Handling New Admits in a Fair Way

caliotter3 · May 12, 2010

Anything should be done in a fair manner, and this is one thing that is easy to do. Give each new admit to a different nurse, unless there is some overriding reason why a certain nurse should not get one. Perhaps, that nurse is overloaded to begin with.

nialloh, RN · May 12, 2010

I do charge a lot on my unit, and we try to give everyone an admit before we go around again. Also, floats to our unit will usually be the last to get one as they are already uncomfortable on a strange (to them) unit. the only exception is if one nurse has fewer patients they might get another one sooner, but we try to avoid this.

As to getting multi admits back to back because all the empty rooms are in your section is not only unfair, its a little unsafe. How are you to care for your other patients if you are doing all those admits. And your charge who was doing this should remember, God gave people legs so they can walk a little bit to get to another nurses section. Its not a great strain.

kathy313 · May 12, 2010

I work on a really busy med-surg unit, admits and discharges fly through there. Yesterday, my assignment completely turned over. The charge tries to space them out, but sometimes the acuity level for one nurse isn't quite as high as the others. It sucks, but the work's gotta be done.

Propranolol · May 12, 2010

We have a board with new incoming admissions/transfers. If everyone has 5 pts and one nurse has 6 pts at the beginning of the shift, that person is last on the list to get an admission/transfer. Thats ridiculous that they would give you all those admissions because you have open rooms on your side. Sometimes i'll have 2 admissions and they are on the opposite sides of the unit. Not a big deal.

kcochrane · May 12, 2010

If there are alot of empty rooms, they will try and break up the assignments so that everyone has a empty. If not, they will rotate admits.

Ahhphoey · May 12, 2010

That doesn't sound very fair. The person who made the original assignment should have took into account where the empty rooms were and took that into consideration when making the assignment, even if it meant people couldn't have all their rooms side by side down the hall. When I do charge, I have to consider where the next admission or two can go and which nurses will take them for the oncoming shift.

monicanurse · May 12, 2010

Ive never done charge on this floor but I really thought I was being taken advantage of. I think being in charge though is not the easiest job but I also agree with the above opinions that sometimes you have to use those legs that god gave you to take an admit if it relieves the other nurse from taking all of them because she has the empty rooms.

locolorenzo22, BSN, RN · May 12, 2010

admits are a LOT of work...let's be honest. and if you already have a patient load, and you've had a admit, I'll be honest...I will not be ready for another one for a while. Last night, I had 5 patients.....admit that came up during report, and a discharge that days had done NOTHING for discharge. I had to enter papers, d/c note, resolve careplan, teach, and get doctor orders.....took me about 1.5 hours because I had to go check my admit, see my other patients, etc.....then I had to admit patient from before......finally at 2030, my now 4 patients were ok. I couldn't take another one right then, and my charge is going "ok, you know your admit is coming?" I quickly said NO...I'm not taking it! I can't I have a pca, a continous dilaudid drip and 2 fresh sxs....not happening right now...maybe in a hour I can take the next one(that we never got).....thank goodness we all help out and take turns.

It's crazy to give em to you just because you have empty rooms...now if something happens and you lose one, and you have less patients and have had the admit, you should take another one to even out the load.

emoening · May 13, 2010

Our original assignments always include an extra room or so (unless we're full of course). That way new admits can rotate. Our max is 6 pts. If someone already has 6, they will not get an admit. The nurses who have only 5 pts. would get the first admits. If everyone has the same amt. of pts. (rare occurance) the admits will start at the top and work their way down. At any rate it's still ALWAYS rotated, never will one nurse get 2 admits back to back without any other nurse getting one. Sometimes it works where one nurses will have the same 6 pts. all day and never get a new admit, where the other nurses will discharge several and then get several back. Our charge nurses are great about taking admits, where if everyone else is drowning, they will take back to back to back admits until we're caught up. I think this is a great system but it only works because A.) our charge nurses are awesome, fair, and are more than willing to help out. and B.) all of us staff nurses are very team-oriented, and even if I have 5 pts. and someone else has 4 and is about to get an admit, but still can't handle it, I'll take it if I can (making me have 6 and someone else 4). We are all very helpful toward one another and will make it work whatever the circumstance, even if that last new admit has 3 nurses doing things for them, just as long as it all gets done.

Caffeine_IV · May 13, 2010

I work charge and I rotate admissions and usually take the first one myself. If all of the empty rooms are in a certain section then we just have to walk. Simple as that.

TDCHIM · May 13, 2010

@monicanurse: My goodness, is your charge nurse an ex-waitress? That empty-room method is the way I used to get three tables in a row sent to my section way back in my first college days! "Well, your section is empty, so you need to take them...." It ran me off my legs just trying to handle it in a restaurant situation - I can't imagine trying to deal with it in a health care setting!