State's 'no diversion policy' is putting strain on Massachusetts hospitals
Massachusetts Nurses Association - News & Events - Archive - 2009 - State's 'no diversion policy' is putting strain on Massachusetts hospitals
From the Massachusetts Nurse Newsletter — April 2009 Edition
Wait times on the rise
Many nurses across the state reported that their emergency department wait times were increasing, some significantly. According to one respondent from a Partners-owned facility, when she came into work at 11 p.m., “The waiting room was packed. There were 17 patients waiting to be seen and those actually in the department had been waiting an average of four hours to be seen.”
Another
nurse from a hospital on the South Shore reported wait times of 10 hours, which decreased to seven hours after the implementation of a new hospital patient-flow project.
Others report that psychiatric patients are waiting even longer for care. “We also see a large number of psychiatric patients and do not have a ‘dedicated area’ for them,” said a nurse from a suburban hospital outside Boston. “While these psychiatric patients wait for bed placement they stay in the ED, taking up beds which could be used for other patients. As there are limited psych beds in the state, we’ve had psych patients in the ED as long as three days—hardly therapeutic.”
Another nurse from a North Shore hospital reported, “Many nurses are exhausted and have been in tears because they are afraid someone will die on their watch. Patients wait with significant pain in the waiting room because there isn’t an open space in the ED. A myocardial infarction went undiagnosed for hours because the ED doctor was called to the intensive care unit twice to intubate another patient.”
Policies push patients out of the ED
At some hospitals, patients are moved out of emergency departments with arbitrary time limits. For example, nurses in other units are told that they have thirty minutes to turnaround a room to receive a patient—whether or not they are prepared to do so. The MNA has received other reports of hospitals admitting patients to floors without orders.
According to a nurse, “We are forced to take the patient without medical orders and to call the respective house officer to have orders written within 15 to 30 minutes of patients arriving on the floor. This is an extremely dangerous practice for both the RN and the house officer.
One patient was on the floor for five hours before a nurse was able to conduct an assessment.”
