in pt transfers to ED

sjoe · Sep 19, 2003

1) Never heard of this before, and

2) Nope.

OO7Trauma · Sep 21, 2003

No way! Our management thought about that for about a split second. At my facility, if there isn't any critical care beds, the medical resident has to stay and monitor the patient. You would be suprised how fast a bed becomes available.

Rena RN 2003, RN · Sep 22, 2003

i'm at a small rural hospital with only a 9 bed ICU. we do hold people in the ER if ICU is already full and wait for a.m. discharges. i have never seen an in-house transfer for us to sit on.

TaraER-RN · Sep 22, 2003

same here...we never get transfers from upstairs down to us...only the other way around...but sometimes we do have to hold onto our ICU patients for a little too long...

CougRN · Sep 22, 2003

Ours go to the PACU if there are no unit beds. Trauma's will stay in the trauma bay in the ER if there are no unit beds but we don't send patients to ER for ICU care.

Traumsquad · Sep 23, 2003

We do hold patients in our er on a more frequent basis than I like to see, but in the 5 years I have worked in the unit, we have never gotten a patient transfered to us from an in-house hospital floor. Our administrator does not permit it. Also, I was under the impression that it was a violation to transfer a patient back to the er once they were an inpatient. Of course, I could be wrong. This is an interesting question, I will have to study up on it.

EastCoast · Sep 23, 2003

I have never seen it done like this although every once and a while someone would think this was a 'good' idea.

I think this may violate in some degree the 'scope of care' type of policy that your emergency department must have to maintain jcaho accrediation.

In our hospital if a inhouse pt. crashes and there are no icu beds at all (assumming everyone has been evaluated for possible transfer) a ICU nurse or the house officer (who is an NP or PA) stays with the patients. We have in crunch times held postops in PACU or had ED patients sent to PACU . However, the PACU must be staffed with an ICU nurse and not be the sole responsiblity of the the PACU nursing staff.

When something bad happens the person who thought this was a good idea will realize their error.

Most importantly the training of the ER staff and there practice is different from critical care. The ER and ICU are not interchangeable.

MissBehavinRN · Sep 23, 2003

We seem to hold patients in the ER for extended periods of time EVERY DAY! In fact, we have dubbed this the "Emergency Dept. Transitional Care Unit". If we are going to have them for more than four hours, we have to start floor orders and care. And then there are the psych patients we always end up holding. And yet the MDs on staff will accept transfers from outlying hospitals all the time. I don't quite understand how it is allowed when we can't find beds for what we have already.

Having recently returned to ER nursing and coming back to a bigger ER than I have ever worked in, I really feel like I'm drowning. I'm not tolerating it well when my day consists of constant apologies for time delays, and worse yet when my patients are being neglected because there is only one of me and I have six of them at any given time.