internal waiting room

[LoveMyBugs]

Anybody have these in your ED? Management has decided that the ED times are too long. They have hired a consultant who has implemented an internal waiting room. The idea is when beds are full, we take the patients who really don't need to be on a gurney and put them in our new internal waiting room, opening up those beds, and finish treatments and discharge there. We do have a quick medical exam/fast track area as well. Has anyone worked in an a hospital that does this? What concerns most of the staff is the new internal waiting room is one of our larger monitored beds.

[Uptoherern, RN]

our hospital has now started a "bedside triage" rule. If there is an open bed, pt gets thrown into it. Am willing to try.......since we were told basically we would be fired if we don't. mgmt seems to be breathing down our neck. If 10 pts and 3 ambulances all arrive at once, and there are 4-5 nurses total in the ER, then someone is probably gonna have to wait at least a little bit, aren't they? Apparently not. Throw them in a bed. The nurse assigned to that bed is supposed to triage (sometimes, I geuss, the doc might get there first).

I don't know how this is supposed to work, haven't had any formal meeting about it. What about the "ankle injury" sign in who actually had a syncopal episode due to an underlying heart px who is thrown into a fast track bed? Move 'em out, I geuss. Hope you have a bed in main ER, because it may hold a 15 year old "chest Pain" who has a cough. Sometimes, pt's are moved in the computer and look as though they are in a bed,, but aren't. Where are they? Does a nurse have them in the bathroom? are they in the waiting room still?

If this works at your hospital, please offer some encouragement. I geuss the bottom line somewhere has to be $. Move faster, work harder, get em in, get em out.

[LoveMyBugs, BSN, CNA, RN]

our hospital has now started a "bedside triage" rule. If there is an open bed, pt gets thrown into it. Am willing to try.......since we were told basically we would be fired if we don't. mgmt seems to be breathing down our neck. If 10 pts and 3 ambulances all arrive at once, and there are 4-5 nurses total in the ER, then someone is probably gonna have to wait at least a little bit, aren't they? Apparently not. Throw them in a bed. The nurse assigned to that bed is supposed to triage (sometimes, I geuss, the doc might get there first).

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That is kind of what the are doing with us now. Before a CNA would sit at the window, sign people in, if it was something really bad, then we would notify the triage nurse. What they now have done is a RN sit at the window ask what the CC is then determines if they go to fast track or direct to a bed. The triage nurse dosn't really triage anymore just directs traffic, they no longer get vitals or history. They have eliminated a lot of what we can use fast track for, their problems have to be able to be resolved in 15 min or less, if it takes more time, they need a bed in the back. Which is where the internal waiting room comes up, get them to a bed get them seen then transfer them to the IWR to finish treatments up.

The last two days every RN that has had to be at the window hates it, before the triage nurse wasn't subject to all the verbal abuse that you get from the waiting room and phone calls, now they have to based on a conversation detrimine where the pt goes, plus answer all incoming phone calls and deal with visitors. They brought the concaultant in because the door to physican times where long, not door to nurse, or door to bed, but door to physican.

[TraumaNurseRN]

We have a huge ER and it still has times when the triage room has people waiting. It's true they throw minor ailments into main beds when they aren't open beds in the quickcare side and it's frustrating for all the reasons listed previously. The ER system isn't going to change....