Holding admitted pt in ED

[TraumaNurse30]

Every year around October our hospital census skyrockets. Patients who need admission are sent to the ED to wait when beds are not available in the hospital. We hold anywhere from 6-40 patients a day. We even get all direct admits from doctor's offices etc. Is this a common occurance and if so how do you deal with problems (ie; staffing shortages, staff moral, etc.,..) associated with holding?

[AZTRAUMANURSE]

I agree that some preparation should be made prior to holding admitted patients in the ED. It is unsafe not to adjust the staffing levels of the ED to compensate for the increased patient load. The nurse to patient ratio is often much higher in the ED than it is in the intensive care unit or the floor.

[NIC]

Our ED has 15 beds and we very rarely hold patients for more that 6 hours. If it is more than that it is because of the difficulty with the floors cooperating with us. Ususally there are problems with getting patients upstairs to their rooms because their nurse is either in report, on break, on lunch or on a second break, in report again and so forth. Major frustration on the part of the ED nurses and the patients themselve!! No support form ADM either. All they care about is the money and not what is taxing the nurses in the ED.