Reply To: Overflow/off-service patients + PD patients

  • Michelle Smith

    January 9, 2020 at 11:10 pm

    We are solely a 16 bed PBMT unit currently but are going to become a blended unit in the near future.  We have had periods of low census and taken many overflow patients.  All are screened to ensure “clean” as we are currently just BMT.  We get lots of hem onc, neuro onc, have had lots of “feeder-growers” from the ICN, cardiac cath kids that need to stay overnight, T&A’s and other “simple” post ops that would typically be out in 1-2 days.  We very recently had a pt receiving PD.  He dwelled at night and the dialysis RN’s would set it up and take care of his dialysis.  When he was getting HD, he stayed on our unit but went upstairs to dialysis 2xweek.  With his PD, he received it every night and was able to stay on our unit.  Hope this helps!

    Michelle Smith, BSN,RN
    Clinical Nurse IV
    Durham, NC
    United States
    Original Message:
    Sent: 11-19-2019 05:26 PM
    From: Mary Lynn Rae
    Subject: Overflow/off-service patients + PD patients

    Hello All:

    For those of you that work in children’s hospitals with multiple floors…

    We have doubled our Hem/Onc/SCT unit from 24 to 48 beds (October 2019) (we decided to keep a mixed vs. separate unit of Hem/Onc/SCT).

    Our census is all over the place and of course we are getting some off service patients (several bilirubin patients; cellulitis; fracture), especially as we gear up for winter/flu/RSV season as a hospital.

    What are some of the off service patients that your dedicated Hem/Onc/SCT unit might accept?

    Also, if you have an ONC patient that needs PD (peritoneal dialysis), would that patient stay on your Hem/Onc/SCT unit or would the patient be admitted to the surgical/kidney floor? Who would be responsible for setting up/taking down the PD if kept on your unit? We have historically only kept those patients on our surgical/kidney floor but now that we have more beds one of our attendings wants the patient on Hem/Onc but the learning curve is high.

    Same lines as above, what about external EVDs? Typically our brain tumor patients go to the neuro inpatient unit post surgery but I am anticipating that ask too (to have external EVDs on our unit).

    Thanks for any advice!
    Mary Lynn

    Mary Lynn Rae, MSN, RN, CPHON
    NPD Practitioner/Clinical Educator Hem/Onc/SCT
    Ann & Robert H. Lurie Children’s Hospital of Chicago
    225 East Chicago Avenue,
    Chicago, Illinois 60611-2991