Ramblings of an Emergency Physician in Texas
18 admitted patients sitting in the ED, waiting on a bed. 18 beds that cannot be used by ED patients to be seen.
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Scary, eh? After 9-11 there was all this talk and concern nationaly about disaster preparedness. Truth is your local hospital wherever you are really isn’t prepared for your typical mundane weekday morning.
The school teacher wonders…..”Is this the beginning of a logic problem?”
Only if 6 were on a train to St. Louis moving at 50 mph and 12 were on a train to Waxahatchie traveling at 65 mph.
Answer: The conductor’s name was Ralph.
you would think someone would do the math and just put you on divert, but if your ER is like mine, that probably takes an act of God.
I am reading this to the song “18 monkeys sitting on a bed, one falls off and hits his head…17 monkeys sitting on a bed…another one falls and hits his head…”
Welcome to our wonderful new world. Primary care docs quitting, ER’s closing, specialists refusing to take ER call, Nurse to patient ratio’s – the floor nurses won’t break ratio so the patients sit in the ER even though there are plenty of beds upstairs on the wards.
Throw in a disaster and WE ARE SCREWED!
Nurse K you beat me do it. Thats what I get for working so dang much and not being able to read my favorite blogs for a few days.
All I kept thinking was “roll over … roll over, so they all rolled over and one went up. There were 17 in the bed and the nursing supervisor said ‘roll over … roll over’ so they all rolled over and one went up…”
GruntDoc, I don’t envy you. Were you seeing patients in the bathrooms or what?
Six nurses on the floor upstairs running frantically back and forth between their six very sick patients as bed control pages them more patients for beds that don’t exist.
I’m a little touchy about the “floors don’t admit” rhetoric, as lately all we’ve done is been understaffed and overfull while bed control keeps trying to give me patients that i have no physical room for. There’s not a lot we can do, some nights.
Holding 18 patients in an ED that only has 25 beds is a significant problem.
But 18 patients in a 56 bed ED that can expand to 72 beds if you use the hall beds is not as bad. 16 of those patients were in an area that usually closes after midnight so the effect was minimal on the normal function of the ED. It did tie up two additional nurses, but those nurses were on call and one was brought in from the float pool to take care of them.
We have had to over come space/staffing issues that effect every hospital, old buildings, remodeling, and staffing problems.
For years the “experts” have said that you need 1 bed for every 1000 people. What this doesn’t take in to account is service radius, familiarity with the health system/hospital, and specialty care.
Basically we are victims of our own success. Just look at our patient satisfaction scores.
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