Question

You are the house supervisor in an acute care hospital. Most of the of the units are full. The ED request 2 admissions to the step-down unit. The floor with appropriate and empty beds has only 4 RNs on duty for this 30-bed unit with a census of 20 patients. The charge nurse (one of the 4 nurses present) tells you that they can’t safely admit any more patients. You currently have no more float pool staff and upper administration has already said no to closing the unit for admissions at this time. What should be done? What is the ethical dilemma? How does this impact patient care? What possible solutions are there for this situation?

Answer 1

In this case the patient should be kept back in in ED itself inorder to avoid lack of care to the patient.First and foremost makesure that the patient is comfortable in ED.Then approach the step down unit head nurse and ask her to inform the consultant of the patients to assess the patients in the step down unit and shift out the patient who is really can be shifted out,to get the bed vacant.D the necessary arrangement for the shifting out for the patient who is not really need the care in step down unit.Example there can be patient after 24 hours of observation after the thrombolysation ,these type of patient can be reassessed and shifted out after the doctors advice.

The nurses should do arrangements in such a way that the patient should not lack anything in his care.But there is possibility to have lag in the routine care after the admission,and he may lack a very comfort area because ED is not comfortable for a patient to take rest ,and the ED nurse are not able to spend too much time near the patient.But in the aspect of the nursing care patient wil not lack if the nurses care him with vigilence.