Patient beds in hallways

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Just wanted to know how many hospitals are putting their inpatients in the hallways when the floors are full. This will be the new trend where I work. In MA there is a "no diversion" rule. Patients routinely line the hallway in the ER but now the hospital is planning to "admit" patients to hallway areas when rooms are full. Questions raised: What bathroom do they use, how are they billed, how will it affect the ever so wonderful "Press Gainey" scores, would you want to be in a hallway getting your care, does your family want to see you there, what about all the obstacles in the way, ie linen carts, dirty linen, patients trying to ambulate, walking past you with any host of different diseases???? Any thoughts out there? Management of course feels it will all work out fine, will the "VIPs" be put in the hallway?

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The hospital I worked in as a CNA used to have ER patients in the hall. It was a wide hall so there wasn't really a space issue. But having admitted patients in the hall does not sound like a good idea at all. I can just see the reviews...

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I recently got a taste of what it feels like to have a patient in the hall. I had an elderly patient in a room waiting for x-ray results and then a young girl came in and I had to tell the elderly woman and her daughter that they had to be moved to the hall (explained why). So, I felt so uncomfortable because they had to watch us pass them by and give this young girl most of the attention. I understand why it has to be done but it was still very uncomfortable. This was in the ER I think it would be horrible on the floors. It was only my 2nd day as a nurse I guess I was probably the only nurse that felt this way.

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Specializes in Critical Care, Education.

Wow - terrible situation for patient care. Hopefully it will just be a temporary 'staging' location until a normal bed is available. Sounds like this may be a kludge (jerry-rigged) solution intended to generate additional revenue. Even without the ability to go on 'diversion', can't the facility simply hang out a 'no vacancy' sign when you're full?

I would also imagine that this would be a violation of fire code/safety regs... it is a violation of Joint Commission EC standards. They don't come down on an organization for doing this type of thing in an 'emergency' situation, but if it happens a lot you are out of the 'emergency' realm and into a 'routine' situation.

Just curious - How does this work with HIPAA/confidentiality requirements? Will the patients have some sort of screen around the bed to protect their dignity? What kind of nurse call system will they have?

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Specializes in Advanced Practice, surgery.

In the UK most hospitals will admit patients to ward corridors when there are extreme capacity issues.

We have escalation policies that state that when there are patients in the corridors in the emergency unit, as soon as there is an identified discharge on a ward then they will accommodate a corridor patient until the discharge vacates the bed. There are no other circumstances when it is "acceptable" but what it does mean is that wards will delay declaring discharges to our bed managers until the patient is ready to go.

Not sure what the answer is, it certainly isn't safe to have patients in corridors in the emergency unit, but it also isn't safe to have them on ward corridors either. But if there are 10 patients in EU, then surely it would be safer for 1 to be waiting in a corridor on a ward rather than with the other 10 in EU (not sure if you follow my logic with that one)

It is a huge source of complaint in the UK, and rightly so

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My hospital medsurg/tele unit tried this a couple of years ago. I didn't work out, thankfully! The poor patients were put in a high traffic areas for staff. Patients never had any type of privacy, even with a curtain. They also had access to our staff restroom. It was so gross. My memory is foggy,but I believe our union fought against it or

it didn't pass govt. inspection. It was a poor idea that lasted only a few weeks.

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Specializes in Med-Surg.

If you are putting inpatients in the hall, what is your nurse to patient ratio? We never have enough nurses scheduled to safely have all our beds full, never mind adding patients in the hall. Isn't that a fire hazard as well? We aren't supposed to leave empty beds in the hall due to fire codes. Sounds like a nightmare, hope this doesn't become a trend.

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I am stunned that any administration would consider this. It is wrong on so many levels: HIPPA, fire safety, pt privacy and dignity etc,etc,etc. I would hope your adminstration will look at this more thoroughly before implementing. I truely thought this practice went away decades ago!

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This happens sometimes at our local hospital. Sometimes there is just no where else.. I know as soon as a bed opens they are put in a room.. Just makes you wonder if they d/c people early just so they can get someone out of the hallway..

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If you are putting inpatients in the hall, what is your nurse to patient ratio? We never have enough nurses scheduled to safely have all our beds full, never mind adding patients in the hall. Isn't that a fire hazard as well? We aren't supposed to leave empty beds in the hall due to fire codes. Sounds like a nightmare, hope this doesn't become a trend.

The fire department made rounds and pointed out areas where beds could "safely" go without creating a hazard. They are currently putting in more electrical outlets. I do not think they have gone so far as to think about call lights but due to the fact that the nurses will essentially be constantly going by the patient, it should not be a problem. I think the intent is to move the patient ASAP to a room when it opens, unfortunately discharges on the floor are historically slow(MD's/hospitalist are seeing too many patients), admissions are many and they do not plan to add more nursing staff. There will be portable curtains, adding to the clutter and here in MA I believe it is becoming a trend. Supposedly it will be the "walkie-talkie" patient put in these beds. Regardless it seems it should not be tolerated. I would personally rather sit in the ER a few more hours than on a floor feeling like I am truly in the way. I would not want to have to take care of a patient in the hallway.

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Specializes in Hospital Education Coordinator.

a local trauma I hospital does this frequently. The break down is in trying to get the rooms ready which is amazing to me. How much do housekeepers make?

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Specializes in ER, Step-Down.
a local trauma I hospital does this frequently. The break down is in trying to get the rooms ready which is amazing to me. How much do housekeepers make?

from what i've heard - $8/hr at my hospital I believe. they are the lowest paid employees and some of the most overworked. it's RIDICULOUS what admin expects such a small crew to do (night shift = less than 6 house keepers for a 450+ bed hospital, or some other slightly higher, but still crazy low number). we have permanent house keeping in the ED, and boy oh boy, do we EVER run those poor girls (and guy..) ragged.

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