Heavy Turnover? An Admissions Nurse Might Be the Answer

Gone are the days when patients stayed in hospitals for two weeks or more.

I can remember when some stayed so long we considered them residents. And I’m sure veteran nurses can remember a time (must have been pre-Medicare) when elderly people were dropped off at hospitals because the relatives were leaving town or were tired of caring for them at home.

Yes, these patients needed an admitting diagnosis, so doctors usually manufactured one or chose one that was barely legitimate (possible pneumonia was a favorite). The most amazing thing of all? Insurance usually paid most of the costs.

Considering today’s hospital environment—DRGs, utilization review, corporate-type budgets and Medicare/Medicaid cuts—the stories about admissions and lengths of stay “back in the good ol’ days” seem truly outrageous and unbelievable. Today, it seems, the pendulum has swung the other way.

I recently read an article about the rapid turnover of hospital beds—more the rule than the exception these days. The “churn” rate on any acute-care unit can be between 25 percent and 70 percent, according to the American Organization of Nurse Executives. On a really crazy day, a nurse can see three patients occupy the same bed (sequentially, of course). That makes for a lot of extra time, paperwork and interruption.

The Rush-Copley Medical Center in Aurora, Illinois, has come up with what they think is a solution.

It’s called an admission nurse and it is his/her sole responsibility to admit patients. If you’re saying, “I want one of those!” you are not alone. After surveying their nurses, Rush-Copley found that many of the veterans were considering leaving their units because the pace of their work was unmanageable.

The new admission nurse not only relieves floor nurses of extra work, but probably does a more thorough job of taking the history and physical. This, in turn, means a more comprehensive care plan can be implemented and new patients and their families are bound to feel more confident about the care they are receive.

What do you think about the admission nurse idea?

Do you see any disadvantages?

Tell us what you think.