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Discussion

Oh, this Pt should be on a stepdown unit, but....

I work on a med/surg floor and one of the residents said this to me today. The whole "but" about it, is that we do not have a stepdown unit and this pt was not unstable enough to go to the icu. But i was playing chase the resident around for getting dropping a dobhoff in the pt so she can get nutrition, addressing code status- peg placement-picc placement with the family, getting a wound nurse consult giving about 4-5 different iv meds or drips, changing 5 different decubitus dressings,checking the pt pressures, and then on top of it all I was charge nurse ( still new so I was a sucky charge nurse today)- What am i suppose to do when it is obvious that the pt is not appropriate for the floor but not sick enough for icu?

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This is a regular patient on my floor. Some of the regular pts on my unit are much worse than what you just describe. I agree with though that such pt should be on step/down. When I charge, I take less pt and not the very sick.

This is a regular patient on my floor. Some of the regular pts on my unit are much worse than what you just describe. I agree with though that such pt should be on step/down. When I charge, I take less pt and not the very sick.

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X2 When I used to work Med/Surg we had patients like this all the time. Beyond the pressure issues, a large patient with decubs and mult. abx running doesn't make them a stepdown patient. The LOC of the patient is worrying. M.D's at my old facility would have had resp. draw a gas and if it came back WNL then the patient would not have transfered.

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Update on pt - The pt ended up going to ICU 3 days later. The pt wounds had been surgically debrided and the pt started to bleed out and still a full code. Service was not able to give blood related to religious affiliation. The pt had previously before admission been on coumadin and her albumin was low.

what is PCU i am from the UK and we don't use that term.

we have ICU 2 or more systems failures level 3 patients

and High dependency Units HDU 1 system failure so we can step up or down care as required for the patient. level 2

and then the ward level level 0-1 patients

How can you be charge and have someone else assign you patients? If you are charge you should be making the assignments.

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