Description by Charge Nurse as to how Patients are Assigned Beds on Medicine Floor
Typically, I get a demo on the printer, either the HUC puts it on my desk or I find it myself in the printer. If we have open beds, I tend to scan the printer for demos more regularly than if we don’t.
Regardless, I get the demo in some fashion or another. Upon receipt of the demo, I look to see what nurse(s) is available, and if we have an appropriate bed. One of the biggest problems with our unit is that we have 13 semi private rooms and 10 private rooms, so that means that if a patient has MRSA, C-diff, etc. it makes it much more difficult to place them.Additionally, if all I have open is a male room and I'm getting female demos, this too makes things more complicated and timely when it comes to placing.
Once I find an appropriate bed/nurse, I call bed control with a bed number. At this point, it is a waitinggame....it could be just a minute or two before my nurse gets a call with report, or it could be several hours. If more than an hour has gone by and my nurse hasn't received report, I have him/her call theunit to get report. Sometimes that works and sometimes the nurse is not ready to give report to my person for a variety of reasons.
Eventually the patient will getto our unitand that is it.
So here is my perspectiveof where the bottleneck is:
1)From the very beginning, we don't always receive demos in a timely fashion. For instance, I'll have 4 open beds at the beginning of my shift,and no demos, yet I'm hearing that the ED is full, code purple, etc. I'll call bed control and specifically ask them to send me any demos they might have. Sometimes it happens,sometimes it doesn't. If I don't get any from bed control, I'll call the admin sups to get demos (they may or may not be able to send them.)
2)Then of course, we'll get slammed witha bolus ofdemos all at once at the end of our shift.That is inconvenient for all parties.
3)Additionally, I know I have had issues, along with theother charges, with bed control forgetting to tell the sending unit that a bed is available.
4)Another issue with bottlenecks is that in the afternoon especially,it can take an hour to get a room cleaned. Again, this is a problem because it is holding up the transfer.
5)I know that sometimes that my nurses get frustrated waiting to receive report from the sending unit. Of course there are good reasons that the nurses can't give report right away, but sometimes it seems that the nurses hold their patient until right at change of shift, so that they won't have to take another admission before they leave. This is very frustrating and happens sometimes, and also adds to the bottleneck.