What kind of patients are you admitting?
I am a Nocturnist in the suburb of a major city in the Midwest. It is open ICU and responsible for intubation and lines (including HD lines). (And other procedures as needed). For the last 2 to 3 years, I have seen interventional cardiology for STEMI and GI twice overnight for acute GI bleed. GI and IR are fighting for GI bleeding whether it is CTA positive or not. Vaginal bleeding without active bleeding seems to end up in our service even if we have Gyn all the time. Acute appendicitis without medical history comes to our service. (All appendicitis seems to get surgery still even if it is first time, uncomplicated.). All brain bleeders end up in our service. There are no in house intensivists in house. I have never seen neurosurgeon yet. Pretty much anyone that is not pediatric who needs to be admitted to the hospital comes to our service and don’t get seen by consults no matter how sick they are. Are we now universal admitter now?
Two nights ago, I had one patient coding for total of 6 times with PEA. We are a catholic hospital and not allowed to make patients DNR by futility or can’t stop code. Couldn’t get a hold of family members. I had 6 admissions piled up during the code. Gyn just wouldn’t admit 20 year old with vaginal bleeding.