High care area

nightmare, RN · Mar 16, 2008

My immediate thought was 'how are you going to staff it?' Will this be a 4 bedded room?So you would need at least one nurse 24/7 just for that room.Will they give you the extra staff or will this just put added pressure on the staff already there?

scattycarrot, BSN, RN · Mar 17, 2008

I would be very wary about this personally. As Nightmare pointed out, it would need a staff nurse for that area and area only and support staff as well, ideally. How likely is it that they would stay in that room and not be 'expected' to help out in other areas, especially if he/she has not got a full quota of patients. You would really need a seperate bay for such an area and what about monitoring equipment and just equipment in general. Would that area have its own specified equipment, eg..each bed monitored or would it share with the ward...meaning long treks by the one nurse to find the ECG/BM/dynamap/whatever machine. Who would decide how sick a patient needs to be before admission to that area and/or transfer to HDU/ITU. Would there be policies in place saying what types of patients can be admitted, for example,patients requiring BIPAP or cardiac or invasive monitoring. What would be the medical cover? Would it be the SHO for the ward or would they have at least a resident overseeing the area and on call 24/7. Where would the money come from to fund this? Would it be out of the exisiting ward budget or would it recieve its own funding?

Just some thoughts......not very well expressed, I might add. Its late!!

allnurses Guide · Mar 17, 2008

Thanks both. There would be extra staff which is why I am involved. There was talk of "it won't really increase the workload" to which I responded pahh!!!!! not on my bloody ward you won't

Anyway, yes there will be more staff, it will be in one of our big bays which at the moment takes 9 patients but I would like to see that 7 high care if we have to.

Patient types will be big post ops, those who need chest drains / TPN / close monitoring and regular bloods

not for CPAP / BIPAP maybe invasive monitoring

I am very wary as I spent all day yesterday with a deteriorating patient who should have gone to HDU but because of bed pressures we were told special him on the ward. I think it may end up as an excuse to dump HDU patients on us too early.

ANy other thoughts

nightmare, RN · Mar 17, 2008

I would say drop the number down to 4! In my past life I worked in a HDU with 4 patients. As they all had 15 obs, ventilators,and all the other bells and whistles you went round and round a bit like a hamster on a wheel ,but it was do-able. Put it up to 7 and you will need roller skates!

Call me cynical but I also think your thoughts are right,you will be getting patients who should still be in HDU so that they can free up a bed there.

RGN1 · Mar 17, 2008

I agree with all the above - despite what you've been told I bet you'll end up short staffed for it & with patients much sicker than you were originally expecting.

If they want a "step down" unit for sicker patients they should build a new ward & independently staff it. IMHO!! I wouldn't be happy if I was a staff nurse on your ward knowing that was on the cards because I would just know that I'd end up with extra workload & no support.

scattycarrot, BSN, RN · Mar 17, 2008

I agree with RGN1. It has 'dumping ground' written all over it. If it was to go ahead, I think 9 beds is ridiculous and would even suggest a maximum of 6 beds with 2 nurses. Big post ops are so time intensive!

Good luck with this!

allnurses Guide · Mar 17, 2008

Thanks all, your comments have been really helpful

nightmare, RN · Mar 17, 2008

I hope you get on OK with this ,Sharrie.

allnurses Guide · Mar 17, 2008

Thanks, me too. THe only reason I have agreed to be involved is because I have a feeling it is going to be implemented despite any opposition so I figure if I can have a say and take a bit of control then at least the nurses voices will be heard.

If it is going to happen it will happen properly and fully supported and at least if I am leading the project I can influence this.

yes yes head in the clouds but I'll keep trying :smokin:

nightmare, RN · Mar 17, 2008

Thanks, me too. THe only reason I have agreed to be involved is because I have a feeling it is going to be implemented despite any opposition so I figure if I can have a say and take a bit of control then at least the nurses voices will be heard.
If it is going to happen it will happen properly and fully supported and at least if I am leading the project I can influence this.
yes yes head in the clouds but I'll keep trying

Good thinking ,Batman! :lol2:

RGN1 · Mar 18, 2008

Sharrie you're going to have to be mighty strong on this one then! Any fears you have need to be written down officially in black & white so if the proverbial hits the fan (as it probably will) at least your rear end is covered!!

PHEW!! I think I managed that without breaking the TOS on language!!