I work on a progressive care unit which had a pt:RN ratio of 3:1 when I started 3 years ago and now we are moving to 4:1 ratios now. The facility/mgmt has stated that 4:1 is the national standard for progressive care units now.
They have decided to off-set this increase in patient loads by increasing the number of CNAs on the floor. So now each CNA also only has 4 patients.
The problem I am seeing is that the nurses are way over worked, stressed out, skipping lunch etc. while the CNAs walk around complaining about how bored they are.
On our unit all patients are on cardiac monitoring, (which we monitor ourselves, no tech, and alarms hooked to a pager) we do some titratable gtts (cardizem, nitro, heparin and insulin). We have some respiratory patients including chronic and/or stable ventilators, rescue bipap, and hi flow 02. We also have pre and post cardiac catheterization pts, and also post open heart (usually day 2) when they still have external pacer wires, chest tubes, insulin gtts, etc. Needless to say, the assignments are busy and adding an extra patient seems unmanageable.
The union was of very little assistance with this transition. It seems to me that patient safety and satisfaction are at risk here. I'm just wondering what others find in similar units.