2009 News

MNA Information Request for Acute Care Nurses


Regarding Impact of DPH No Diversion Policy and Hospitals’ Response on the Patients You Care For

As of January 1, 2009, the Department of Public Health has instituted a “no diversion” policy for patients accessing care in hospital emergency departments. The MNA is investigating how the hospital industry is responding to this directive and, most important of all, how these activities are impacting the patients nurses care for.

Our initial investigation and anecdotal reports we have begun to receive reveal apotentially dangerous situation for patients and for nurses. We are circulating this message in an attempt to hear from nurses across the state what they are experiencing in their care. For example, we would like to know:

  • How has this change impacted waiting times in your emergency departments?
  • How has this change impacted your ability to move patients from the ED to floors/units?
  • What policy changes has your hospital implemented to deal with this situation? For example, has the hospital beefed up staffing in the ED to compensate for the no diversion mandate? Have they opened up a holding area for patients waiting for admission, and if so, have they staffed it with dedicated nurses? Are hospitals floating nurses to the ED to help care for waiting patients? If patients are held in hallways of EDs, are there additional nurses added to care for them?
  • Has the hospital opened new beds and added staff for those beds to account for increases in patient volume?
  • Has your hospital changed staffing patterns to accommodate the DPH policy of no diversion, ie staffing for bed capacity or peak census vs. their common practice of staffing for average daily census?
  • If they have not done so, have patient assignments of nurses increased?
  • We have learned that in some hospitals patients are sent from the ED to floors without orders. Is this happening at your hospital?
  • In a few hospitals, we have heard that hospitals are, or are contemplating placing patients in hallways of inpatient units. This is a practice the MNA strongly opposes. Is this happening at your hospital?
  • Are hospitals implementing patient flow strategies, what are they?
  • In 2000, to deal with this crisis, the DPH recommended that hospitals implement policies to control and regulate elective admissions and surgeries, which are admissions they have control over. Is your hospital working with your physician staff to regulate patient flow?
  • Whatever the hospital is doing or not doing, we need to know what it means for your patients? Have you seen an increase in injuries or complications as a result?

To adequately and effectively address this situation, we need your perspective from the front lines on what is really happening to help us make our case on your behalf. Please tell us what you are seeing by sending an email to David Schildmeier, MNA Director of Communications, at


. Also, feel free to share this message with your email networks.