Is there a time frame for a patient to be seen by an attending MD once admitted?...

[angelinaRN1974]

Hello fellow nurses,

First, can I stand on a soap box and say, "No more admissions @ change of shift!!!!!!!"

Okay, so I'm working nights on a tele/step-down unit...I'm a traveler on my 3rd week @ this hospital. Last night I got a patient who rolled onto the unit 30 minutes before shift change. He came up from the ED with some holding orders and the nurse giving me report had just gotten off the phone with the attending MD who gave her a page of some more orders. He was admitted with nausea/vomitting/diarrhea and 'rapid afib' (which actually was sinus tach on our monitor AND the 12 lead from the ED). To make a long story short, I was on the phone all night with the consulted cardiologist and pulmonologist and eventually transferred the guy to the ICU after his second blood gas showed a pH of 7.12...Most hospitals I have worked at have had a hospitalist in the facility who comes up and sees the patients admitted on the night shift. This hospital I am at does not have this which seems a bit strange to me as evidenced by this patient I am referring to who had not been examined by a doc (other than in the ED) all night.

Does anyone have any feedback on this?

I definitely used all my resources last night...charge nurse, other more experienced nurses...in this case...But I feel uneasy now thinking about the fact that he had not been seen by an MD since admission. Am I being paranoid...? Expecting too much?

Thanks for listening:)

chow:)

[DutchgirlRN, ASN, RN]

The policy where I work is 8 hours. Seems too long to me.

[sweetielin]

if a patient gets admitted to our hospital, the doc sees them the next day. one particular doc doesn't see his patients on weekends. so if one of his patients get admitted friday after he makes rounds (usually about 1pm), they don't get seen until monday afternoon:o. i thought this must be illegal, but i do not know the policy on it.

[P_RN, ADN, RN]

By holding orders do you mean....admit to service of Dr.______ and call him for orders?

Pardon my French but that patient should fire that doc. And the "consultants" didn't see the patient either? I bet they billed for the consults. Oh that burns me.

IMHO and I have no literature on this, but anyone admitted to a monitored bed should be seen within the hour. Did the Nursing Supervisor get involved?

[ZASHAGALKA, RN]

Our hosp policy is 2hrs for critical care/L&D, 4 hrs for everywhere else.

This is a function of hospital policy and i'm SURE the time limits are spelled out in policy. As a traveler, you should make it a habit to become familiar w/ the hosp policies of the places you work - you will be bound to them in court.

Take this example: IF the policy is 4 hrs and something bad happened in hour 6, when you are on the stand and are asked, "what would a prudent nurse have done?" The answer - made an attempt to reach the doctor, or followed the chain of command to get one of his superiors (i.e. Chief of Staff).

By not doing so, you breached your duties and could be found guilty of neglect. I know, it's not your fault the doctor didn't come see the patient. But it IS your fault that you didn't act on the pt's behalf to get that doc's superiors to come see the patient once it was established that there was a breach of care. You are the bedside nurse; nobody is in a better position to know that the pt's needs weren't being met, and to act on that knowledge, but you.

~faith,

Timothy.