refusal of an additional admission- overwhelmed

[2ndgenerationnurse]

anyone know the law in PA for refusing an aditional admission, or 2!, when the staff RN assesses her assignment too full already? when is enough enough and who decides?

[stressednurse]

As a nursing supervisor in PA, I have assessed that an admission would not be in the best interest of the patient due to staffing. That has only happened twice. I did have to get the DON and or the ADON to agree with me though. Both patients were high acuity and would need sufficient resperatory assistance. Most facilites do their staffing on a grid basis which is nurse to patient ration without any consideration to patient acuity.

[moia]

I don't think there is a "law" that says exactly how many patients a nurse can care for .

I believe the standard is what would a prudent nurse do? Meaning if you put 50 nurses in a room 45 of them would come up with same general criteria and limits.

The nurse in charge is required to evaluate the skills of the nurse acccepting the admission and her decision must reflect "the norm"

An example would be a brand new grad with 4 patients all ready for next day discharge should be able to accept another patient of that same level of acuity.

An experienced RN in that same situation could handle two more.

A new grad with 4 patients..one being acute shouldn't be given another acute admission but an experienced nurse could handle it.

The char

ge nurse would be making these decisions but the staff nurse should be vocal before report if she honestly believes she cant do it and feels the patient would be at risk.

I have seen nurses refuse an admission because they feel it is "unfair" they are

getting another patient ...this is not an appropriate reason for refusing an admission.

Consider why you are refusing and tell your charge nurse before a new admission shows up that you won't be able to cope with another patient.

Everyone can agree that getting another patient in the middle of the night sucks but thats the job.If you seem to be always getting the new admission and it's getting irritating ask why.