So I was charge yesterday evening and the minute I took over at 3 pm, it exploded. Here's what happened:
1) 4 ambulances enroute with no beds in ER
2) unexpected hypotensive person from another hospital department
3) unexpected employee VIP sort of person who of course had to be put back right away
4) involved phone call regarding lost item
5) chest pains and dyspneas and lions and tigers and bears in triage
6) suicidal people in triage with no bed in ER
Last time I worked charge, same thing happened only worse. I once again put us on divert for about an hour and a half. Maybe I won't have to work charge any more.
On a day like this I am a well paid bed cleaner and bed rearranger.
There is an emerging problem in the ER: Most patients in the ER these days are complicated and sick. They require extensive testing and treatment. A lot of them are admitted and so we play the bed waiting game. They aren't the kind of people that can be put in a hall bed, so ER is full of people that can't be moved. Meanwhile more people coming in who need beds. What do you do? The least sick go to the hall. Some patients and their families don't like going to the hall. I don't blame them. But whater we supposed to do? Sometimes I wish we had an ER admit holding area...
From the patient end of things, I have a question? I have always felt, the few times this has happened or I was in need) that being put in the hall is equal to being forgotten by the staff. Out sight out of mind. I KNOW I am the least sick and that is cool, but the anxiety level is raised because I feel I will never see a nurse again. Does this happen? If not, the anxiety level for patient and family might go down if this is explained.
ReplyDeleteIn our ER the hall beds are right where we can see them (by the desk). Usually the patients we put in the hall are near the end of their visit (i.e. tests are done), they are waiting to go to a room or discharged.
ReplyDeleteI know that it absolutely stinks when we have to do this. I hate it. Its not right, but as the charge nurse I don't have a choice when I have that chest pain, low BP, etc. patient coming in. All we can say is that we are sorry it happens and we try to expedite things for the patient in this situation.
I completely agree.. the OR gets their beds first, because thats where the money comes from. but we really can't be holding patients in the ER. its not safe practice. Its always been like that and i wish there was a core measure to regulate it. Another example of the healthcare system dumping responsibility on the nurse. an ER nurse should not deal with floor orders. Prilosec, now, really? I have a patient next door who is hypotensive and hypoxic, and another one is in symptomatic heart block and youre going to give me a patient who needs to be turned every hour. THANKS!!
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