So is this appropriate

[labman]

So I work in a medical ICU and there has been an ongoing issue where Emergency room will send up patients to our unit without their physician seeing the patient and them writing orders. So many times we will get a patient transfered up to the unit without orders... Many of times we will change staffing because of this and when the physician comes to see the patient they question why the patient is in the ICU (along with us).

Can ER do this?? They are notorious of doing this on shift change or when the patient is particularly overbearing or a lot of physical work... What would you feel about a patient comming to your unit without orders. Without them even knowing the code status.

Does anyone else have this issue and if you do what have you done about it because it is getting pretty obnoxious...

[PMFB-RN, RN]

This happens in my unit every now and then. In our case it is always due to the trauma team being called to a second or third trauma at just the wrong time. It is not appropriate and sounds like a problem that you manager should be addressing. As far as the doc asking YOU why a patient is in the ICU. I have a standard answer for such silly questions. I say "Hey doc I don't even TRY to explain the actions of MDs".

[RN1980]

yall are just getting screwed over. if your unit manager wont deal with this issue he is not worth his salt.

[sunnycalifRN]

Where I work, the MD in charge of "triage" must go down and evaluate the patient before accepting the patient into the ICU. Once in awhile, if the patient is an obvious admit, the MD will just do it over the phone.

Regarding the situation described by the OP, sounds like a case of "dumping syndrome" . . . the ER just didn't want the patient!! Other units attempt to do this to us, too . . . for instance, the med-surg floor tried to give us a very constipated old guy who had been ordered for Q1 enemas . . . their reasoning for transfer . . . too much work!! But, our triage doc refused, after he stopped laughing!!!:lol2::lol2:

[labman]

Thanks guys and gals for the answers. The funny thing is when they did this thransfer they only had 3 other paitnets downstairs. I am just sick of the MD comming up to the unit asking why the patient is in the ICU when they didn't see them in the ER and the ER just sent them upstairs. We will see what the manager says. I am sick of staffing being adjusted and people getting called in wasting the hospital money when this doesn't happen and also not able to treat the patient (because the only ER order is an x-ray). I can do much with atleast is gander at that x-ray from the ER.

And whoever wrote the enema every hour thanks. That made me laugh...