Wow, these patients are SICK!

[dannibeeRN]

Last year, I returned to bedside nursing after working in an outpatient cardiology clinic and stress testing lab for two years. I'm on a telemetry floor and my patients seem so much more complex then I remember them being. So many co-morbidities, so many confused patients, and so many meds! I know we look to prolong our lives but there can be so many age related body failures associated with doing so that I wonder sometimes if it's worth living for an entire century. Anyone else noticing this trend?

[MunoRN, RN]

It's a pretty well documented trend although most of the research comes from outside the US, it's still consistent with patient acuity trends in the US. Basically, a large number patients who are now step-down or progressive care or even medical floor patients were pretty standard ICU or other higher level care only 10-15 years ago. The volume of higher acuity hospitalized patients has increased substantially but the number of ICU and other higher level care beds hasn't really changed, which is a big reason the supposed nursing shortages never really materialized as predicted; they got the increase in acuity right, they just didn't realize we wouldn't maintain the same acuity to staffing standards over time.

[Libby1987]

They're certainly coming to me (HH) younger and sicker. I can't believe how young.

[llg, PhD, RN]

Yes, it has been well-documented that the acuity of hospitalized patients has steadily increased over the years -- as has the complexity of care they need. The low acuity patients are treated as outpatients. That's a big reason why the profession and hospitals are making such an effort to upgrade the educational levels of hospital nurses.