What is your admitting procedure to the floor?

Isabelle49 · Mar 28, 2011

I'm a charge nurse on a med/surg floor and do admits and discharges instead of taking a patient load. We recently opened up a new hospital and of course the work flow changed. My problem is the nursing supervisor not letting us know when a patient arrives. They come up a back elevator and if nobody tells me the patient is there, I have no clue they have arrived. They don't have to go past the station for the bulk of the floor. We have complained to the manager who had a meeting with the supervisors and the DNS. Nothing has changed. A patient had been in a room for over an hour before I knew the patient had arrived. The other charge nurses have noticed the same thing.
Typically, ED would call report and the supervisor would bring pt to the floor, drop off paperwork and I would go welcome the pt and admit them. It works at other facilities but for some reason not here. UGH..I'm so frustrated. We even have vocera. All they have to do is CALL ME.
What is your procedure. I'm trying to get some ideas to resolve this problem.

If the nursing supervisor does not let you know that the patient is in the room and leaves, she/he is abandoning the patient! A big mistake! Good grief, I can't even imagine doing something like that.

mama_d, BSN, RN · Mar 28, 2011

It sounds like this has been an issue which you have attempted to resolve through the proper channels and nothing has changed. I rarely say this, but given that you've done what you can to resolve the issue and pt safety is being potentially compromised, I'd say write her up, including the approximate delay in treatment it caused. Plus it's bad for Press-Ganey scores for a pt to feel like they were left alone as soon as they got to the floor...and you certainly can't tell them the real reason, your floor just has to eat those bad scores. Pwrhaps approaching it from this POV as well could enact a policy/attitude change?

tokmom, BSN, RN · Mar 28, 2011

I should clarify, the supervisor tells the floor nurse, but not me. A pt can be there for over an hour and I have no clue. This slows the med reconcilliation etc.. because that is my job. The admitting dr is waiting for paperwork from me. I don't have time to keep going up and down halls seeing if the pt is in the room. It doesn't help that the floor nurse doesn't tell me. She assumes that I know. UGH! I get hot just thinking about it.

evolvingrn, BSN, RN · Mar 28, 2011

I would think she would have to give report to you, Why don't they put the call light on in the room when they drop them off and wait for you to arrive

3dayRN · Mar 28, 2011

We have vocera also and ER has to make broadcast ( so everyone on the floor hears) and they announce they are on their way, if help is needed to transfer, if a smooth mover is needed etc. You need to tell management if they are paying for voceras to make sure they are being used that's what they are for! If the floor nurse is told then absolutely they should tell you.

don2 · Mar 28, 2011

ive used to work at private hospital ang government hospital, all both has different protocol procedure in admitting patient, but both of admitting patient from the ER to ward needs a courtesy call for transfer so as the ward nurse can prepare and anticipate the needed care approriate for patient such as,, preparing IV stand, E-cart, Oxygen tank, etc. in Government hospital which i used to work now has "NO refusal policy" regardless of that policy it is the ER or OPD medical staff responsibility to inforn the nurse on ward before the patient can be sent, it seems uncourteous just to send patient without proper information coz it may delay the care due to him/her. as a Ward, we also observe cohorting, we cant place patient with communicable problems with one patient just with hypogylcemia, thus, it is important that someone calls before admitted on the floor, You may refuse admission on your floor by not accepting endorsement and call your supervisor, perhaps the ER or OPD staff needs to be reminded by protocol. in common and practical sense, it is just a matter of courtesy. Hope it Help! :idea:

tokmom, BSN, RN · Mar 28, 2011

Thanks everyone. We have talked and talked and talked... :rolleyes:

I'm going to start threatening the floor nurse of doing her own admit if she doesn't let me know within a half hour of the patient arriving on the floor.

As for report, yeah I do need it. I'm charge and it looks pretty bad when the charge doesn't even know if there is another patient on the floor. :confused:

I like the Vocera broadcast. That's a good idea.