Inappropriate ICU admissions

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Although the majority of our patients require ICU level of care, we occasionally get "dumped" on by the triage doc. For example, I had a old codger with severe constipation who was ordered for Q1 tap water enemas!! The reason we got the patient was that it was too much work for the floors. My end of the unit stunk to high heaven!!

Anyone else experience this "dumping" phenomenon?

Specializes in ER, MS, ICU.

MS nurses rock! I was a MS nurse long b4 an ICU nurse. I get so ill at the docs for short selling them.

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Specializes in icu/er.

aint got nothin but praise for floor nurses. esp at my hospital, never worked floor fulltime before but i'll sign up for a shift every now and then for some extra $ and its all i can do to keep from running around like a headless chicken. 6,7,8 sometimes 10 pts per nurse....too much.

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I work in a public hospital in Australia. We get dumped on frequently. A classic is when the anaesthetists can't be bothered to reverse the patient in theatre. Instead of going them to the PACU unit and then the ward; we get them vented and sedated until the morning. Nice one, guys.

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Specializes in Med-Surg Nursing.
Our small 8 bed ICU has the same issues. We were recently schooled in the difference between a "DNR pt" and a "comfort measures only" pt. Our nurse pt ration is 3:1. The other week, there were 2 floor pts in the ICU so instead of having max of 3 nurses for 5 pts, there were only 2. One pt was on a vent and coding and another pt was in full blown DTs and trying to fight with the nurses. It was a total fiasco!!! One of the nurses turned in her notice....and they wonder about job satisfaction! Our docs are a piece of work...they put pts in ICU b/c we don't continually call on every little issue and according to them "they get better care back here." I resent them slighting the floor nurses b/c they can not help it if mgt staffs by numbers instead of acuity to save the almighty dollar! We are always excited to have a "qualified, real ICU pt"! I am, however, relieved to see that our unit is not the only one that has these issues.....some of our "non-ICU pts" stay there so long that they grow roots and sprout leaves and have to dug up from their bed and removed from ICU usually in protest to family and pt.

Sounds like we work at the same place! The last two weeks, over HALF of our ICU pt's have been DNR's upon admission to the ICU. Admitted a pt last night...from a nursing home...resp difficulties due to MI(being treated medically--heparin gtt) but he's a DNR so we aren't gonna tube him. Was told he's "too much work for the floor nurses" and "he'll get better care down here".

Last Friday, the floor transferred us a pt who again was a DNR in resp distress...since her nurse doesn't like dealing with sick pt's she basically INSISTED that the house officer(new doc 1 month out of med school) transfer the pt to us, taking our last bed. EVEN our nursing supervisor thought it was a bogus transfer. That nurse pushed the pt in her bed into the unit, then immediately turned around and walked out of the ICU, saying as she walked out..call me if you have any questions...nice huh? I'm thinking I need to write her up for that one. Told the on duty nursing supervisor and she supposedly was going to speak to that nurse about that as that is SO not appropriate!!! They had just as many pt's on their floor as we had in the ICU now that they got rid of their 'sick one' who should've just stayed in the med-surg floor since after all she is a DNR at 83yrs old.

Oh I get frustrated with the misuse of inappropriate ICU admissions at my place!!!:devil:

Give me a pt that I'm actually gonna save....not prolong the inevitable!

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Specializes in ICU, Research, Corrections.

One night not to long ago, I had two pts that were both DNR. I told my

supervisor "do you have any idea how boring it is to have 2 DNRs? Rule

out any chance of an adrenaline rush on this shift."

What is worse is a full code that should be a DNR. How long do we have to

torture these poor souls before there families allow them to die? That is one

of my few complaints about working ICU.

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