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Discussion

How do you handle admissions?

I work on a 24 bed Medical unit. I work the evening shift 3:30p-midnight. Our shift gets the majority of new admits. Our staffing is usually 3-4 RN's and 2 LPN's. We do not have techs. Last evening we received 1 transfer and 9 admits. The RN's started the shift with 3 patients and team leading the LPN's patients. During this time frame of 4P-MN we had 3 discharges and the transfer and admits. We also had one of our staff assigned to sitting with a confused pt. Each RN had to do 2-3 admits as well as team lead, care for our existing patients and do two med passes. My question is do you have one RN that is just assigned to new admits? How do you care for your existing patients while trying to process new admits and all the new orders? I am finding it totally overwhelming and I normally have to stay overtime to process all the paperwork. Any ideas, suggestions are welcome!! Is it unusual for your shift to have this many admits?

Thanks

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    When I worked on med surg we had a fast turn over but not as many as your talking about. I can see why your frustrated. On the floor I was on the RN's had 4-6 pts... usually 6. But we had a nurse specifically assigned to admits and discharges. It was so helpful. Except... when nurses on other floors would finally do their transfers to our floor at 6:30pm and your getting ready to do shift change. Thats always a busy time as it is.

    The nurse designated for admits and discharges worked from 8 am to 4 pm. It would have been nice if she stayed a little later but having her at all was a blessing. Hope things get better for you.

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    I work 3-11 and we get alot of DC's and admits too. We are assigned 4 pts OR 5 pts with a cna.We have float nurses if they are not busy to admit the patient to the data base( i believe we have 24 hrs to do this). The rest like all the orders and asessment is up to me. I take vitals, quickly assess, and tuck them in them first.If they are stable. I try to take care of other pts meds and tasks so I can come back to that admit and spend more time carrying out orders. I first make sure though, that a med,fluid, or abx is not needed asap depending on their dx.This seems to work b/c usually I can help the pts I know quickly and then feel good about getting back to the admit and spending more time with them.Good luck!!!

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    Thank you for your advice and info. I don't have a problem with handling one admit or even two spaced out, it is when I get 2 at the same time and then a 3rd an hour later. I can't keep up. And my fellow RN's are in the same boat. My existing patients just have to wait and wait to get any help and I feel terrible. And when you add in the family members of the existing patients following you around to get water, a snack, etc..it is overwhelming. Most of these new admits are starving as they have been waiting in ER for hours, the kitchen is now closed..so I am running around trying to heat up microwave dinners, fetch them coffee, process their orders...on and on. :p

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