why is a general inpatient unit called "the floor"?

[FreakFlag]

this has been bugging me lately - why is the term "the floor" used to refer to a general inpatient unit? don't intensive care units have floors also?

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[Blade28]

Hmmm...good question!

The "floor" is also known as "the wards."

The ICU is also known as "the unit."

 

[gutonc]

Hmmm...good question!

The "floor" is also known as "the wards."

The ICU is also known as "the unit."

True...but I almost always use the phrase, "When the patient hit the floor, s/he ..." when presenting, whether I'm in the unit or the wards. Confuses the heck out of the MICU attending b/c they always think I mean the pt was initially admitted to the floor then transferred to the unit immediately.

 

[Blade28]

True...but I almost always use the phrase, "When the patient hit the floor, s/he ..." when presenting, whether I'm in the unit or the wards. Confuses the heck out of the MICU attending b/c they always think I mean the pt was initially admitted to the floor then transferred to the unit immediately.

Ah. Yeah, in that case they're expecting the phrase "patient found down."

 

[gutonc]

Ah. Yeah, in that case they're expecting the phrase "patient found down."

Alternatively, they expect "FOOBA."

 

[DarthNeurology]

this has been bugging me lately - why is the term "the floor" used to refer to a general inpatient unit? don't intensive care units have floors also?

I always thought it was because on the regular medicine wards patients are usually in rooms on a long hallway with a long floor, and residents and doctors round on the floor outside the rooms, so the floor is sort of where the days work happens. Most ICUs I have been to are arranged sometimes in pods or at least around a nurse's station so that all patients can be seen and monitored more closely, i.e. you can't say have a long hallway and make it an ICU.

For example you can't place an ICU patient on the floor who needs intensive monitoring when the nurse's station may be 60 feet away at the end of the hallway. Often times sadly patients pass away on the floor and nobody finds out for hours. . .

that's just my two cents. Unit is part of Intensive Care Unit, I guess because all the patients on the unit are watched as a group or unit, due to serious illness etc. . . the center of action is usually the nurse's station in the ICU where you can see all the patients, they are usually closer together in the ICU as there is less "floor" to cover between patients.

Saying a patient with a serious condition that needs monitoring in the ICU was admitted to the floor indicates that this critical patient was mistakenly given a lower level of care than what was needed. I.e. a patient s/p MI who needed pressors and was post-op doesn't "hit the floor" . . . Obviously some patients are admitted to the floor, i.e. a 60 year old woman in no apparent distress with cellulitis which needs inpatient evaluation and treatment. . .

Here is a question for you, why do doctors differentiate between SIRS, severe sepsis, and septic shock? Part of the answer involves level of care as most patients requiring pressors who had septic shock go to the ICU. . . makes a big difference in the presentation of the patient if you say floor, but mean ICU as where the patient goes is an overall indicator of their status and required level of treatment. . . the picture of a patient admitted to the floor is drastically different from one who goes straight to the unit, and I would find it offensive/jarring if I was an attending and a resident kept referring to ICU patients as hitting the floor. . . your talking about two different ball games.

 

[SLUser11]

True...but I almost always use the phrase, "When the patient hit the floor, s/he ..." when presenting, whether I'm in the unit or the wards. Confuses the heck out of the MICU attending b/c they always think I mean the pt was initially admitted to the floor then transferred to the unit immediately.

It's slang, nothing more.

There are a lot of old school attendings who will only allow you to call it the "ward," and if you say you put someone on the floor, etc, they will respond with a smart@ss remark such as, "the floor? That's sounds uncomfortable. Hahahahaah!!!"

When I'm dictating a discharge summary or some similar document, I always use "the ward" to prevent any confusion or bad jokes.

 

[gutonc]

It's slang, nothing more.

There are a lot of old school attendings who will only allow you to call it the "ward," and if you say you put someone on the floor, etc, they will respond with a smart@ss remark such as, "the floor? That's sounds uncomfortable. Hahahahaah!!!"

When I'm dictating a discharge summary or some similar document, I always use "the ward" to prevent any confusion or bad jokes.

Our new inpatient EMR includes 2 options for writing admit orders, the first is for when the pt is still in the ED and you only want the orders you write to be acted on once they get to the ward/floor/unit and is labeled "Pt in ED." The other, for when the patient has arrived at their intended inpatient destination and orders should be acted upon immediately is labeled "Pt on Floor." The physician director of EMR implementation routinely calls it the worst thing about the EMR but says they couldn't find another phrase that worked intuitively.