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Discussion

LOS

How long do your patients usually stay in the ER? I am having some issues with this one. Some of our docs are keeping patients up to 9 hours before making a disposition-driving me crazy! We will have a code and if the person makes it, they will sit in the ER for 5-6 hours while the doc tried to figure it all out. Plus he won't order anything for sedation so we have to listen to the alarms from the vent until we are "allowed" to call their PCP for admission stuff. Not only are we too busy for that, it is not fair to that patient, etc. :(

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sounds like some lazy doc's - our general los is probably 2 hours - worst case scenario is holding patients due to no beds in the hospital (which happens frequently) then of course the los is longer - and of course our drunks - some of them have 24 hrs los waiting for the 500 bal to come down!!

BUT..... alot of this has to do w/ the nurses and the charge nurse - the nurses are responsible for initiating a "protocol" depending on complaint (ex: cp= ekg,monitor,ivr,port cxray,cbc,comp,ck,ckmb, and trop)

so - many times some of the labs are back prior to the md ever seeing the pt -

then the charge rn's responsibility is to keep an eye on pt flow -

we have a tracking system - so we can look right on the tracking board and know how long pt's have been there - when it gets to about 2 hours - the charge rn can look through the chart - determine everything is back and go to the doc and say - dispo this one (admit/transfer or discharge) - and it usually works.

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