How visible are your patients in your ICU?

[bobarb, BSN, RN]

We recently moved into a new unit, and it is beautiful.........but we have some concerns. Our pt. rooms have walls, and just the doors are glass. It is in a small rural hospital, and it is just 3 rooms, but I can only see into one of the rooms, in the other two the patients are not visible from the desk. We used to have cameras in our rooms, but mgmt. now says no cameras, that we have to use bed alarms or personal alarms and that should be sufficient for our patients. I am watching them on the monitor (no tele techs) the only RN on the unit, no CNA, no body, and I am complaining that it is unsafe. Especially if I am in another pt. room, and another pt. is ringing or crawling out of bed. My main question is - are you able to see your patients in your ICU? My manager says that in most hospitals you can not see your ICU pts........I can only speak for 4 hospitals that I know for sure you can. I am frustrated, especially if a pt. falls or has some rhythm event and I miss it. Ideas?

[Kymmi]

Let me see if I understand this right....are you saying you are the ONLY person working in a 3 bed ICU? If thats what I understand then I think you have bigger concerns than if you can see your patients.

To answer your question I work in a 8 bed CVICU and we cannot see all of our patient rooms from the main desk but we have pods between every two rooms where we sit and we can view both rooms from one pod.

[midnite688]

All of our rooms have glass walls and sliding doors on the end so you can see your pts from the front. I have never seen an ICU where you can't see your patients.Heather

[nursingpower]

I have never seen an ICU where you can't see your patients. WTH?? Its critical care for pete's sake.

We have curtain dividers. One "walled room" for isolation. For the most part our assignments are right across the hall from each other. So we have eyes on just by turning our heads. Sometimes we get rooms next to each other 2 curtains with a sink in the middle divides the rooms.

I wouldn't like walls. I don't know. I work in a CVICU. I have to be able to pass thru walls. If I have a critical alarm I don't want to push sliding doors and walk around obstacles. Most importantly I want to SEE my patients.

Most ICU's that I do know have walls have windows looking directly into the room with the nursing desk (one desk per two rooms/windows. The monitors are near the windows and can be rotated to view thru the window.

Legally I have NO IDEA, why cameras were even installed. They only do those for psych patients. Camera's are a set up for a LAWYERS FUN DAY IN COURT. Whoever did the floorplan clearly didn't consider nursing or patient safety. Must have been a money saving tactic.

[lee1]

I think the best setups are when the nursing station is in the middle with the front wall of the patient's rooms made of glass and you can see into them.

I agree with the above poster, that you as the ONLY person taking care of 3 critical patients is a legal issue !!!! I would look into that more. Who is watching your other patients when you have a problem with one of them?????

A hospital with only 3 ICU beds. Must be lo acuity????? Who transfers out your hi acuity patients???

[morte, LPN, LVN]

being the only person, even if you only have one patient, IS NOT ACCEPTABLE!!

[nrsgnerd]

Boy, I understand your concern. Our unit has glass doors and the nrsg station is in the middle with desks inbetween each room. Our of 17 beds there are only two rooms that are not very visible and so we try to keep confused or unstable pts away from those rooms. I think you need to make sure you are documenting extremely well and bring this concern to the attention of someone other than your manager as his comment, "My manager says that in most hospitals you can not see your ICU pts" is false. You may want to bring up the fact that the hospital may have a lawsuit on their hands if a pt. falls/dies because they were not being appropriately monitored. If all else fails, I would find another job....your license could be at stake because they are not providing conditions that you can do what any prudent nurse would do to ensure safety....and lets face it....in any lawsuit safety of the pt. will always be the number one goal they are trying to disprove in order to win the suit. My best to you!

[Zookeeper3]

Our hospital has a camera in the corner room so you can always see the patient. Another hospital up the road has a camera in three or four of it's ICU rooms. They are not for psyc, have no taping ability so lawyers can't get to that, they are there for safety.

Now three of the main ICU's work in a 180 degree set up with the nursing station in the middle so I can see everyone while sitting at the desk. Our two new "state of the art" ICU's have more visitor space than that for patient care and you can't see the patients. I don't know who is designing this junk but they need to throw out these new floor plans. So in three out of 5 of our ICU's we can always see our patients (everyone of them, all of the time).