Do not believe it! Hospitals are trying to recruit nurses by saying they have an opening in their “Observation Unit”. But their “Observation Unit” is just another med-surg unit. Do not get sucked in!
What is a true Observation Unit? This is an out-patient unit, sometimes called a “CDU – Clinical Decision Unit”, where stable patients are intended to – like a rose -“just be here for a little while” and then either get admitted, dismissed, or transferred in under 24-48 hours.
The most perfect observation unit I’ve seen (where I used to work in MS) had 10-15 cubicles around the perimeter of the big room/unit, each having a curtain for privacy; and the nurses’ station was in the center.
The furnishings were basic and sparse. Supplies were limited. The TV’s were small. Patients had to share a bathroom. The nurses were cheerful, sharp, and very attentive.
Our documentation was minimal. Care concentrated on achieving diagnosis and watching for patients to meet criteria to be either dismissed or admitted fast. Official observation, in-patient, and discharge criteria had to be handy at the nurses’ station.
Ideal patients for an observation unit include: stable, non-isolation medical, trauma, or surgical adults that can be discharged or moved in under 24-48 hours.
The majority of our patients came to be prepped for, and to recover from, procedures. They were alert, usually ambulatory, and anxious to meet criteria to be dismissed. The few patients who got admitted upstairs were truly sick. That obs unit justified itself financially and medically, and had a stellar reputation.
Here are a few reasons many hospitals lose money on observation patients: admin mixes obs and in-patients on same unit, greater than allotted 48 hours stay, obs patients neglect to bring their home meds, insurance pays less for obs and does not cover home meds – resulting in a large, unpaid hospital bill.
Obs patients need to nicely educated that the insurance industry has determined that they are not sick enough to be admitted as an in-patient – so they will be in the observation unit. Patients who understand their actual status, and are treated respectfully with a positive cheerful attitude, are generally more satisfied with treatment and motivated to go home sooner – especially if the hospital has a pro-obs admin.
There absolutely is a valuable place for Observation Units in hospitals, if they are run effectively. If done right, they could make at least as much money for hospitals as the regular medical floors by rapid patient turnaround. And they should increase patient satisfaction.
So if any hospital calls and tells you they have an opening in their “Observation Unit”, do not believe them without getting ample proof. Take a tour. Ask a lot of questions. After all, it you wanted another med-surg job, you could find one easily enough.
Observation unit nursing takes a special skill-set and is fast-paced and focused. If you are an obs nurse, you deserve to work in a REAL observation unit. Its fun and rewarding. Hold out for the real deal!