Hospitals and diversion

mmc51264, BSN, MSN, RN · Jan 26, 2015

No, we are a level 1 trauma and are divert a lot of the time

AJJKRN · Jan 26, 2015

We stack 'em like sardines :roflmao:

classicdame, MSN, EdD · Jan 26, 2015

AJJKRN: Not sardines, surely. More like caviar (in consideration of patient satsifaction):)

We try never to be on divert, but it does happen.

Editorial Team / Admin · Jan 26, 2015

Extremely rarely. I think the only times we've done it was when we had a mass casualty event going on- full ER and trauma divert (except those related to the mass casualty), and another time when both trauma surgeons on for that evening, the neurosurgeon, the orthopedic surgeon, and the cardiac surgeon were all in the OR at the same time- trauma divert only. The hospital doesn't like turning money away, plus we're the only trauma center in the county. When we went on trauma divert, all trauma patients had to be flown two counties away.

When we start getting full (or has been the case for the last few weeks), we turn single rooms into doubles, have lots of hallway patients being held in the ER, our overnight surgery observation unit takes on other patients, and units that closed are reopened and staffed with float personnel. About the only thing that will stop us from admitting patients would be if we exceeded every single available area. Heck, we don't even stop elective surgeries- one patient leaves PACU, another patient can go back to the OR. I remember one day where I ended up working a double shift- the last scheduled elective patient entered the OR somewhere around 11pm, but gosh darn it, we didn't cancel a single surgery.

Esme12, ASN, BSN, RN · Jan 26, 2015

Diversion depends on state regulations. IN my state they no longer divert unless there is a internal disaster.

messymissy · Jan 26, 2015

Diversion??? There is no such word according to my facility.

anon456, BSN, RN · Jan 26, 2015

We are the hospital where patients are diverted to. We have speciality areas that no one else in the area has as well as Level 1 trauma. I have never seen a situation such as OP described (patients in the halls, etc), but we have been packed to the gills several times over the past month or so, offering extra pay over OT pay for extra staff to come in. I think a lot of the time we take patients that maybe don't need to be sent to us, because the hospital sending them is nervous about their condition. Once they are sent to us, we have to take them and do the full work-up and observation before being able to send them safely home. We also get a lot of scheduled post-ops for a night of observation and if surgery days coincide with days of high respiratory admits or school breaks (teens doing dumb things and getting hurt), we get very very busy.

ICURN3020 · Jan 26, 2015

Have never seen my hospital go on diversion, while another local hospital seems to go on diversion once or twice a week (literally).

We've also been offered very appealing financial incentives (above and beyond normal OT pay/bonus) to work during these times.

mmc51264, BSN, MSN, RN · Jan 27, 2015

We are also the place where everything gets sent to. That is why we get put on divert. We have ~1000 beds. We get the most traumatic cases so the "routine" emergency gets diverted. Usually to the smaller sister hospital few miles away

martymoose, BSN, RN · Jan 27, 2015

This is mostly for medical patients. Then we put them in the Overflow" then they get mad because they just have a curtain for privacy and no tv. etc, have to walk a bit to the bathroom or use a commode( with only that thin curtain dividing you from the general public walking around on the floor.)They usually are stable pts. Sometimes we have to move roomed pts for overflow. Then THEY get angry at being moved. Oh,and dont forget customer service. How can we provide customer service????

This supposedly was "temporary" It's been like this for months, maybe almost a year. I don't see it being temporary. They need a additional medical area, but this way they don't have to expend any money.

sick of being blamed for this.

Esme12, ASN, BSN, RN · Jan 27, 2015

This is mostly for medical patients. Then we put them in the Overflow" then they get mad because they just have a curtain for privacy and no tv. etc, have to walk a bit to the bathroom or use a commode( with only that thin curtain dividing you from the general public walking around on the floor.)They usually are stable pts. Sometimes we have to move roomed pts for overflow. Then THEY get angry at being moved. Oh,and dont forget customer service. How can we provide customer service????
This supposedly was "temporary" It's been like this for months, maybe almost a year. I don't see it being temporary. They need a additional medical area, but this way they don't have to expend any money.
sick of being blamed for this.

UNfortunately it isn't that easy. A hospital in licensed only for a certain amount of occupied beds. The emergency room doesn't "count" even though they are "admitted". In order to increase inpatient beds there must be proof of need sustainability (sort of) in most states and approval from the Board of health setc before you can have more patient beds.