Mixed Unit

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I work on a 36 bed unit. We are in the process of becoming a mixed unit (which we really already are, but it's becoming official). We trying to figure out how to work it out and would like to hear about others' experiences. Do you have certain rooms that are reserved for observation patients, other rooms for higher acuity patients? Does the physical layout of the unit matter? Does a nurse have a mix of the patients, or one nurse has all the OBV students and another nurse has fewer patients with higher acuity?

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Specializes in retired LTC.

Like what kind of mix of pts are you talking?

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Specializes in Emergency & Trauma/Adult ICU.

"Mixed unit" could refer to many things, so if you want helpful input you might want to include some specifics about the patient population of your unit prior to and after the change in policy.

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We occasionally get observation patients transferred to our med-onc floor, especially when the ambulatory care center shuts down. There's usually little to no difference between them and our other patients. They are mixed in our assignments.

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Are you talking about mixed sex units?

Mixed services units? My hospital trialed a gong show of a unit. Mixed surgical/medical patients and for good measure toss in some ortho. Can't keep staff or managers.

Are you talking step-down obs beds? If so, it works in my hospital. The obs beds are in a four bed ward room opposite the nursing station. Usually two patients per staff member. The rest of the unit is surgical with a 4 patient 1 nurse ratio.

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Specializes in Critical Care, Education.

It's best to adopt an arrangement that provides a separation (geographic & staffing-wise) between the different patient populations. There's just no good way to explain to the MS patient "well, we are checking on your neighbor much more frequently because he is here for observation and you're not".... yeah, that would work, right? The normal workload for MS nurses is much too heavy to expect them to have to juggle two different sets of everything.

We ran into this a lot back in the "swing bed" days when some hospital geniuses decided it would be a great idea to put SNF patients into all those "empty" beds. Sheesh.

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