Low Census. Trend started by the bad economy or sign of changing times?

[eriksoln, BSN, RN]

A lot of people are under the impression that hospital census will improve and go back to the good old days where hospitals would do anything to hire an RN. I'm not convinced. I think people have learned, hospitals tend to be cash cows for people who have no regard for the pt. They've decided its better to suffer and deal with things outpatient, and only become an inpatient when it is life vs. death.

I know for a fact a lot of our problems stem from the urgent care facility fixing a lot of things people would have to come us for. Its more convenient for them, cheaper and quicker.

I think the poor census is a permanent thing more than people realize.

[Tait, MSN, RN]

I do not believe in absolutes when it comes to a system as large as health care.

Personally our floor has been buzzing all summer with options to bid-shift overtime all over the hospital. Despite this being our general "slow" time of the year.

All systems have cycles of slow and heavy volume and despite the minor dent that Urgent Care can make, most of the time people are much sicker than the common cold. To be honest I am glad that UC's are clearing out the UTI's/ear infections making way for heart attacks, GI bleeds, uncontrolled diabetics to get into our ER's and to the floor where they can get help.

I do not concern myself with worrying about the impact that a few docs handing out abx in a clinic will have on my job, only that they aren't thinking when they do it. Eventually those people come back with Percocet addictions, MRSA and other fun side effects from under-treated care.

However! All this being said I work in a large metropolitan hospital, and prior to this job worked a small rural hospital, where I did feel the effects of summer slow downs a lot more than I do now. I do believe that perspective is key, but overall I do not feel we are on a downward trend in incoming patients, especially because of UC's.

Tait

[Virgo_RN, BSN, RN]

Dammit. I just typed up and awesome response and my computer ate it.

The gist of it was that I think it's just a phase. People aren't going to quit smoking, start exercising and stop eating crap just because the economy's bad. People may put off nonemergent surgeries like bladder slings and knee replacements, but they will also put off seeking primary care for chronic conditions and/or acute conditions that could easily be treated by their PCP, and end up sicker than they need to be, before finally seeking treatment in the ED.

I predict a swelling of hospital censuses, with patients who are sicker than usual because they have put off seeking medical attention in the early stages of their illness.

[eriksoln, BSN, RN]

Tait: Yeah, I'm in a smaller hospital now, rural by nature. When I travel nursed I was in major cities and could not understand why people thought census was falling. Now I see it.

Maybe thats the solution, I need to be in a bigger hospital. I do really like the one I am at now though.

[classicdame, MSN, EdD]

economy has input of course - people tend to put off "maintenance" care and end up eventually in hospital.

Just wait till the kids are all in school and the flu hits. I predict a busy season for us all.

[ChristyRN2009]

I predict a busy season for us this fall/winter as well, as it is every year (I think this might be a little busier flu season though). I've heard from too many seasoned nurses to count that census is always cyclical in a this way. There may be some higher or lower cycles however things are always busier in the fall, busiest in January, and they fall off a cliff July-September.

[Ginger's Mom, MSN, RN]

Summer is slower, but admissions are down. Why many people are putting off elective surgery and not going to the MD until they are really sick. Yes, in my opinion it is a sign of the times.

[llg, PhD, RN]

Our census picked up about 2 months ago (after being lower than usual for about a year). We are worried about having sufficient resources for a winter surge due to influenza.

[SlightlyMental_RN]

I work in a CDU, and our census is up--we're scrambling for coverage.

[locolorenzo22, BSN, RN]

i work ortho/neuro....I think people are putting off hip/knee replacements(but they usually do due to summer, warmer weather, and not wanting to take it easy for 2-3 months post replacement), back surgery patients are frequent, but only maybe stay overnight or 2 nights, and then they're gone. I think we are also slow because we lose the VA contract for the area from may to november.

Its more felt due to the economy, true, but I think that things will pick up again soon after labor day.