The Non-Admit Nurse

As a charge nurse one of my responsibilities is to assign beds to patients coming in from the ED.  Somedays that gets sticky:  do they need to be close to the station?  isolation?  what nurse can I overload?  Others it’s real simple:  there’s one room and one nurse.

I’m looking at the locator (which shows what’s in the ED with notes if the patient is expected to be admitted) and see the following:  admit tele, k2.8, poss. seizure.  So I mark them on my cheat sheet and wait for the call from the nursing supervisor.  And like clockwork the phone rings.

I give the room away and tell the nurse.  Eons later the ED calls up with report, but the residents don’t want tele.  I mean, really?  A potassium of 2.8 with a seizure and no tele?  As I finish pounding my head against the desk, the nursing supervisor calls back.  “So they don’t want tele.  But I have a room on neuro and a chest painer who needs a room.”

“OK, let’s swap.  Neuro can have the low K and we’ll take the chest pain.”  I say.

“Hey J” I say to the nurse who was taking that patient, “Low K is going to Neuro, but we’ve got a chest pain for you.  Same room though.”

And we wait.  The morning is slipping away and we’re starting totake bets on whether this new chest pain will show up before shift change adn the phone rings.

“Hey is the room where chest pain is going an isolation room?” ask the supervisor.

“Yeah, it’s a private.” I say.

“But is it a negative pressure room?”

“No, what are you getting at?”

“They’re ruling them out for TB.  They have a nodule on the chest film and a positive PPD in their history.”

“Sorry, it’s just a private.  You’re out of luck.” as Isay as I hang up.

“Uh, J.” I finish, “they’re ruling out chest pain for TB so their not coming either.”

2 admits, not a single on to the floor.  I say to J, “Y’know, I should try to give you patients more often.  Guess they just don’t like you!” I joke.

As frustring as that may be, I love it when that happens.  One night I tried to give 3 patients from the ED to a nurse, all three ended up going somewhere else.  I guess the patients have heard about our reputation and just don’t want to come hang out!

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