Movement of pts is dependent on the decisions of the medical provider.

[admc4444]

I am an old ER nurse Movement of pts is dependent on the decisions of the medical provider. Typically one hour before the doc is scheduled to go home they stop seeing new pts and they make final dispositions. At 600 or 1830 the doc reports off to the admitting provider and simultaneously the nurse can call the admissions dept or the supervisor to get a room. Just like the ER doc wants to complete care of their pts, the ER nurse like to report off to the accepting nurse.It is a higher standard of care.

But you get your room assignment at 7:15 or 19:15. The floor nurse refuses to take report. I learned to beg the on coming floor or unit nurse to take report and then beg the on coming ER staff to hold the pt until 800 or 2000

[LessValuableNinja]

What's your question?

[HouTx, BSN, MSN, EdD]

THIS ^^^^^ is exactly why most organizations are focusing so much on ED throughput.

Care should be arranged to meet the patient's needs, not the needs of the physician or nurse. There's a lot of resistance, but I think that the Six Sigma crowd is making inroads. You know who they are.... they're the ones with stop watches and clipboards keeping track of what is happening with the patient & trying to figure out why no one moves until the physician is good and ready to do so.

[anchorRN, BSN, MSN, RN, APRN]

As a prior house supervisor I flat out refused to assign a bed during turnover. I knew the motivation of some ED nurses, I'm not stupid. I also know that some floor nurses will stall as long as they can also. So the blame lies between both departments. It created chaos for me but i didnt care. Both charge nurses calling me pleading their case and the physician would call pleading theirs. Suck it up buttercup your "patient movement" can wait til 0800/2000. (Unless its an emergency of course).

[mmc51264, BSN, MSN, RN]

Both dept know that shift change is not the time to be sending pts. I hate getting report on a pt, then not seeing the pt and having to give report to oncoming nurse about a pt that I haven't seen. Same as an ED nurse who has not taken care of a pt calling report, I tend to get a lot of "i don't know"s from them. We will have beds ready and assigned, and they don't send them until 1845?? Then the pts complain that they spent 4 hours in the ED or PACU when we had room for them. Not sure drops the ball at these times