When I was in nursing school they never taught us about “administration.” I guess they figured we would learn that ourselves soon enough. Well..it is that time of year again! It seems that all the “prn” staff has quit. I wonder what new jobs they have found. Oh…the weather is changing and somehow our floor is full~ every bed taken. Administration likes to come on down to the floor from these tidy little office and they start staring at the bed board as if that was going to miraculously “open” up beds for the patients being “held” in the ED waiting for a bed. Now I understand the situation, I know those ED admits need beds. Here is the thing though. Administration turns the place into a “feeding frenzy” Nurses are rushed to get the patients to regular floors to open up for the new admits. That means badgering the MDs starting with the cardiologist~ “Does this patient still need tele?” or “Can this patient go to a general medical floor?” If they say yes~ Another call needs to be placed to the attending to get the final approval as well. Now I am a busy nurse with 6 patients, understaffed and under appreciated just TRYING to keep my patients safe. I do not have time to keep making all these phone calls! I think that the Nursing Supervisors should start making those phone calls. I am sick of it.
Ironically I came across this article here by way of Kevin MD~ It is a merry-go-round. I have no problem accepting patients from the ED in a timely manner if there were just enough NURSES and enough BEDS to take them! Sometimes the ED nurse will think that we on the floor are “stalling” or taking our time. The patients on telemetry can only be moved off telemetry with orders from an MD and it takes time in the midst of doing other things to get those orders.
I really “feel” for the ED~ it should not be a holding area and the flow should be appropriate for everyones safety. I hope it gets better. We need more staff. That is the bottom line.