6 patients at once? How do you do that?? Any advice?

[RN0302]

I'm a new grad RN and just got my first job working days on a M/S floor. I will start in two weeks and was informed that you carry 6 pts per RN on this floor. In all my years of working in healthcare I've never, ever seen a 1:6 RN/patient ratio. I know it's out there but I've never seen it. How is that even possible?

I'm absolutely terrified of my new job after hearing this and now don't even want to do it. To me it just sounds wildly unsafe. I don't even know how you can keep up with the assessments, meds, and many needs of 6 M/S patients. I'm already anticipiating how horrible this new job will be and dreading it so much that I've developed stomach pain.

Any advice on how to manage 6 patients at once????

[dudette10, MSN, RN]

I'm well on my way to the coveted 1-year experience, and everything comes with time. You just have to hang in there, make changes on your time management routine based on your own self-reflection, and always keep learning.

Just starting out is overwhelming. Much of the anxiety comes from not knowing processes: the forms and flowsheets, the docs' names and specialties, where supplies are, the computer system, developing your own brain sheet, etc. Learning these things will slow you down. You will think you went into nursing, but the first few weeks, you'll feel like a glorified paper pusher!

Take those first few minutes after clocking in to lay eyes on your patients. It helps to identify specific questions you will need to ask during report, and a good portion of your assessment can already be done.

The amount of time necessary for your assessments will probably seem too long in the beginning. You might start out assessing one thing at a time. Give yourself a few weeks, and you'll learn to assess multiple things at once, often while doing something unrelated to assessment. Transferring a patient to the commode? You can assess strength, gait, hand grasps, quick look for edema, any sores/redness on the backside, any dyspnea on exertion, how quickly they fatigue, pain with movement, etc.

Concentrate on getting the basics down. If you work on a good unit with a good charge, the other nurses will have your back in emergencies.

If there is an emergency with someone else's patient, PAY ATTENTION. When someone talks to a doc, listen with one ear. What are they talking about? What was the nurse's assessment of the situation, and why did she want to talk to the doc? What orders are being given? File it away for later, and do your own research. Much learning can take place just by watching others; it doesn't always have to be through a direct line of questioning to your preceptor.

Good luck!

[DeeAngel]

I have 6-7 (never more than 7) on night shift and I have to say that the hospital I work at is the most generous in staffing ratios out there. The other hospitals will make you take up to 10 patients on night shift. Six is a very reasonable number.

[NewRookie, RN]

On 4/13/2012 at 1:44 PM, DeeAngel said:

I have 6-7 (never more than 7) on night shift and I have to say that the hospital I work at is the most generous in staffing ratios out there. The other hospitals will make you take up to 10 patients on night shift. Six is a very reasonable number.

my god