Busting at the seams!

  1. 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 designed to hold 70 patients, we hit 90 last week. Our neonatologists seem to think it is okay to keep cramming more equipment into every nook and cranny. We are not getting any extra staff to take care of these little bundles, either, just overloading every one with too many patients.

    Do you ever close the unit to further admissions or transports, or keep packing 'em in like sardines?
  2. Visit LANurse profile page

    About LANurse

    Joined: Oct '02; Posts: 16


  3. by   NicuGal
    We can't close to the hospitals we have an alliance for, and when our census hits over 50, L/D have to close to maternal transports. We had 60 kids at one point in a 50 bed unit...that was so much fun...and you sound like it is much more fun where you work LOL J/K.

    We have to fight with the director to close...it is such a hassle. Once we even had to close because we were so short staffed that we could barely cover the kids we had....we had 50 some kids and 30 vents...and not one of them stable!

    Will your unit manager and CNS go to bat for you? Or the Director? We have the advantage because our Director of Nursing was our NM.

    Good luck!!!
  4. by   dawngloves
    Do you guys work with me ? Our director's motto "We never close!" Well empty out the drawers 'cause we need 'em for beds!
    We will stop transports of high risd pgs and shuttle out what we can to the nearest Children's hospital. But we have had up to 40 babies on what is really a 32 bed unit. And legally we can only have 32 babies so heaven forbid.....
    It's always a good time scrounging for monitors, space, staff! Love having 4 feeder/growers! Especially when they all eat at the same time! Good thinking!
  5. by   dawngloves
    Originally posted by LANurse
    Our unit is designed to hold 70 patients, we hit 90 last week. Our neonatologists seem to think it is okay to keep cramming more equipment into every nook and cranny. We are not getting any extra staff to take care of these little bundles, either, just overloading every one with too many patients.
    Maybe someone needs to call the state with an anonymous tip when this is going on?
  6. by   NiteNICUNurse
    Are unit is licensed for 45 beds at a census of 42 we close to lateral transports and try to send down the hypoglycemics, r/o sepsis and hyperbili babies down to the nurserey. After that it's crunch time...3 babies in each isolation room with transport monitors. Never do we close to higher level of care transports, we just keep packing them in!!! We had to steal beds, and pumps from PICU the other day, but they just seem to keep coming!
  7. by   prmenrs
    The really critical issue is staffing--when things get tight, and they do when the unit is consistently over the census they budgeted for (which is based on historical data for the month), L&D closes to maternal transports, babies get transferred out. back to the hospital they came from if appropriate, other hospitals in the community commensurate w/ the level of care required by the pt.

    The NM's, case managers, docs all work together to reduce the census.
  8. by   nurseiam
    When I first started in my unit, that can take 65, we were busting at the seems. Staff was over worked, getting double time......Now three years later we can barely staff for 32. It really sucks. So now when it doesn't look like we will have enough staff we have to close, the maternals are transported out, and being the level three and regional transport center we have to divert. It really sucks for the families. Imagine spending two months in perinatal to be transported because your ready to deliver your 30 week twins, delivering 50 miles from home, the babies being transported back after the cencus of 30 comes down, only to be transported to the hospital down the street because of insurance! Its very frustrating!
  9. by   LANurse
    Administration, as usual, is not much help in the matter. We have a new DON, and she came up to our unit to see if anything could be done.Suggestions were transferring our older chronics to PEDS and PICU. which the attending neo promptly shot down.
    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.

    The DON went away, tail tucked, and nothing more was said. We are having to take way too many patients, we get no extra help, so Progressive Care Nursery has been taking 7 pts apieceon many days, and they scrounge up feeding help for them (mighty nice of them, don't you think), you may find yourself with three vent patients in our most acute areas, have to run to high risk deliveries, and just generally run your butt off all day long.(luckily,I have a lot to spare LOL)
  10. by   prmenrs
    I agree w/what Dawngloves said--drop a dime!! Well, ok, maybe 50 cents or whatever. This doesn't seem legal to me!
  11. by   nicubabe
    We keep packing em in. i think it all comes down to the almighty dollar. Heaven forbid , we should actually give these kids the care they deserve. Administration in our place tries to butter us up by giving us pizza, doughnuts etc. once in awhile.( not that anyone ever has time to eat it anyway) . Like this is going to make us feel so much happier about being overworked and overstressed! Personally I think it's a plot to kill off the seasoned nurses so they can replace them with new hires at a cheaper rate!!!
  12. by   NicuGal
    3 vents is totally unacceptable. You all need to start writing ancedotals to cover your behinds! Is the neo attending the director? I would be finding out who is over him and going to that person. And where is your NM in all this?

    Our VP of nursing has also been called to our unit when we can't get anywhere with the others. Try that.

    Do you have residents? If so, do what we do...we refuse to go to delivery. Sorry , got to many kids now. Too bad. You guys need to buckle down and do some serious documenting and talking to your uppers.

    I don't mind working hard but that sounds completely unsafe.
  13. by   canoehead
    Our tertiary care facility transports back to the home hospitals the stablest babies, growers, bililights, etc when they are too full. Parents are closer to home, and we have their neonatologists to call if things go wrong.
  14. by   lily0004us
    Last edit by lily0004us on Nov 21, '02