Let's create the Perfect Hospital!

[ScarlettRN]

After reading the threads about staffing ratios and the shortage, I thought it would be fun to create our own hospital....done the right way! What would Perfect Medical Center be like? In my world....

In Perfect Hospital, there would be an RN to do the assessments and to put out all the fires that get lit during the shift. There would be an LPN to pass meds and an Aide to do patient care. The patient load could stand to be a bit higher with 3 people looking after them and this group would be a team that always works together when they are there at the same time....or have the same schedule so they always work together. They would have to get along and respect each other, but their patients would get the best care available!

There would always be an available unit secretary. The RN would be able to sign off orders and call the docs as needed. In Perfect Hospital, there would be patient transporters and/or runners available every shift. There would be no floating to strange units, as all units would be closed, but because of the excellent staffing, it would be no problem calling in someone if the census takes a huge jump.

Hmmm, what else am I forgetting for Perfect Hospital? I haven't even STARTED on the ED for this facility!

[jnette, ASN, EMT-I]

Gee, this is sounding better and better all the time ! I LIKE it, I LIKE it !!!

Sterh.. I think what you do is WONDERFUL !!! At least you get to touch base with just about everything pretty routinely. I'd like something like that myself... I guess I'm just so nosey.. I'd love to learn and dabble in ALL of it !!!

[Marie_LPN, RN, LPN, RN]

Originally posted by jnette

How about ALL docs orders computerized so they can be READ ?

They would have their own central computer area to write orders, and the orders would be printed out as well as automatically sent to pharmacy as well as the patient's chart on the computer....

Hmm. They went through kindergarten (some did), then grade school, learning handwriting and it's still sloppy. I could see the typos now lol.

Legible physician handwriting. Heck i'd be happy with that as a U.S.

[Tweety, BSN, RN]

Forget the handwriting. The docs enter their own orders at the computer while they are looking up their vital signs, labs, and reading the nurses notes.

[Marie_LPN, RN, LPN, RN]

They'd need to follow their signature with your "I apologize" sig. line, Tweety lol.

[ktwlpn, LPN]

Originally posted by ScarlettRN

After reading the threads about staffing ratios and the shortage, I thought it would be fun to create our own hospital....done the right way! What would Perfect Medical Center be like? In my world....

In Perfect Hospital, there would be an RN to do the assessments and to put out all the fires that get lit during the shift. There would be an LPN to pass meds and an Aide to do patient care.

yech-count me out...I'll stay where I am rather then just pass meds all day..not fulfilling in the least

[Flynurse]

I would love love love to have all supplies readily available when needed. Enough with the, "We ran outta saline flushes, 3cc syringes, and blunt needles. And there aren't anymore water pitchers!"

All equipment used frequently, such as O2 meters, suction set-ups, decent IV poles, feeding pumps, IV pumps, etc. etc. etc, at least one in each room or one for each bed, depending on the frequency of use. It really irks me when we have so many aspiration precaution patients on the floor, but um...."Where's the suction machines??"

And the Pharmacy??? Well...that's a whole other story. I would have one Pharmacist for maybe a small cluster of units with some Pharm Techs under her. This way they can concentrate on specific units. You would be able to call the pharmacy and know that you specifically need to talk to "Jane Doe" about your need. Orders and medications would be picked up, filled and to your unit within the hour. And to help this beautiful senario out we have a tubing system, fax machine, and phone for each Pharmacist's station directly linked to the units they serve!

AHHHHHHHH............Dreams!

Melissa

[flashpoint]

We generally have one CNA, one LPN, and one RN for between 5 and 10 patients. The CNA does VS and basic cares, LPN does meds and basic cares, and RN takes care of meds the LPN can't do, rounds with doctors, and does basic cares. There is a deifnite TEAM atmosphere right now...sometimes by force not choice, but it is NICE.

I would like to see larger rooms...just a foot or two in each direction. Then I'd like to see equipment in every room...thermometers, B/P cuffs, etc...dedicated equipment would be so fun...LOL.

We're working on computerized physician's orders, progress notes, etc. I'd like a ward clerk in the ER, quicker response from the doctors, and more respect for EMS...sigh. :-)

[Marie_LPN, RN, LPN, RN]

TEAM atmosphere DOES describe the perfect hospital!

Not to mention IV poles that have all 5 wheels rolling instead of the usual 2 that marginally scoot.

(And BP cuffs with decent Velcro)

[live4today, RN]

...I could only win the lottery to build the perfect hospital!

My perfect hospital would consist of:

All private rooms big enough to look like a small hotel suite with its own microwave, small fridge, sink, cups, coffee, sodas, utensils, paper products, etc.

The hospital would be built in a circle with the nurses station in the center of each unit.

Each patient's room would have its own computer system for charting, a service area where the meds would be kept under lock and key, a service counter for passing meds specific for each patient's condition, up to date equipment for taking vital signs, etc.

Each patient unit would be a "closed" secure unit allowing two visitors in at a time with specific visiting hours that would allow nurses the crucial time needed to assess and care for their patients.

Every nursing assistant would have to take a 10 to 12 week nursing assistant course, pass the final exam, and receive a certificate of completion when done.

Certified Telemetry Techs would be available each shift to sit and read strips, alert nursing staff to critical findings, etc.

Any doctor who fails to respect my nurses would be counseled ONCE, the second time FIRED. Each doctor would be responsible for touching base with his/her patients nurse once every four hours.

Lunch breaks would be one hour and on the clock. No one would miss their lunch hour, and each employee MUST take that hour OFF the unit.

There would be a MAXIMUM of four patients per RN, one CNA to every eight patients (MAX), and each unit would have their own housekeeping staff.

I have lots more to add, but for now.......I'll pause....gotta go eat and take some cold medicine. HA-CHOOO!!!

[ScarlettRN]

Admissions would be controlled so they don't all come to the floor at the same time.

It would not take an hour to admit patients.

History and home meds would be stored in the computer and much of it available to pull up on subsequent admissions so I don't have to spend 20 minutes asking about history of COPD, MI, renal, liver, diabetes, etc....including FAMILY's medical history!

Care plans would be on computer so diagnosis would automatically trigger certain nursing diagnoses also.

Yes to all who said all private rooms and the accompanying amenities. I just wish all pts had water in pitchers before I bring meds around so I don't have to stop and run BACK up the hall to fill the pitcher. IV polls that roll.

Linen and towels, etc. in a closet every few feet to keep from having to run back and forth down the hall.

What a great hospital we would have!

[Marie_LPN, RN, LPN, RN]

How about a little storage device installed in people? An outpatient procedure done at birth that automatically logs in every med or procedure they have taken. And at admission all that would have to be done is plug them into a PDA, and boom there it is. Then you wouldn't hear "Oh by the way, i have an allergy to penicillin..." after they take the pill.

I can dream.

[tntrn, ASN, RN]

I'd like rooms to be designed by real nurses, not by architects who don't have a clue what we need (like having all the outlets, O2, suction equipment panic buttons, behind the head of the bed and just out of your reach because the fetal monitor cabinet is between you and the wall.)

And I'd also like to have IV cathethers that work like those old ones we used to have, before the so-called 'safety' IV, which IMHO are garbage. They are no safer because there are more steps necessary in using them, and they are of very quality, sometimes requiring actual force to penetrate the skin and vein. Yeah, I hate 'em. First needle stick I ever had in 27 years was with a 'safety IV needle.