Trauma centers are challenged to share beds with a larger hospital population of critical care patients. Often, this means that patients may be shifted between units when beds are not immediately available in the specialty unit that fits their diagnosis. They are admitted to the first intensive care unit bed that becomes available. This practice results in patients with special care needs being cared for by nursing staff who do not perceive themselves as trained to provide those needs. This practice is referred to as displaced specialty unit (DSU) admission. A review of 2-year data from one large trauma center revealed a total of 1072 DSU patients, of whom 50% were medical patients. A questionnaire given to intensive care unit nurses found that caring for DSU patients did affect their perceptions of their ability to care for such patients and affected their sense of job satisfaction. Strategies to improve nurses' comfort level and competency in treating diverse critical care patients were recommended and implemented.

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http://dx.doi.org/10.1067/mtn.2002.126252DOI Listing

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