Please Help Me

I’m having a really hard time understanding why it takes six hours and twelve minutes to complete two bed moves between 5 South and 2 South so we can free up an ICU bed and get a critically ill patient upstairs —  one who’s already been rotting in the emergency department for ten hours.

I mean, is there some weird breach of the space-time continuum up there, where the minutes pass more slowly?

Or is there some simpler explanation?

Another mystery: when after five hours and fifty-seven minutes the ICU charge phones in me triumph to tell me they’re ready for the patient, why do I thank her for expediting the bed moves when clearly she did nothing of the sort?

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  1. #1 by JennJilks on Sunday 21 March 2010 - 1557

    Perhaps, because if you don’t follow protocol, you will pay later?! Like Dr. Eagerpants… :-)

  2. #2 by Zoe on Sunday 21 March 2010 - 1714

    When I’m in charge, I feel like banging my head against a wall would be more productive. At least I’d have something to show for it…may be just a giant hematoma, but hey, at least it’s something.

    I once spent almost an entire 12hr shift trying to get a septic patient up to ICU. This required several moves to be made within the hospital to make room. I made several phone calls pulling my “bitchy ER charge nurse” act to get things in motion, and several follow-up phone calls to make sure things stayed in motion (the hospital world does not follow the laws of inertia the same way the physical world does).

    The nurse caring for the patient then informed me that she had managed to wean this lady off the Levophed drip, off of the bipap, and had her up to the commode even! Sigh…this means the patient no longer needed ICU, and step-down would be more appropriate. This required a whole different set of moves to be made.

    Can you hear the thumping of my head against the wall????

    • #3 by torontoemerg on Sunday 21 March 2010 - 1723

      I hear you, sister, I really do… probably in time with my own head banging. . .

  3. #4 by DreamingTree on Sunday 21 March 2010 - 1839

    Maybe the moves out of ICU required discharges on the other unit. Simple enough to get a discharge done, unless you are understaffed or the discharged patient has to wait for family. Or, maybe one of those patients needed an isolation room, which required extra shuffling.

    Don’t get me wrong, six hours seems to be a ridiculous amount of time to wait. Hard to imagine what would cause that type of hold-up. But, it isn’t always easy on our end.

  4. #5 by Maha on Sunday 21 March 2010 - 1959

    I get that the floors can be really busy too but 6 hours is half a shift! Emerg has no control over its patient flow but it seems like the ER staff HAS to make room somehow.

  5. #6 by fuzzy on Monday 22 March 2010 - 0918

    Well….because the floor that the ICU pt has to move to has to move a patient out of PCU to tele…..and all the tele beds are dirty ’cause we’ve had 6 admits and 7 discharges after 7p. So we called housekeeping, and we called housekeeping, and the nursing coordinator called housekeeping, and….then another PCU pt decided they needed to crash and be a RAT call and took YOUR ICU bed, so they had to pick another patient to move, and clean the PCU bed…..’cause that was the last PCU bed, and…..

    Actual night last week……

  6. #7 by Gert on Monday 22 March 2010 - 1041

    When I worked on the floor, we were usually not sitting around with empty beds. We were waiting for the MD to discharge the patients and sometimes waiting for the patient’s ride home before we could get them out. Then we had to wait for housekeeping to get the room cleaned. There are so many reasons why any of these things may take longer on any given day. Then having to play phone tag to give/receive report. For some reason, it seemed that nearly all admits from the ER took place right at shift change. This was not the floor nurse’s preference, believe me!

  7. #8 by Gert on Monday 22 March 2010 - 1043

    fuzzy’s reply is great. And since the ER can line ’em up in the hallways I suppose the floor can, too? I wonder if that would bother pt’s less than a long ER stay…..

  8. #9 by shrtstormtrooper on Monday 22 March 2010 - 1438

    Just one of the many reasons why I have no desire to ever become charge…

  9. #10 by JC on Tuesday 23 March 2010 - 0832

    I went upstairs and cleaned the bed myself once. Walked out with cleaning supplies in hand, sauntered up to the (stunned) nurses at the desk and told them I’d be back with the patient in 5 minutes and that they better be ready to take report.

    It was a total stunt.

    And absolutely worth it.

  10. #11 by JennJilks on Tuesday 23 March 2010 - 0840

    I love JC’s comment. I understand the mindset and have performed this kind of stunt myself!!!!

    Glad that our torontoemerg *is* in charge. We need more people like you around.

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