For nurses at Eliza Coffee Memorial Hospital, tasks such as moving beds in and out of undersized rooms and up and down ramps aren't impossible, but the conditions are "less than optimal," said Kevin Bowling, director of emergency services.

When a patient has to be moved from the emergency department to the catheterization lab, for example, there are at least two ramps staff members encounter while they push hospital beds.

The ramps were installed as sections of the hospital were added after it was first built in 1943, RegionalCare spokesman Tom Whetstone said. Since the hospital is built into a hill, ramps had to be used to connect levels.

"It can be a comfort issue for patients," Bowling said. "Laying down on a bed looking straight up at the ceiling, you have no concept of where you're going. Add in to that ... you're sliding around."

In addition, the ramps mean staff members' time is used inefficiently.

"Our beds are almost motorized so that they can move by themselves without someone pushing, but because of the ramps, we have to send two people every time a patient goes from the ER up to the cath lab," Bowling said.

"Someone has to be at the patient's head and at (his or her) feet."

Bowling said in regard to satisfying a patient's family's needs, bigger rooms are a must, especially in the emergency department. He demonstrated the size of one of the department's smallest rooms by standing in the middle and reaching his arms out, his fingers touching either side.

Beth Ware, director of patient care services, agreed, saying the pull-out chairs in rooms on general care floors give family members a way to stay with patients, but they're not the most favorable choice. Because of the size of the rooms, though, and the technology explosion that added computers to each room, the chairs are the only options.

"Patients' families want to be with them, and we feel like they need to be with them, but it's very hard to sleep in there," she said.

In some of the smaller, general care rooms, if a chair is pulled out, beds must be rearranged to accommodate the chair's foot rest. This can cause problems for nurses, as well as for patients who have to get up to use the bathroom, Whetstone said.

Ware said because various labs are located on different floors, and because patients' rooms are too small to accommodate certain exams, patients have to travel more than they should.

"It's about the patient journey — making it the best it could be," she said.