Nursing vs Intake: The Never Ending Battle

2017-05-21 12.31.35

1500. Shift change. Acuity of the unit…high. Packed house. Seclusion rooms occupied. Intake calls…

“We have the admit here, ready to come to your unit.”

Me: (WTF?)

We’ve all been there. In my professional experience, it’s actually a common occurrence. You could probably ask any psychiatric nursing facility. Ninety-nine percent of the time, you’ll notice that there’s an endless battle between the Nursing Department and the Intake Department. Of course, I represent the nursing side.

You see…in the eyes of nurses, the intake department has one goal and one goal only: increase revenue margins by increasing the inpatient demand. We get it Intake. You all sit behind those desks of yours, taking calls, checking insurances, with some higher up boss telling you to take the call. You’d accept any patient, without thinking, having your legs wide open (pun intended). I get it. It’s a business after all. That’s how we all get paid.

But, you don’t get it do you. To you, it’s all a numbers game. To us, we’re actually on the therapeutic side of things. We think about safety, we think about the harmony of the milieu, we think about acuity, we think about staffing, we think about the progression of care and then we think about safety some more. So, while you’re sitting in your comfortable chair, we’re out in the front lines taking on the heat. Let’s switch roles for a day or two. And then let’s see who’s smiling.

Just the other day, our intake department had the nerve to rush an admit ready to come back to the unit. The patient has a history of aggression, been out of prison a 1 year ago for assault, and certainly had the intimidation factor. And yet, she insisted on admitting the patient into the seclusion room. Who the freak does that?

Coming onto the unit, I had no beds available and 2 people in the seclusion rooms. Sure, we had transfer orders, to a different unit, for 1 or 2 of our patients. However, it doesn’t really help if that other unit didn’t have any beds available yet. Our transfer orders clearly state, “TRANSFER WHEN BED AVAILABLE.” So, of course, we were all in a pickle…destined for arguments. Supervisors on both sides stepped in. Everyone was jammed up.

Who the heck admits into the seclusion room? What if we needed the room for an emergency and the so called “border” decides he wants to take a lovely nap? I swear, sometimes I feel like the intake department doesn’t use their brains.  I remember, one time, Intake was ready to admit an aggressive guy, with a history of traumatic brain injuries and a questionable brain tumor. Yet, after all that, the intake department didn’t have the brains to just send the guy out first, to get medically cleared and have that collateral. Turn on your light bulb, genius. What if that patient got struck by a symptomatic schizophrenic and then died on the spot? Who’s to blame? Obviously not you.

Back to the present. After some intense interdepartmental quarreling, the intake lady suggests “Oh just transfer out 111B and I’ll bring him back now. It’s not my job to watch the patients.” #STOP. First of all, you don’t run the show back on the unit. We’re the ones to shuffle the things around, so you can move on to your next ticket. How much of an impact are you to the patients anyway? All you know is “Hi…here’s your unit…bye.” Patients don’t even remember your name. So, you could sit there, with that patient for 5 more minutes, while we figure out what all the units are going to do. If things were to arise, what’s the point of training you for combat situations? You are in psych lady…grow some stones or move on to another job (which I will bring up, in a different topic…#staytunned).

I don’t really know who people think they are, or who I am…but I’ll tell you this. You don’t run my unit. I don’t really care what you think about me. Say I’m “not a team player” or “he has an attitude” all you want. The bottom line is. I’m the charge nurse on the unit, for a reason. It’s because I know what I’m doing. Unless you have a license on the line and/or lending an extra hand to watch these patients, by all means….please feel free to do whatever it is you want. But, until then, sit down and take a seat.

My rant has ended. Thank you for taking the time to read through our frustrations. Please by all means…if you’re a representative of an Intake Department, feel free to justify and elaborate your views! But to tell you the truth, I probably couldn’t care less on what you have to say.

Comment below! Let me know what you think!



Author: nursesarereal

My nursing professor once said that keeping a journal, over time, will allow me to see growth. In myself? I’m not sure yet. I’m hoping. I like to believe that nursing school saved my life. Maybe I’ll have some fun doing this. Cheers.

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