"Holdover" beds in the periop area???

[wayover20]

I'm new to the periop area but not to nursing. After too many years in the ER, I am now working the preop holding area and I love it. A situation has come up and I'd like your thoughts to be able to just go with the flow or tell them why I think it's a crazy idea (not that it will do any good).

In the preop area at the end of the hall we have 4 rooms that have been used to keep OR x-ray equipment, wheelchairs etc. Now the so called "higher ups" have decided to convert these rooms to ER "overflow" holding rooms for when there are admit pts in ER that no in-house bed is available for yet, be they ICU or med/surg pts. They say they will staff it with whatever type nurse is required to monitor those pts. My director has fought hard to prevent this from happening as these rooms in a pinch can be used for PREOP pts. when we are hit extra hard and need the bed space. But he's been overruled by an out of control nursing director making the decisions. One of my concerns is traffic flow and appropiateness of people walking around/thru the periop area. There is one door (in the preop area) that pts come thru from the waiting area to start their journey thru the periop area. It will still be the only door and now we'll have to deal with traffic control from family/visitors wanting to get down the hall to see the holding pts. As it is now, we have people visiting the preop pts and every so often if the desk is not manned, someone will still try to go thru the main OR doors! I can imagine the increase in traffic and problems we're going to have. The beds they are going to take are in the preop area and just feet away from the PACU area.

I always thought the periop area was sort of a closed area because of the nature of OR. As it is now, we allow visitors to be with the preop pt as they wait to go back, but we can limit the number if needed to keep down the chaos. This area of rooms that are being taken has direct view into the PACU as well as the preop area. The route the visitors to the holding area will have is to pass the preop desk, make a left (if they go straight they will pass thru to MAIN OR), pass the preop running board, down the hall and to the right. If they make a left, they enter PACU where no visitors are permitted.

Am I just overreacting or being too territorial?

[RN34TX]

You are not over-reacting or being territorial.

The whole trend toward allowing visitors in areas previously restricted has gotten way out of control.

Your hospital is asking for trouble.

The PACU I work in uses some slots for pre-op when the holding area fills up early in the mornings. They only allow one vistor to sit with them until they go to surgery but even that causes problems.

As you know, the PACU has very little privacy, it's just one big room.

Sometimes in the mornings, I've had either early morning recoveries or ICU overflow patients.

The visitors will watch and listen to everything going on, to the point of getting up and walking to the other side of where I've pulled privacy curtains to prevent their viewing because they want to see all of the action.

They will even often ask "What's wrong" or "What surgery did this patient have" which I can't believe that people STILL have the gall to ask.

They come up to me for pillows and blankets when I'm in the middle of managing difficult airway situations, falling BP's, etc. as well as walk into our breakroom wanting something.

A few have even attempted to put their hands inside the cribs of our ped patients recovering and try to wake "the cute little baby" up.

People are insane.

I guess the next step would be to actually allow visitors into the OR suites to watch their loved one go under the knife.

It's all about what the "customer" wants.

[amnesia]

:angryfire So True! Its all about what the customer wants! Never mind if their prying eyes and imposing/rude questions violate the privacy of other patients! Heck, we might as well start recovering people on the sidewalk to make it easier for thier ever-loving families! There is no such thing as preserving privacy for our patients anymore despite HIPPA!:angryfire

[RN34TX]

:angryfire So True! Its all about what the customer wants! Never mind if their prying eyes and imposing/rude questions violate the privacy of other patients! Heck, we might as well start recovering people on the sidewalk to make it easier for thier ever-loving families! There is no such thing as preserving privacy for our patients anymore despite HIPPA!:angryfire

One time while charting, I jumped up to place a patient back on the vent that popped off only to turn around and find a family member of another patient reading what was open at the desk.

Of course, in the grand scheme of things, who was to blame for HIPPA violations? Me, of course, for not closing the chart before placing my patient back on the vent.

I'm supposed to safeguard health info from people who have no business being in the PACU to begin with.

What's wrong with this picture?

[wayover20]

I see nothing but trouble on the horizon for us. Heck, as it is now...the other day I walked by our break room which is about 15 feet away from the desk, and there was a man sitting in there drinking coffee and eating cookies someone had brought in for us. I politely asked him if I could help him (not knowing what else to say) and he said "no, I'm just having a snack while the nurses check my wife in". THE NERVE!!! I asked him to please wait outside in the waiting area until we called him in, that this was the employee's lounge.

[Marie_LPN, RN, LPN, RN]

One of my concerns is traffic flow and appropiateness of people walking around/thru the periop area.

That would be my concern too.

I wonder what Joint Commission's thoughts are for this....

[nursenurse]

amen!