beyond all hope

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It's 230 am and I'm waiting for labs. It takes, on average, about 4 hours for labs to come back - 3 hours for the order to get done by nurses, and an hour for the lab to process them. 4 is an average - can be as little as 1 1/2 hours (if I draw and run them myself) to 8 hours or more.

How long do your labs take to come back?

How about scutwork? How often do you draw your own labs, start fluids, push patients to x-ray/CT?

It takes about 2-3 hours after I write a patient for discharge for the nurse to actually give them papers? How about you?

Please let me know I'm not the only one working in third world conditions...
 

Seaglass

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I have worked in hospitals that were very efficient (<30 min for labs to be drawn, ~1hr for results) in a community hospital to very inefficient (~1 hr for labs to be drawn, ~1 hr for results with reporting on LastWord - my absolutely least favorite reporting device). I just got in the habit of drawing them myself if I had the time (which I always did as a student). The nurses were happier, I was happier, everyone was happier.

Casey
 

Febrifuge

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Dude, that's what your friendly ER Techs are for.

At "my" ER, order slips (blood, pt to Xray, etc.) are printed up and sit on the countertop only long enough for the next free person to grab them. They stay there >30min only if we're slammed. We hate being bored and like assisting the docs.

(Especially if you're cool, bring an iPod to the station, share snacks, and let us help with/watch the cool procedures.)

Then again, the lab is a little overworked and can take a little time. I think it ranges from ~90min to ~4hrs, but 4hrs would get Staff grumpy, and involved.

I have never seen a resident pushing a cart.

Discharges are quick for us too; usually it's the nurses waiting on the MD/DO to write up instructions and 'click' the pt off the system.
 
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SweetMD

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hey there beyond!

i can't believe that it takes your nurses 3 hours to draw blood, and 3 hours to give the patient your discharge instructions!!!
are they so understaffed? how many patients per nurse?
do the patients actually wait ??? :wow:- all our patients would just leave i'm sure. how many people do you have at any time in your waiting room and inside your er? how many residents?
how many new pts do you get to see / hr with all the scut?


in our er the nurses draw blood right away, sometimes i put in iv's if they can't get it -not that often- , sometimes i draw blood cultures. we bring critical patients to ct or whereever they need to go, we do bloods and iv's for peds, we have 2-8 patients per nurse, depending on acuity.
er's about 50 beds, every once in a while up to 70 pts.
waiting room at any time - can be 3 to 40 roughly.
we're 3 to 4 residents on, 12 hrs.

how about others?
 

beyond all hope

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We have a triple problem: we are severely understaffed, many of the nurses are really bad, and they are clogged with paperwork/inefficiencies. There are up to 10 patients/nurse (which is currently illegal in Cali). We have some excellent nurses but the majority are slow and lazy. On top of that, for every action they have to document in triplicate, so drawing blood on one patient usually takes 20 minutes even if they're efficient. Then something is always broken or missing - syringes, the computer, the lab, etc.

Due to the problems above, I see about one patient/hour. (see patient, draw labs, start IV, write up, push patient to X-ray, push patient to CT, redraw labs because first ones lost/clotted/QNS, argue with attending over disposition, etc) Also, many of my patients are very sick with multiple medical problems and social issues as well.

Can't wait to work at a real hospital some time in the near future.
 

The White Coat Investor

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And I was complaining about my 1.5 hour lab turnaround time. Geez, I had no idea I was living in the lap of luxury.

Our nurses and techs (and hospital) are also clogged with paperwork/inefficiency, but its nowhere near as bad as you guys describe. As an intern I'm seeing 1.5 or so patients an hour (Urgent Care type patients filtered out.) The only crappy thing is when we get a lot of boarders and we simply aren't moving as many rooms, then it is sometimes hard to carry as many patients as I would like to.
 

DrQuinn

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Lab draws happen very quickly (we get a lot of nursing students, special ops paramedics rotating through) and are drawn almost always and just held if need be. The nurses tend to actually wait for our orders and the stickers, then send them off. Our lab is hit or miss. Sometimes 45 minutes, sometimes 2 hours.

Q, DO
 

EMT036

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At the hospital I worked at, there were protocols. (I.E. Pt comes in complaining of CP, order x,y,z.) Usually the labs were back before the MD ever saw the patient. The MD could then order any additional tests he/she desired from the blood already in the lab. Added tests usually took 1-1.5 hours.
 
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