I’ll never understand why stupid policies get put into place that are obviously dangerous and/or make no sense.  Well, I understand why a person far removed from bedside care might do so if it saved a few dollars.  This is not the case.

I work on a telemetry unit, one of four telemetry units on a single floor.   In the past, a person who went for a cath returned to their previous room unless they required more intensive care for whatever reason.  I would send my patient to cath lab, and they would return to me a few hours later.

The powers that be have decided that any person who goes to cath lab and receives an intervention will afterwards be moved to one of the units.  If they do not receive an intervention, they return to their previous room.  There was a vague explanation about the patients being monitored more closely by a specially trained unit.

Bullshit.  Whether or not a person receives an intervention, the care following the procedure is the same.  Patient returns flat with extremity straight for the ordered amount of time.  Vitals taken frequently and site monitored closely.  Pressure held if hematoma occurs.  Repeat.

This change would only make sense if they changed the criteria from just receiving an intervention to having the person transferred to a specialty unit if a sheath was still in place and must be pulled on the floor hours later. That is when the patient is most at risk.

Instead, what happens is what happened to that poor unit tonight.  The cath lab closes at 5-6ish.  Every patient is transferred to them.  They receive 6 at once.  Many of them still with sheaths as cath lab does not hang around to pull the sheaths for late cases.  All require close monitoring for the next several hours… at least.   This is just asking for trouble.

Why do we always have to wait for the sentinel event?

P.S.  Now that I think about it, is this a yearly ritual on this hospital’s telemetry floor?