Busting at the seams! - page 2
Just curious, what is the practice of your unit regarding admissions when you are getting too darn full? We never stop admitting and accepting transports, no matter what the census. Our unit is... Read More
Oct 22, '02Occupation: Level III NICU Specialty: NICU ; From: US ; Joined: Oct '00; Posts: 1,605; Likes: 929Wow, I must have it easy. I've never seen us full. Our capacity is 61 and 58 is the highest I've ever seen it. Once they get over 55 or so they close to outside admissions, ever from our allied hospitals. We just deliver too many babies upstairs to risk not having beds. We even try to transfer our babies to our allied hospitals with level II units when we approach full. This works if the Level II hospital is closer to home for the parents.
One time the nursery sent us a tachypneic baby that had no other risk factors. Ended up taking our 59th bed one night. And there was 31 week twins and a 24 weeker cooking upstairs. The charge nurse was led to believe the baby was worse than it was. She was so pissed she sent that baby back up to the nursery within 30 minutes...
Oct 23, '02Occupation: once a manager, now a staff nurse, preceptor, educator and practice member Specialty: 30 year(s) of experience in NICU, PICU, PACU ; From: FAM ; Joined: Mar '01; Posts: 2,797; Likes: 3,172Don't you hate that KRVRN? We fight with our nurseries all the time about crap like that! We will have 2 beds left and they will send us some tachypneic kid...who is POing 100% in RA! They act like we are taking off their arm if they have to take a kid with an ng or and IV! Makes me want to scream!
We don't reverse transport that often anymore, why, who knows? I know that some of it has to do with the cost...a lot of insurances won't pay for the trip back to another hospital. Isn't that stupid?
Oct 23, '02Joined: May '02; Posts: 278; Likes: 5Wow! All of the hospitals in our area work together and the Perinatal Dispatch Center keeps tabs on bed availablilty and type: level I, II, II, ECMO, etc. We are licensed for 16 beds and go "code red" to outside admissions at 15 (sometimes less if we are expecting sick twins or don't have the staff for some reason, like, the high acuity of current patients - we would NEVER have even two vents/nurse). There is one hospital in our area that does staff 2 vents/nurse - the maximum allowed under California law-, but they can't keep nurses either (they're the one offering the big sign-on bonus...)
He told her that if a nurse had time to sit down, then he wasn't worried about us being overloaded with patients. He said we worked better under stress, and fewer mistakes were made than when our census was low and everyone was sitting around.
Oct 23, '02Occupation: Re-retired Specialty: 42 year(s) of experience in NICU, Infection Control ; From: CA, US ; Joined: Dec '00; Posts: 12,419; Likes: 3,760Our NICU is on the 2nd floor, and the Mother-Baby Unit is on the 4th--we used to call that tachypnea, poor feeding, low glucose garbage stuff "ALTITUDE SICKNESS".