TraceyJ

Thanks for the replies so far. I think it's interesting that systems differ from the US to the UK. Unfortunately a locked door system is a bit of a no-no mostly on grounds of practicality. Essentially it is a unit for patients without mental illness and so the three exits on the ward are frequently in use. I agree with the 'sitter' facility that has been referred to and it is often the case that when situations are difficuly, we are permitted to request an extra nurse to 'special' and give 1 to 1 ratio to the person causing difficulty. In the example given however, there had not previously been the need for this as any confusion was contained relatively well. This absocndment was pretty much an unpredicted escalation; earlier on in the day the patient had been perfect! So just wondering then, is the consensus to go with the patient on their little jolly or to return to the hospital to get more help?

Just putting by a scenario here to find out what others would do in this instance. 65 year old patient with chronic confusional state as a current patient in an acute setting. Patient looks very 'well' and is physically very independent but assessments by pschiatrist and other MDT members and confirmed not safe to return home. Consequently requires placement in appropriate residential setting and so stuck in the beurocratic and hideous system of waiting for this to be actioned. Level of confusion varies. Often settled but can frequent get desire to wander from ward and will want to leave in order to go 'home.' Usually persuaded to return to ward. Never shown any agrerssive tendandcies but will be strong in opinion that spouse is still alive when they are not. Does not always respond well to distraction. On a particular evening patient had been quite agitated and so had already been given usual plus additional dose of Trazadone. Remained restless and wanting to leave. Reluctant to give further sedative as speech a little slurred but had already absconded from ward twice and was escorted back to ward by nursing staff. Time was now 10:15pm and my shift had officially finished but as usual I was pfaffing about with a few things. Noted that the patient had gone from the ward again. Other staff were busy with a sick patient just returned from theatre and so I felt it reasonable for me to persue the pateint to where they had been found on one of the previous 'trips' off the ward. I took my jacket and told a HCA that I was going to look for the patient. I found the pateint exiting the door into the carpark. Unfortnautely I did not have my phone with me but was able to advise security via a phone just inside the hospital door. I expained it was urgent and where I was but stated I had to go as the patient was going out of sight in the carpark. With the patient in sight I held back to wait for security so that I could be seen. After several minutes they did not arrive. Persuasion to get the patient to return proved futile with them just continuing thier brisk walk out of the hospital gounds and on towards an area that is a mix of dense housing and parkland. It was quite cold at about 3 degrees C, not raining but obviously very dark. So the question is....what would you do next?

So are you saying that it's a good thing or not to price things up? I am of the same sort of school of thought as your previous manger in that if it's needed then that's the bottom line but I just don't like seeing things used excessively or unnecessarily.

As a budget conscious senior member of staff, any suggestions for trying to instill the same enthusiasm in order to develop a budget conscious workforce?!?!?! Tis hard as I see folk using various stock where alternatives could be used that would be cheaper, albeit only marginally, but don't want to come across as penny-pinching. Examples of saving a few pennies; * Patients with overnight conveens having drainable drainage bags rather than 'overnight' bags * Patients with conveens that fall off (as they always seem to do!) having conveen and drainage bag renewed * Using disposable male urinals to empty catheters - bedpan liners are cheaper to use * Excessive use of incontinent pads Blimey I sound light a right tight old g*t!

Not a very technical question but just curious as to what folk use to empty catheters on their wards/units. Generally we use the disposable urinals or bed-pans but I can recall other wards use CSSD jugs that would get replaced periodically and wahs them inbetween times. Curious in terms of a cost issue an infection control issue too.

:) Well this is my first posting on this forum and I do hope that the replies do not disappoint! My quest in this instance is looking at staffing levels in relation to the number of beds and I would be most grateful if others would help by giving information from their own clinical areas. The sort of information I am looking for is; 1. Type of clinical area, eg cardiology, medical. elderly care etc 2.Number of beds in your clinical area 3. Intended staffing levels for Earlies; Lates and Nights in terms of registered and non-registered staff. (EG 3+1 means 3 registered nurses and 1 HCA) 4. Do you have any supernumerary staff to assist such as a ward co-ordinator? Also, you can put which part of the UK you are from if you so wish. Thanks in advance for this!