FED Holds & Attendance

FED Admission Holds

This is becoming an issue again; I wanted to review our transfer process. Please review the flow policy which actually has the patient transfers to be out of units in 30 minutes; however, this was pre-covid with issues that we have never faced before. FED patients will be given room assignment priority.

<CLICK HERE TO READ THE FLOW POLICY>

The physician will put a decision to admit in Cerner

Either the physician will call the transfer center or they may ask the nurse to call and ask if a MS/ICU bed will be available in the next 4 hours.

IF YES – physician will admit per usual process by securing an admitting physician and place the AOT order in Cerner and the RN will be in contact with the inpatient RN and call the ambulance for transfer as soon as the room is available.

IF NO – physician can pursue transfer to other facility: ED to ED or Direct Admit beginning with BSA

If no other admission avenue is available and the patient is appropriate for NW Services, the physician will admit to NW and the FED CN will work with the ED CN to initiate an ER to ER transfer. It is an expectation that both CNs will act with courtesy and respect in working out a transfer plan.

If the ER to ER transfer is not going smoothly, the RN will call the house supervisor for assistance. The house supervisor will assist in a transfer plan and/or escalate the issue to the AOC as needed.

Call-Ins

We have seen a tremendous increase in call-ins lately. Please review the NW Attendance policy, and want to encourage you to have a responsible attendance record. I am not encouraging showing up ill as that will cause more call-ins but please be proactive to find replacements and alternate forms of care for family as this places a tremendous burden on your coworkers. Also, with the addition of the third nurse per shift, it may seem of no consequence to call in; however, this position is important if we want to retain staff and practice safe patient care. This excerpt is out of the attached policy and will be followed:

<CLICK HERE TO READ THE NW ATTENDANCE POLICY>

Progressive Disciplinary Guidelines
A. A preventative counseling will be issued to an employee with three (3)
unscheduled absences in a twelve (12) month period.
B. The first written counseling will be issued to an employee with four (4)
unscheduled absences in a twelve (12) month period.
C. The final written counseling, with possible suspension without pay
issued to an employee with five (5) unscheduled absences in a twelve (12)
month period.
D. When the employee has six (6) unscheduled absences in a twelve (12) month period, termination of employment may occur at the facility’s discretion based on the employee's previous work record and the circumstances surrounding
the absences.