Pt beds in the hallway

Nurses General Nursing

Published

Not to start an ER vs. Med/Surg/ICU battle, but I attended a class at work that turned ugly. What it boils down to is: ER nurses wanting to add patient beds to the (med/surg/tele/ICU) floors in the hallway, to facilitate moving patients out of the ER quicker. And the hospital is considering it. Has anyone ever heard of this? We're talking about putting sick patients in hospital beds in the hallway and providing patient care there. I see so many things wrong with that picture, but they all thought it was a perfectly acceptable solution to fixing "flow" problems in the ED. Any thoughts on the matter, without starting World War III?

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No way, and I'm an ER nurse!

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I worked at a hospital in Philadelphia at one time that actually had pts in hall beds while they waited for a bed in a room to be available. Even went to the point of hanging curtains from the ceiling for privacy. How much privacy do you have when you are on a commode in the middle of a hallway(this actually happened) with nothing between you and people walking down the hall but a curtain? BIG BIG nono as far as the state is concerned. I was so relieved to see the curtains come down and no more pts in beds in the halls.You may want to contact your State board of nursing to see if it is allowed. To me that is an ethical dilemma, not to mention a safety hazard.

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Specializes in nursery, L and D.

We have hall beds in the ER, but I don't think my hospital has ever considered hall beds anywhere else. Doesn't sound like a good idea. I personally don't like the hall beds in the ER, but they are just trying to do what they can to treat pt and get them home.

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Specializes in Emergency, Trauma.

We do this at my hospital....EVERY day we have hall pts in the ER, and not just 1 or 2; I'm talking about 20-25 hall pts that completely overwhelm the ER. These pts create an unsafe workload daily for the ER nurses-our assignments are made by pt acuity, so the ER nurse taking care of 2 ICU pts will also have 2 hall pts/the ER nurse with 8 med-surg pts will also have 3-4 hall patients, etc. So on the days where we are so oversaturated that ambulances cannot even unload their pts and the waiting room has pts who have been waiting for over 12 hours to be seen because we can't move admitted pts upstairs...we go into a "code purple" and pts are moved into hall beds upstairs. There is a strict cap on the number of pts who go to hall beds upstairs and specific criteria (i.e., no ICU, MRSA, open sores, NGT, GI bleed, etc.) as to which pts can go to hall beds upstairs. These pts only go up to a hall bed when they have already been assigned a room but it is either dirty, or in the process of being cleaned, so they are in the halls for a fairly short period of time, whereas ER pts may remain in the halls for up to 24 hours at a time. No, its not a perfect scenerio, but it does lessen the strain on the ER, who has to deal with numerous hall pts all day long. If your hospital is considering doing this, it might be an eye-opener to take a walk through your ER on a busy day-its probably like mine. (I'm not saying that to sound mean; I just don't think those who've never worked ER realise the sheer volume and madness!)

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ER is different. I can see it in an ER and even wish that my current ER was set up that way, but for in-pts????

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Specializes in Float.

Is that not a fire code regulation? Like when you have a fire alarm you have to clear the halls..where would you put them?

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Specializes in Emergency, Trauma.

I believe you're okay as long as you can move freely through the halls..our halls are large enough to accomodate the stretchers and push other stretchers/equipment past them.

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Agree with the concerns about fire code violation. Also...does anyone else find it strange that in some threads we hear of management emphasizing how the patient's stay should be like a catered "hotel" experience and in other threads we hear management is proposing ideas like beds in the hallways (never had THAT experience at a hotel)? Are these the same institutions? Can't have it both ways, guys and gals.

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

If I was an admitted patient parked in a hallway on a floor I would sign out AMA!!!

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Specializes in Emergency, Trauma.

If I was truly sick enough to be admitted, I probably wouldn't care where I was parked. If I felt well enough to sign out AMA because I didn't like being in a hallway, then I shouldn't be there in the first place. (Sorry, grumpy ER line of thinking!)

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Thanks for all the replies...I'm glad to know I'm not alone in thinking this is wrong. I was about the only non-ER nurse there and was attacked from all sides when I spoke out against it. I keep picturing in my mind having a patient in the hallway and needing to put a foley in or digging out a fecal impaction. And, no, this isn't a big city hospital, but a well-to-do small, community hospital. I left a big city hospital, thinking this smaller community centered hospital would be a little more "sane". Apparently not.

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