Always Admit to TELE

At the end of my last shift………The ED calls to give report. The diagnosis: peri-prothestic hip fracture, male in his 50s. The nurse tells me that the orthodude tells her to “admit the patient to where we normally admit”   So I stopped her immediately. I says to her “This is tele not ortho…Don’t ya think the orthodude wants the patient admitted to the ortho floor?”  She actually admitted that her and the ED doc figured the patient should be admitted to tele for the high blood pressure with no history of HTN. What? The patient had 10/10 pain and a blood pressure that normalized after the administration of morphine!

This is one example of a totally inappropriate admission to telemetry. We are not even “set up” for ortho! So of course when the patient required traction–it took hours to get the equipment and then find and ortho nurse to come down and set it up for us.

Pathetic!

I’m sticking to:  TELEMETRY/PCU

Ortho patients should go to the ortho floor.

It just seems unfair to us! Imagine the ED nurse calling the ortho floor to give report on a patient in a rapid A fib on a cardizem gtt and heparin gtt. ! All hell would break loose! The cool nurses on ortho would not manage that so why should I have to deal with bucks traction on a patient that is now normotensive with no cardiac history?

The bottom line is this: The ED nurse entered the admit to telemetry orders into the system before she got the order from the attending orthopedic surgeon: and the high blood pressure was the excuse to cover it. The bed was paged before she even got the order!! UNBELIEVABLE ! 

Admit to tele. Admit to tele. Admit to tele.

Don’t ever send me to ortho……….pleaaaaaaaaaase. It scares me!!!