What's up with all the Tele holds?

[saymo82]

I work in a pretty busy ED in the STL area and it seems that lately (since January) we have a ton of tele holds everyday! Any other hospitals experiencing this? It's so bad that we're holding some tele patients for nearly 24 hours until a bed opens up. Today we had 24 holds at one point. It's getting insane and frustrating, I'm starting to dread going into work. Most days it looks like an episode of ER because we're having to put patients all over our hallways since the rooms are being used by the holds. Just wondering if this is a common problem or if it's just us!

[mama_d, BSN, RN]

I think when I left yesterday morning we had about 15 in EPIC listed as "bed requested". All were CP, SOB, syncope, etc.

It used to be that we'd have at least two or three every night that really didn't need tele, so we'd call and get downgrade orders. Not anymore. I don't know what's going on, but it's to the point that our CSNs start looking for downgrades before bed board b/c we know how tight beds have been lately.

I'm sure that it doesn't help the ED flow either that we've been getting direct admits more often. Used to be about once a month it would happen on shifts I was working...the other night we had two in one shift!

I'm getting tired of being on red all the time just from the floor nurse POV...I don't know how you all in the ED can stand it night after night. And the number of rapid responses have been ridiculous as well, b/c we're downgrading to medical too fast on some pts who then turn around and end up back on tele or worse, have to be put in a higher level of care than they came from.

Maybe once the rehab hospital opens up they can change 2S to another tele floor...it's wired already...but that doesn't help us now.

[ccatch3306]

I can tell you it's been this way on the Kansas city side also! I work on a tele unit and we have pretty much been full since October/November! We will discharge a pt and have a new one by the time we walk back upstairs were constantly waiting for clean beds! And multiple times a week we have to open an overflow unit or even pre/post to have more monitored beds! I hear since this is a constant problem the hospital I work at is planning on adding on since we just don't have enough beds also making it possible to have some beds that are able to be monitored (cause ortho is just not my thing and they would be much better on their own floor) I don't know whats going to happen but I hope it slows down soon! Constantly being short staffed and always full is starting to get to everyone!

[rninbloom]

I think it's all the stress everyone is under right now in life! People losing jobs and homes, causes a LOT of stress. I know a guy 40 years old just had triple bypass and valve replacement...all damage was due to stress over the past year!