Shift Report [Annotated]

Report  @ 1900

CLINICAL CARE LEADER: [TorontoEmerg]

BEDS AVAILABLE: None. [5 North and 5 South are short-staffed and in the event, are over their census anyway. ICU has too many vents. 3 South is at census, but has an outbreak. 3 North can’t bed space. L&D and Paeds are full. NOTE: the ED is never over census. Nor can we refuse to take patients.]

ADMITS — 24

Medicine: 8 [one is dying: all we can do is find a hospital bed and an isolation room. Dying on an emergency stretcher is grosteque.]

Telemetry: 7 [One patient is Day 4 and a no code and has been asymptomatic for 48 hours. Physician refuses to take off telemetry.]

Surgery: 4 [all upper GI bleeds]

ICU: 1 [Intubated.]

HOLDS — 8

Ortho: 3

Medical: 4 [out which 3 will be telemetry]

Psychiatry: 1 [a frequent flyer psych OD who will get the boot as soon as her ethanol level drops below 20.0]

EMS OFFLOAD: 4 [EMS supervisor has called twice, looking for non-existent stretchers. No dice.]

Comments:

16 patients in waiting room; 4 will be probable admissions; 1 active chest pain is being treated on the triage stretcher waiting for a monitored bed.

Hip night, previous [3 fractures, elderly ladies tripping the light fantastic.] Trauma: pedestrian versus SUV, shipped to Holy Somolians downtown. Code Blue, v tach arrest at triage, cardioverted in two minutes, to to ICU alert, oriented and happy [(and on an amiodarone drip.) Never happens. But it did.]

Toilet in the waiting room overflowing.

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  1. #1 by AnonymousRN on Monday 24 January 2011 - 1209

    How can ICU have “too many vents”? That doesn’t happen here…. Smaller ICU?

    • #2 by torontoemerg on Monday 24 January 2011 - 1404

      ‘Tis a puzzle. They also tell me, occasionally, the patient is “too sick” for ICU.

      Seriously.

  2. #3 by Maha on Monday 24 January 2011 - 1256

    I got called in by the charge nurse for a similarly crappy looking department. For me, all hope is lost when the toilet overflows. Outlook is bleak at that point.

  3. #4 by Prada Nurse on Monday 24 January 2011 - 1819

    So glad to be out of THAT rat race. SO glad. I appreciate your reminder, though.

  4. #5 by Zoe on Monday 24 January 2011 - 2136

    Just a typical day in ER…minus the toilet flooding. Sometimes.

    I wish ER had a census.

  5. #6 by The Nerdy Nurse on Tuesday 25 January 2011 - 0120

    I love the “toilet in the waiting room overflowing”, as if to ad just a cherry to the top of the sunday.. Oh BTW- theres shit all in the waiting room, good luck!

  6. #7 by Raquel on Tuesday 25 January 2011 - 0934

    Good Lord! Wishing you the best. I don’t understand about the ICU. Isn’t that what it’s for ?

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