"The Golden Hour"

"The Golden Hour" is a term my facility uses to dictate an hour of time from 645 and 745, during shift change, where patients are not supposed to be transferred to the floor. It was believed this hour of time helped decrease patient deaths and increase safety.

It has come to my attention that this practice is now being lifted at my hospital. It is believed that due to telephone taped report there does not need to be this lag in transition as more nurses are available on the floor.

I am curious as to how many of you work for facilities that have this practice, have had it in the past, or have never heard of it. From your varying experiences what are your feelings on this practice? Important? Cumbersome? Meaningless? Safe?
Hmmmm I have never heard of this. I will have to see if my facility has a policy around this. I have never known a patient to be admitted to our unit during that time but I don't know if it's because it's meant to work like that.

I know technically we're not supposed to have transfers into the unit between 6:30 and 7:30, but it happens all the time and we accept them anyway.

Never heard of it but am extremely jealous of those who have it!

We have that, but we get admissions from the ER during that time anyway.

I would ******* KILL for that. Too often Day shift dumps these guys onto us and it drives me crazy.

Haven't worked under that policy, but it was just respect for the patient and staff that transfers were not done at that time, however some units were privileged and could transfer anytime they wanted no matter what.

No, but my facility tries. When the ED is overflowing, the hospital is on divert and critical care beds need to be transferred for cases coming in, we get admissions regardless of unit report times.

It depends upon the nurse working in the ER whether we are given an admission at that time. I don't mind starting an admission for the following shift. I can also understand the thoughts regarding patient safety, though in practice it may not have much effect. I do believe it would improve documentation by not feeling so rushed, and thereby improving patient outcomes.

I Dont think our hospital has an official policy, but our floor created an unofficial one.The charge nurses are really good about rarely accepting a patient when its close to shift change. Of course, it does happen. In that case, we have a list of the tasks that need to be completed based upon the patient's arrival time to the unit. For example, a patient comes in at 630, the current RN is supposed to do a,b,c. Patient comes in at 645, current RN does a,b. Then during report, the new nurse knows when the patient got to the floor and what was done. Usually its stuff like get patient comfortable in room, do initial assessment, those type of things.This plan/policy was in place before I was hired. I believe that the staff as a group voted on the times and what tasks needed to be done accordingly. I think this plan creates a lot less problems. Both the oncoming and leaving RN understand their duties and its not left up for interpretation. In most cases, the leaving RN documents a basic assessment and makes sure the patient is comfortable. The rest of the stuff (med rec., admission profile, all the FUN stuff!) is left for the next shift to finish up. It's really never expected that you will stay to finish that, only if you are feeling extra nice!

We try, but then ER complains and it's out the window.I don't mind admits at that time, IF they are stable. But I'm always getting patients at that time that are anything but stable.

Not many places do although I had studied it years ago and found incidental OT actually decreased because the nurses didn't have to stay and finish the orders and admit. I have worked at a facility that has a policy to settle the patient on one shift and the paper work for the next if within the "witching hour"Sad they are getting rid of it.....

We have a policy of no patient arrivals (admits or transfers) and no called reports between 0700-0715, 1500-1515, 2300-2315 so that on-coming RNs can get uninterrupted report. The first five minutes is "huddle" then we get 10 minutes to get report on 4-5 patients from 2or3or4 off-going RNs and the computer. What a joke.This is in no way enforced. Team leaders are in report at this time so no one says boo about it. We get patients from multiple areas (ICU, ED, cardiac recovery, PACU, admissions area, direct admits) so it is not uncommon to see 5 stretchers in the hall at 1510. When the ICU nurse gets pi$$y with me because she had to wait 2 minutes I tell her to take it up with the ED, they beat you up the elevator and I had to call a rapid response on that one. Our manager "understands that this could be a problem", and "we have to have that conversation". At that is as far as it goes. No sentinel events. Yet.