We can't go on divert!

[RNcDreams]

Has your ER ever tried this?!

We are unable to take our divert time during the month of February (diversion = financial loss for the hospital, and they want to "ensure that patients who are followed at our hospital will be brought here, and that pt's from other hospitals will go there instead")

I'm in a smaller community ER (30 bed plus 3 or 4 wall beds) so we're not getting big traumas or anything, but the department has been inundated!!

It's a "trial" of no diversion, which hopefully will not extend past this month... but it's terrible

All beds full (including the Trauma room for the most critical patients), several chest pains, ICU holds, Fast track is full, Pedi is full, wall beds are full.... all beds WITHIN the hospital are full.... it's gross.

We were fully staffed with a float and an extra nurse to take a room from each assignment/take the wall bed people.... and it was still nutty!!

I left work in tears and woke up this morning with a lump in my throat and a stomach ache....

Thoughts?

[lupin]

We don't go on diversion ever. We are the place the Med center 20 minutes up the road diverts to. We've had twice as many people out in the waiting room as we have in the ER (14 beds, counting trauma). The staff balked at having stretchers in the aisles saying it created a fire code hazard and also was unsafe for the pts in those beds, since there is no way we can safely assign them a nurse. So people sit in the waiting rooms and sit in the exam rooms until beds get cleared out upstairs or we can find a reason to send them elsewhere, like when our CT scan goes down (at least 2x a month).

[33-weeker]

when the nurse in charge of the department found out, she blew a casket...

Blew a casket? ha ha ha I'd like to see that.

kidding - couldn't resist

Of course with that kind of staffing they might have needed some caskets...

[mmutk, BSN, RN, EMT-I]

We don't do divert either, even though there are times I think we should.

There are plenty of hospitals in the area 8 in town and 3 in the surrounding area and we are not even a trauma ctr, but in East Tennessee we just don't do the divert thing, patient satisfaction issue.

[mmutk, BSN, RN, EMT-I]

Day shift nurses are carrying 7-9 pts. each, and nights are carrying 9 + patients. CRAZY!!!!

That's damn dangerous, no way I would go along with that..

[MAISY, RN-ER, BSN, RN]

We've been on divert several times a week for the past year due to high volume and non-stop holds. They have begun to have change of shift meetings and emergency get togethers between departments to get patients moving up. The floors are now getting patients on beds in the hallway(ohmy), they are riding housekeeping's backside to get rooms clean after discharge, and supervisors are walking the floors asking why beds are open. What a change.

For our UK friend, divert only means that we ask ambulances not to come...THEY DO NOT HAVE TO COMPLY. Also it is against the law to turn away walk ins, so divert really affects ambulances only. In addition, our health protection law very rarely allows ward-like ER. In a disaster, all bets are off...different rules.

So in the end, divert rarely makes that much of a difference...it really depends on the ambulance driver, and patient's preferences.

Maisy:rolleyes:

[scattycarrot, BSN, RN]

For our UK friend, divert only means that we ask ambulances not to come...THEY DO NOT HAVE TO COMPLY. Also it is against the law to turn away walk ins, so divert really affects ambulances only. In addition, our health protection law very rarely allows ward-like ER. In a disaster, all bets are off...different rules. Maisy:rolleyes:

Thanks for the clarification!

[scattycarrot, BSN, RN]

Blew a casket? ha ha ha I'd like to see that.

kidding - couldn't resist

Of course with that kind of staffing they might have needed some caskets...

Haha! That wasn't a deliberate mistake!! I meant gasket, of course but I think casket is much more amusing!

[S.T.A.C.E.Y, LPN]

Even when you have ambulances lining up outside, waiting an hour(or more!) to get in.

An hour?!?! Thats short! Where I am, ambulance crews routinely wait 2-3 hours minimum) just like every other walk-in non-critical patient. With occasional waits for ambulance crews of 7-8 hours! If the patient is unable to get off the stretcher, but is not sick enough to come right in, and theres no beds available, what can you do?

And my hospital doesn't go on divert either. Ambulance dispatch tries to spread the ambulances around so that 7 dont all show up at the same hospital, with none at the next one, but still, we frequently have 5, 6, or 7 crews waiting with patients.

[scattycarrot, BSN, RN]

An hour?!?! Thats short! Where I am, ambulance crews routinely wait 2-3 hours minimum) just like every other walk-in non-critical patient. With occasional waits for ambulance crews of 7-8 hours! If the patient is unable to get off the stretcher, but is not sick enough to come right in, and theres no beds available, what can you do?

And my hospital doesn't go on divert either. Ambulance dispatch tries to spread the ambulances around so that 7 dont all show up at the same hospital, with none at the next one, but still, we frequently have 5, 6, or 7 crews waiting with patients.

7-8 hours? That is unbelievable. In the UK, patients aren't supposed to be in the department for more than 4 hours let alone ambulance crews. What a waste of resources! And, how frustrating for all concerned!

[MAISY, RN-ER, BSN, RN]

We don't keep our crews waiting, critical come right in and placed on monitors.....all others if non-urgent go to triage and then to waiting room. An ambulance ride is no guarentee of quick service, acuity is.

Maisy

[KNARE]

I feel everyone else's pain. Diversion in our area is a voluntary county wide program that our hospital does NOT participate in. As others have said, every aspect of the ED backs up, sometimes 3/4 of our pts. are admits being "held" in the ED. The waiting room will have 20 some pts., we will have hall beds everywhere. We have a doctor in triage so he/she will order a work up including meds in triage but unless there is a place to watch the pt. in the triage area, we can not give the med. So the pt. gets to the treatment area 4hrs. later w/ orders for meds that are also 4 hrs. old. Makes me feel real comfortable (NOT) Also, the long waits, etc. negatively affects our Press Ganeys (which is another thread)

[Uptoherern, RN]

i read somewhere that for every hour of diversion, an er looses approx $1800 an hour. So yeseree bob.........the bottom line is colored green.