! Of course I thought he had coded and they "forgot" to call me...

The problem, I work Oncology - the patient are either neutropenic, septic, vomiting, GI bleeding/diarrhea....which means that they should not be in the hall.

Or all of the above. Don't ya just love oncology sometimes?

Thank God we don't have an ER, and working on a very specialty unit, we don't get extra admits beyond what our beds can hold. We haven't been full above capacity since I've worked there. I believe we would just refuse anymore transfers. We just built a new unit and there's plans for 3 more.

Is it more acceptable to keep admitted patients on stretchers in hallways in the ER?

No, it's really not acceptable there, either. But an emergency room is for, well, emergencies, so situations aren't always ideal. On the floor should be more "civilized" just because of the much longer-term aspect of care. A lot of things in the ER aren't always "acceptable." Do you always know full medical history or what meds and doses a patient is on before treating them? Do you always have a chance to get an interpreter before treating a non-English speaking patient? I'd guess no, but if it's truly an emergency, that's not that most important thing at that moment. Hopefully those things can be resolved once the patient is stable and on the floor, though.

Acceptable and necessary don't always mesh well.

I work in a large county hospital and until our new ER was built we had hallway patients in our ER. Hallway patients are doable but you have to consider the acuity of the patients you are putting in the hallway! Not any patient can be put in a hallway bed...

I don't think that JCAHO or the fire inspector would look at it too favorably. And the practice of sliding a stretcher in between tow beds (with no regard to gender!) is shocking to me. It has all the makings of a tragic story should there be a disaster to strike the hospital. Patient rescue would be severely compromised and patient accountability would go straight in the toilet.

The bottom line is that the suits at the top have to realize that full means full. It is unfortunate if you are the only hospital in a rural area. So accomodations may need to be made on occasion, but these hospitals should also have tangible and safe overflow plans in place. And of course during true times of crisis there may need to be some accomodations made, but these are in fact rarities.

I know that some places have a "fast track" portion to their ER so they don't take up a stretcher or room for someone that doesn't necessarily need one. ER's by me are fairly close in proximity, so it is not uncommon to hear an order to the ambulance that So and So hospital ER is on divert.

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