The view from front-line nurses
“As a medical surgical nurse who
often finds herself overloaded with very acutely ill
and vulnerable patients, I find it hard to believe anyone
who cares about the quality and safety of care in a
hospital would even suggest boarding patients in the
hallways of emergency departments or inpatient units.
I can’t conceive of how I would be able to manage
a normal case load of patients in rooms, and also be
assigned a patient in the hallway. How could that patient
have any privacy? How can I take a history? How can
I maintain any semblance of compliance with HIPAA regulations
with that patient out in the middle of the hall? And
what happens with their family member? There are so
many problems that could arise, including the total
lack of infection control, not to mention the management
of pumps and other equipment that the patient may need.
It’s a recipe for disaster. This is not the solution.
This is an insult to every patient who is forced to
endure such care.”
—Marlena
Pellegrino,RN, St. Vincent Hospital in Worcester
“Caring for patients in the hallways
in and around our ED has become so common that there
are now two permanently established beds that are used
just for this purpose. These beds are each curtained
off and they’re outfitted with the basic types
of equipment that an RN would need to care for a patient
. . . but they’re in a hallway! In addition, the
hospital will add up to two more beds in the halls if
they need to—all while they shuffle patients back
and forth between ED rooms, hallway beds and waiting
room chairs depending on what a patient’s condition
and situation are.
“This situation has become the
norm in our hospital, and it’s one that the patients
don’t even recognize as dangerous and intrusive.
It is also a situation that could potentially put my
license in jeopardy. The mandate from hospital management
is that we DO NOT transfer patients out, but caring
for them in the halls goes against what I was trained
to do in nursing school. Under these circumstances,
I find that I begin each shift by hoping and praying
that there won’t be a case that tips the scales—the
type of case where I’ll have to fight with management
over how and where this patient is cared for.”
—Diane
George, RN, North Adams Hospital
“As an ED nurse for more than
20 years, I understand the frustration of colleagues
who struggle every day to provide appropriate care in
overcrowded emergency departments, having worked many
a shift with stretchers in the halls, waiting for a
bed to clear up on the units and floors. But as a patient
advocate, I cannot and will not condone a practice that
simply transfers the indignity of hallway care from
my unit to another unit.
“As an MNA member for my entire
career, I know the MNA has never condoned placing patients
in hallways anywhere in the hospital. The problem
with ED overcrowding isn’t about nurses being
pitted against nurses, it’s a problem with administration.
“I know the reason a bed isn’t
ready for my patient is because management hasn’t
staffed or hired enough nurses to open that bed. I know
it’s because my administrator hasn’t taken
other steps such as postponing elective surgeries. I
know that hospitals that could be going on diversion
are choosing not to or are waiting too long to make
the decision to go on diversion even though that
would be the safe thing to do.
“It’s time for DPH and MHA
to stop this policy and to work on solutions to deal
with this crisis that aren’t based on pitting
nurses against each other, and most important of all,
that put patients’ care and well being first and
foremost.”
—Linda
Condon, RN, Quincy Medical Center
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