So last night I did something that could get me fired. Oh well I was looking for a job when I found this one .
To give a bit of background, I work swing (3-11) shift in a small SNF (45 beds) We are usually occupied at 85 to 90%. There has been recent push by our Corporate Office to get to 100% occupancy and to accept more residents with higher medical and psychiatric acuity. Understand we are not a locked facility and are 100% restraint free.
So I came on duty yesterday and told we were getting an admit from a hospital that regularly dumps fragile patients on SNFs. As I read the packet I became concerned as the patient was 3 days post op and just out of ICU for respiratory depression. On continuous bi-pap. Were going to wean off the machine and do PT/OT for the surgery.
So the hospital calls to give me report at 10:30 pm. Really Not even fully weaned of bi-pap satting in the high 80's when machine is off. I asked if patient would be coming with own Bi-pap as we do not have that equipment and would not be able to get it until the next day. Nurse said "well you can just leave it off and see how patient does. I said I would have to speak to my manager and the admitting physician so hung up and paged both. Admin called first an of course said take the patient. The physician called next and said "What happens if the patient codes after arrival? He further stated that he did not feel comfortable accepting the patient without proper equipment and said tell them to send patient in am to give us time to be properly set up. I called hospital and relayed info then texted my manger also tried to call her with same info but she did not pick up or return my call.
I am on my way to work today and am sure management will want to talk to me about this. From the first day I became a nurse I have always been a strong patient advocate. In reality I feel a work for the patients and not for the facility where I hang my hat. So if this is the end of this employment I will walk out with my head held high.
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Not even fully weaned of bi-pap satting in the high 80's when machine is off. I asked if patient would be coming with own Bi-pap as we do not have that equipment and would not be able to get it until the next day. Nurse said "well you can just leave it off and see how patient does. I said I would have to speak to my manager and the admitting physician so hung up and paged both. Admin called first an of course said take the patient. The physician called next and said "What happens if the patient codes after arrival? He further stated that he did not feel comfortable accepting the patient without proper equipment and said tell them to send patient in am to give us time to be properly set up. I called hospital and relayed info then texted my manger also tried to call her with same info but she did not pick up or return my call.