Staffing a telemetry unit

How do hospitals get away with this crap? I can't believe some of your ratios.

I've had an eye opener since I started telemetry. We have 5 patients 80% of the time...with 4 and 6 being the other 20%. I think 5 is too darn many. I had 4 last week and ALL 4 were train wrecks. I would leave one room and situation only to have to go to another room and situation. Then, at 3 that afternoon I got a direct admit. Of course, I didn't get to chart until shift change that night.

I've decided I'm probably going back to LTC soon. It's hard work and yeah...you might have 30 patients..but, if they're sick...they get sent out to the hospital and they are not your problem anymore.

A lot of days at work...I feel like I'm holding on to the edge of a waterfall...drowning because I can't keep up. Add that to the fact that while I was in RN school (I was an LPN first), I realized I didn't want to be a nurse anymore....and, well, burnout is going to come quickly.

My Heavens, I'm glad I nurse in California. Our nurse-patient ratio requirements got us shut of a lot of the abuse I see our sister nurses taking. (Though the managers still try)! Telemetry is NOT Med-Surg with monitors. Telemetry is VERY sick patientswho need 3 hours of care instead of two. Where the hospitals got the idea that it was ok to staff at 2 hours, I don't know. The working premise seems to be that if it becomes common, it becomes standard; ie: The more you do, the more they want you to do.
So, DON'T. I know that a lot of you cannot file Assignment Despite Objection forms, but at least make a big noise about it. Do yourselves, and your patients a service.

CSA

Y'all are making my hospital look good. I work on PCU - all beds are monitored. Our ratio is either 4:1 or 5:1......never do we get more than 5. I think 5 patients is too much...especially when the majority are new admits & very sick.

Having a PCT is another story. Sometimes we have one, many times we don't. If they could get that position staffed properly, I'd be quite happy.

we are just dealing with this where I work, had an incident 2 weeks ago that spurred me to go to the powers that be, our nurse-pt ratio is between 6 and 7 per nurse, we have techs that can do accuchecks and pt care, I had a team 2 weeks ago where 5 of the 6 pts were very,very high accuity including 2 that were having chest pain/sob,both still being worked up and 2 other pts. that were having extreme blood pressure issues that were unresolved, my one stable pt wound up going into flash pulmonary edema and we coded him, after I managed to get the attention of management and we met to discuss staffing issues, how teams are assigned simply based on number of pts with no regard for pt. accuity. we are now looking at using some kind of accuity system to help prevent this from happening again. anyone out there use an accuity system that they like?

Hi all,
This looked like a good thread for my first post. I'm in PA on a tele/med-surg overflow floor.

Day shift: 4-6 pt (charge has no pt) with 2-4 aides.
Evening shift 4-7 pt (charge can occasionally have pts) with 2-3 aides. Night shift (my shift) 7-9 pts (charge has 6-8 pts) with 2-3 aides. I usually volunteer for charge at night so I can have 8 pts instead of 9 plus that whopping extra dollar per hour for charge!!

We usually have a monitor tech for each shift. However, that isn't always the case. 2 weeks ago, the nursing assignment was 8-8-9-9 with one aide for the whole floor and NO MONITOR TECH! The nurses rotated through the MT station, covering for each other on the floor.

We have an IV therapy team (1 person for the whole hospital on nights), a respiratory therapy team (1 person for the whole hospital on nights, 3-4 days/evenings).

There are mornings I go to give report and can barely remember any details about the pts I "cared for" overnight. Mix in the cardizem/amio/heparin/dopamine/insulin/nitro/protonix drips, the c.diff pts requiring the iso garb each visit to the room and it's frustrating. This isn't safe health care by any stretch of the imagination. I've only been nursing this for a year and a half and I can certainly understand burn-out!!!

Oh well. Sorry for the rant on my first post.

I have worked tele for about 15 yrs. We have 33 beds divided into 3 modules that used to be split 11 each but we remodeled the floor about 8 yrs ago and mod 1 has 10 pts, mod 2, 11 and mod 3, 12 pts
A typical day is 1 RN to each module with and LPN so 2 licensed people and hopefully one tech sometimes 2 split the floor. Module 3 is always the bear. We do caths, r/o's, AICD's, perm. pacers, PCI's pre-operatively and pre-op CABG's. We have pretty much the same staff for days as we do for eve's and nocs. We are an extrememly busy floor. So busy we seem to have a revolving door especially for the LPN's. Our hospital recently changed from JCAH and went to HFAB (I think it is) as apparently they are about 50,000 cheaper than JCAH so now the RN has to assess all pts, as HFAB requires, BID. Basically all the LPN gets done is passing meds. We sometimes have a float RN to do admissions and discharges----but 1 person isn't enough to go around. We cry about staffing to no avail. We have the same staffing we did 15 yrs ago when we had 8 monitored beds and only did caths in a big truck 2 days a week. No CABG's or PCI's back then either nor did we have an EP guy. In fact we only 2 cardie boys back then, we have 7 now. No gtts back then either except Lido. (Eastern IN)

I work a tele unit and I was told our ratio was 4-5. When I have 6 and a couple of them are walkie talkies I can manage but when at least three of them are very sick and there is any kind of turnover it gets scary. I only have a year experience but I see nurses with 20 years of experience struggling. I think it depend on acuity level and the demographics of your patient population. For instance: my patient population is poor, uneducated and really ghetto....It makes the workday a lot busier for many reasons.

that is awful and disheartening

before I left for acute care rehab (hard, hard HARD job) I did tele, (maybe 1 1/2 years ago, and we had 5-6 pts with a CNA to do accuchecks as well. No drips unless I had to start a nitro gtt before shipping off to the unit, no AMi's, real bad chf's went to ICU. The work wasn't bad, it was all the "extra" stuff we had to do, like customer service stuff, and paperwork. The actual patient care wasn't terrible. In any given shift I would have one "bad" pt, and one total care, and 3-4 stable r/o type patients going for ECHOS, Caths, scopes, CP, CHF, Copd, drug seekers, post caths (no pulling sheaths). Like I said, the actual caring for the patients wasn't the hard part.....