What Hospital Floors Have The Most Amount of Ambulatory/Independent Patients?

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Specializes in Cardiovascular Surgery, Cardiology.

Hello everyone,

I just graduated the RPN program at Centennial College in April 2019, began registered with the CNO in July 2019, and landed a RPN job as a clinical research assistant in October 2019. Unfortunately, the clinical research job is only temporary, and I'll have to find a permanent nursing job when the contract ends this year (2020).

I would love to be able to find a nursing job in the hospital, but it has been difficult because most of the areas I want to get into require more training (such as OR, ER, ambulatory care). I realize that I would have to bare the task of being a floor nurse first, to gain the experience that these specialties require, and to save up enough money to pursue higher education for their areas of nursing. During my clinical experience in school on a med/surg/general floor, and I found that nurses were more focused on completing tasks, with little time to actually build a connect with the patient (due to lack of time). Most of the patient weren't ambulatory, there was a high patient to nurse ratio, and nurses struggled to/didn't complete personal care (bathing, feeding, clothing, etc) in addition to their nursing procedures (medications, IV, wound care, etc). I want to find a floor in the hospital that will still allow me to preform a variety of nursing skills (medications, IV, wound care, etc), but where the patients are independent (so I can focus on building a nurse-patient relationship).

P.S. I don't mind providing personal care, but I found it unrealistic to expect a complete bed bath/showers, brief change, medications, feeding and charting to all be done for 5+ total care (non-ambulatory) patients before units huddles during a day shift.

What floors in the hospital have the most amount of ambulatory (independent) patients/less focus on nurses preforming personal care?

I heard the cardiac unit was a good floor- but that was from someone I spoke to in the U.S. (where they have PSW to do all the personal care if needed, and the patients the majority of the patient are independent anyways).

Thank you! ?

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You won’t find that anywhere in Alberta, and I can’t see Ontario being much different.
maybe psych? If you’re really focused on building the nurse/patient relationship.

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Try addictions. I've given zero showers and changed one diaper in five years.

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Specializes in Cardiovascular Surgery, Cardiology.
5 hours ago, amandab13 said:

You won’t find that anywhere in Alberta, and I can’t see Ontario being much different.
maybe psych? If you’re really focused on building the nurse/patient relationship.

Alright, thanks for your input!

1 hour ago, GBC_Student said:

Try addictions. I've given zero showers and changed one diaper in five years.

Interesting, I will look into it- thanks!

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I’ve worked in two provinces. What you dream of rarely happens in Acute care. Stays are rarely long unless your patient is a train wreck and then they become emotionally draining.

Inpatient Psych, maybe?

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Specializes in Cardiovascular Surgery, Cardiology.

It's not a dream, I'm just wondering if anyone has experienced it. But I totally hear what you are saying, thanks!

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On the unit I work on, we have an exclusion criteria that says "no total care patients - independent patients only." However, you have to keep in mind that all units are part of the hospital. When there are 60 patients waiting for admission in emerg and your unit has the only open beds, you're gonna get all sorts of patients. The site managers will push the unit to admit, even if the patients are not suitable for your unit. This happens a lot, since most hospitals operate at > 100% capacity.

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Specializes in Cardiovascular Surgery, Cardiology.
4 minutes ago, Kenobi said:

On the unit I work on, we have an exclusion criteria that says "no total care patients - independent patients only." However, you have to keep in mind that all units are part of the hospital. When there are 60 patients waiting for admission in emerg and your unit has the only open beds, you're gonna get all sorts of patients. The site managers will push the unit to admit, even if the patients are not suitable for your unit. This happens a lot, since most hospitals operate at > 100% capacity.

Very interesting! What type of unit do you work on?

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Many hospitals are opening 23 hour stay units. If they are used for what they are created for life should be good. All have to be walkie/talkie and able to leave 23 hours after their admission, so day surgery patients that couldn't go home for whatever reason, surgery patients that are kept overnight for monitoring and should go home the next morning, many stipulate no high BMI's due to limited equipment, no blood transfusing due to limited staff, no known IV drug users.

But Bed Managers will call and want you take their "almost ready for discharge patients", emerg is full and can you take an on-call appi, broken ankle, etc.

The patients have to be basically self caring to be on the unit. But they will try and place dementia patients, total cares, Etoh patients that are detoxing. You need to be able to weed out the nonsuitables and hold your ground but many Charges will take whatever gets sent and then expect a medal for going above and beyond, while their coworkers are filing incident reports.

It's also not a good place to have your first nursing job because you need good assessment skills and be able to work with a very small team, often an RN, LPN and NA.

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You would be looking for a unit that is Subacute/Transition or Restorative care. Edmonton has a few of those in AHS. Calgary has a few, PLC unit 51, Carewest has RCTP (restorative care program) which helps people rehabilitate a bit longer once they have stabilized medically. RGH in Calgary also has an Acute Geriatric unit, that is a bit more medical but still rehab focused.

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Specializes in Cardiovascular Surgery, Cardiology.

WOW, thanks so much- very insightful!

7 hours ago, spetryk22 said:

You would be looking for a unit that is Subacute/Transition or Restorative care. Edmonton has a few of those in AHS. Calgary has a few, PLC unit 51, Carewest has RCTP (restorative care program) which helps people rehabilitate a bit longer once they have stabilized medically. RGH in Calgary also has an Acute Geriatric unit, that is a bit more medical but still rehab focused.

WOW, thanks so much- very insightful!

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Specializes in Operating Room.

Definitely Mental Health, Mom & Baby units, Peds

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