Last year I posted about the annual winter surge in patient volume that leads to us holding in-patients for hours or days in our ER which leads to longer and longer wait times for the ER patients due to reduced space to see them. I was frustrated at the lack of planning for the surge despite the fact that it happens without fail EVERY SINGLE YEAR.
Here's a comment from an anonymous reader on the same subject:
I have worked for the same system for nearly 15 years. Our census doubles in the winter time. This happens every year without fail. Come winter we are forced to hold anywhere from 15-30 admitted pt's in the er because "there are absolutely no beds upstairs, sorry". As a result, there becomes no place to see er pt's , pt's in the lobby wait hours (sometimes 9-10), ambulance offloads are extended 1-2 hour waits unless they are a priority 1, any ambulance that can go out to the lobby (even the ones I would normally not have sent to triage)will go out to the lobby. admitted pt's may or maynot get a hospital bed to lay on instead of a stretcher-let alone a tv or a phone for diversion, admitted pt may miss a couple of meals while they are there and hopefully all of their orders are being implemented cause as any ER nurse knows, It is very difficult to be in both modes of nursing at the same time. In the meantime, EMS shift commander is calling and screaming at me that their medics are still sitting in my ER waiting to offload-can't blame them- if all the medics are sitting in our ER's -how can they respond to 911 calls. Pt's and family members of the people sitting in the lobby are angry because their poor 91 year old mother can't sit out there for 6 hours-can't blame them either. I wouldn't wait 6 hours for anything.
So, I ask you this- if we know the hospital is inevitably going to explode like this at the same time every year-why doesn't the hospital ever plan ahead? Is it neccessary that somebody should die first and we should have some major lawsuits before it becomes a real issue? Oh wait , that's already happened and I don't think anybody cared. I have made suggestions in the past of things we can do in our ER to keep some of the flow going, but because they never have enough staff it is impossible to even do this. In my opinion, The problem starts with administration who is either really ignorant to the fact that this issue impacts everybody, the floors who are constantly at capacity, the ER who way over capacity and now very long waits to see a dr, the admitted pt's who are forced to stay in a very noisey environment and probably not being taken care of well as they could be,EMS who has no place to bring their pt's to and the community who can't seem to get any medical attention without spending an entire day at the hospital.
This will probably be my last year as the charge nurse. I want to be able to not care and be frustrated by this another year. I feel that if the hospital administrators put their heads together, they can come up with a solution. And yes it will have to cost money but if we are the only hospital in this county to serve the community, then they will have to suck it up and invest in itself.
On top of all this, the hospital just built a unit (approx 20 beds)to lease out to another company. Under the circumstances, that would have been a perfect place to board these pt's.
Thursday, February 26, 2009
Subscribe to:
Post Comments (Atom)




14 comments:
Is the problem a lack of physical beds, or a lack of floor nurses to staff those beds?
my management has just reduced evening staff numbers in my ED to 3 (was 5) to save money.
some evenings 5 are not enough to cope with the workload.
we are also not being paid other entitlements under the award
Hello, I have a blog website Tourist Spots in the Philippines and Pinoy Jokes Feel free to visit it and if you find this two blogs interesting and entertaining I hope you can feature it on your blogs too or put a link on your site pointing to my website... That would be a great help in making my websites popular... Or I should say "Our Website".
Oh my lord, I could have written this blog. But for me the fact is our administration did make some major effort to combat the problem. They increased the size of the ED, and doubled the number of doctors and nurses. They even added a whole new adult wing onto the already large hospital putting us into a new category. What happened next was amazing! While we knew we were part of a growing community our neck of the woods had expanded as much as it could and was virtually at a standstill so we didn't expect the number of people to increase tremendously but it did. We doubled everything, the community tripled. You can't win! Falling over exhaused-LOL :)NJZONIE
Great post....Good an excellent work keep it up! Thank you
Hello
I'm portuguese, i have 22 years old and i'm nurse!
I must say i read all your blog and i love it...
its so great read about the "health reality" in another countries.
Plans are already afoot around these here parts to "expand the ER".
I've been telling every joker in a suit till I've lost my voice: "Listen. The problem is not ER capacity. The problem is ER throughput. Instead of expanding our ER, add more Tele floors and AT LEAST another ICU and I guarantee you'll see an improvement. All you're going to get from expanding the ER is simply ending up with more 'holds' in the ER".
But hey, what the hell do I know?
I worked a shift this week in ED with the 2 laziest and slowest dr's in the ED.
They do not lift a finger to help the nursing staff in any way and will happily dump their work on someone else. They also leave easy quick admissions sitting around for hours instead of getting them out the door.
needless to say, the place was inundated that night and some sick pts too.
non urgent wait was 4-5 hours
who gets the blame - the nurses
and these 2 quacks were seen in admin last week asking for more money
i really love to read your er blog! keep up the good work!
You know- we've been wondering the same thing for so damn many years. They actually closed an entire floor in my hospital to 'cut costs.' I am disgusted with the ridiculous senseless and ongoing trend of lousy healthcare. We can keep the crack heads alive for the 'next time' they code but the 90 yr olds sit in the wait room.
viagra free samples pfizer viagra effect of viagra on women buy viagra without prescription free trial of viagra natural viagra substitutes viagra free samples viagra for cheap watermelon viagra side effects of viagra buying viagra online in britain cheap viagra tablets viagra jokes viagra benefits
[url=http://www.xbox360achievements.org/forum/member.php?u=259462]buy mexitil online[/url]
Hello
I personally really appreciate your work it has a lot of info for a new blog... i myself quite new in this field i once again say thanks for your great info
Dear fellows!
Is it a deal to convert iTunes to MP3? I say NINE :) Its really puzzling not being able to play iTunes tracks with my $300 iriver!
Digging for a solution brings certain results. To [url=http://drm-removal.com/features/iTunestoMP3/convert_iTunes_to_MP3.htm]convert iTunes to MP3[/url] I used this tool drm removal (drm-removal.com or something like this, please ask me - will find that web again). I don't care what is drm - what I read, its something dealing with protection and nothing about iTunes.
But this tool really works for me and it converted quickly my iTuines entire library, including video files!.
What you your solution? Why iTunes brings this inconvinience? I didn't like ipods at all! They simple stuck and suck!
What is that drm that I loose converting my itunes to mp3?
thanks in advance!
Post a Comment