Surgical floor getting inappropriate patients "dumped" here on weekend

[nursenatalie, ADN, RN]

I work on a surgical floor. We supposedly only take non-contagious medical patients as overflow from our medical floor. It is becoming a trend that on the weekend we are getting patients dumped on our floor that should be on other floors. For example, our tele unit is having a new call system installed so 5 of the rooms are out of use. They triaged an 89 year old woman with bilateral pneumonia and atrial fib to my floor. She had been on our floor for a couple hours before my shift began so when I heard in report that she was in atrial fib I assumed it was controlled. I went to her room to assess her and her heart rate was 157 and irregular as $#!T, I looked in the chart and there was no order for her to be taken off tele!!!!! I immediately called our tele unit and asked the nurse which doctor ordered this patient to be taken off tele and transferred to another floor, she came and wrote the verbal order but this did not help me feel comfortable caring for this lady as she was not a DNR. Two hours later we received an admit from the ER, a 41 year old male who had surgery to remove a subdural hematoma three months ago (perhaps this is why they sent him to the surgical floor ) When the transporter wheeled him up to our floor he was grey and greasy looking and I stopped him before he took him in the room. His 02 sat was 58 !! Turns out he had taken an overdose of Lorcet for the umpteenth time. This patient got a vent and a quick trip to the ICU. This is always happening on the weekend and it is getting old, sorry for the length just had to vent...does anything like this happen to you?

[Noney]

Anyone in afib running 150's should remain on tele with a drip. I don't blame you for being upset.

Sorry your having such bad weekends:o

Noney

[nursenatalie, ADN, RN]

I have talked to my units service director about this. The house supervisor influences the ER doctor at times regarding the floor the patient is admitted to because she wants to be sure to have beds available if needed. It just so happens our census goes down over the weekend because most surgery performed on Monday and we get them home by Friday. So knowing why we are getting dumped with inappropriate patients we are trying to come up with a solution to this problem in order to protect the patients as well as my liscense!! Hopefully not too many more hairy weekends like this

[bellehill, RN]

nursenatalie,

I know this won't help but all surgical units I have worked in have this problem when census drops. The admitting department sees the empty beds and freaks out by sending whatever they have on their desk. Several times we have tried to stop this only to be told by the house supervisor that we had to take these pts. One pt had specific admit instructions for another floor, the doctor wanted to know why he came to our floor. We let her talk to the supervisor. If the floor manager gets involved sometimes you will find relief but a lot of times they want those beds filled...empty beds don't help to meet budget. There is no easy solution, just talk to the ER nurse before the pt comes up to make sure they are stable and get a little history before they come up, you might be able to prevent the two situations you described. Sorry!