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?
I do kind of agree with Flying Scott Leslie, the situations we are talking about here is when hospital capacity is no longer able to cope, I know in the UK that the ER's don't have curtains in the corridors so why is it any safer or more private nursing a patient in the corridor in the ER than it is on the ward / floor. It's poor practice no matter where it happens but at least on the ward / floor there may only be one patient not in a bed where as in the ER there would be more in the corridor
Plans for our hospital is to put up to six patients in the hallway if need be. It seems to me too that at least in our ER, the patients waiting for an admission bed are given actual rooms and hospital beds while in the ER. Those that will be in and out in a few hours are given hallway placement in the ER.
This is something that is being discussed at our hospital however no one except management supports the idea. I hope it never actually happens, I really see no positives to this except the wait times for beds looks shorter.
My thought is that the first people that should have to have a bed in the hallway should be one of the administrators so they can experience for themselves what being in the hallway, potentially overnight will entail. First hand experience should be the best and if it is not tolerable when one is feeling well, how would the ill person needing admission feel??
"I just can't get over this thing with admitted patients being in the ED for days. We get yelled at for not taking them when we have no open/clean rooms, and we get them cleaned as soon as we can (yea, I'm not doing housekeeping myself, too). They may be in the ER for several hours, if we're bad off census-wise, but not days. "
My hospital has noone to divert to, the closest hospitals we could go to are in another city 60 some miles away. If there aren't any inpatient beds, there isn't going to be any movement. Sometimes we get floor nurses sent to us, more often not. I'd be thrilled if my waits were only hours on high-census days. My staffing numbers go down at 11P and 3A in the ER; we aren't staffed to actual numbers but averages (on the whole a very good thing, but...). When we have 11 to 17 inpatients, some critical care level, they have to have nurses, and ER nurses are the ones there. Of course, we also continue taking care of the ER patients who never stop coming in by ambulance or through the front door. Our waiting times have hit 8+hours some nights. Critical care ratios end up 3-4:1, not the 2:1 max in the actual critical units.
Specializes in Emergency Dept. Trauma. Pediatrics.
But what I am talking about ARE the admitted patients! And yes they do spend more than 24 hours. I've had them for up to three days in a hallway bed (sometimes not even on a bed but a gurney). In the ER they are low priority patients due to the nature of our patient load. Heck even the kitchen forgets them. They get their breakfast trays at 1100 and have to eat off their laps because we have no overbed tables. Add to that the different kind of nursing. These people should be taken care of by nurses with in-patient skill. Believe me, we don't have it and we suck at it even though we try really hard. Again I fail to see why having overflow patients on the floor is worse than in the ER hallways. It's bad all around for everyone.
I did not realize that, then no I don't think it's ok in the ER. I thought we were talking about for a few hours while waiting for a transfer or something. This doesn't go on in my hospital. We do have diversions although they are rare, we do have 3 other hospitals within 15-30 miles that people can go to. I have never heard of someone being admitted to a hallway in ER or on the floor and would never support that UNLESS it was a big trauma scenario where there were a large number of people hurt once, something like that I could understand. But this really just blows my mind.
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massrn116
117 Posts
Plans for our hospital is to put up to six patients in the hallway if need be. It seems to me too that at least in our ER, the patients waiting for an admission bed are given actual rooms and hospital beds while in the ER. Those that will be in and out in a few hours are given hallway placement in the ER.