New Grad Scared Witless of high pt load

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    I am having my preceptorship at a local hosptial and I really like the staff but I am worried about the Nurse to Patient Ratio. They are a busy Telemetry floor with a pretty high accuty of patients and the RNs usually have 6 or sometimes even 7 patients. My Preceptor (who is also the charge nurse) has talked to me about working there after I graduate in May. I want to work on a Tele floor but I'm just worried that I woudn't be able to handle that many patients. I am super scared!

    Since I am Preceptoring on the floor, can they cut my orientation?
    Is that Ratio normal?

    HELP!
  2. 11 Comments so far...

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    Down here in Florida, 5-6 patients per nurse on days is the norm. 7 only happens at night. They might TRY to cut your orientation short but you really need to stick up for yourself and demand a full orientation.

    I'm having a really hard time with 6 patients. But I am told, and am trying to believe, that it WILL get easier with time...After 3 months off orientation, I feel comfortable on a day where I am dealing with typical problems that I know how to solve. The problem occurs when I suddenly have 3 discharges and an admission all at the same time and (since we are short staffed at the moment) there is no charge nurse to help me out. Then I sink miserably. Also, when I have multiple issues that I have to deal with that are not everyday problems I am so green that I just dont know how to solve them. Those instances put me way behind but I am hopeful that as I am exposed to more and more unique situations the "unique" situations will get farther and farther between and I will be able to rely on past experience in determining my actions and this will help me to resolve them faster. And I am also hopeful that we will be better staffed soon
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    Thanks for your help. My preceptor while I'm a student will almost definitely be my Preceptor for orientation. She is really awesome (nurse for 35 years) and I know that she will not allow me to be "Fed to the wolves" so to speak. I hope when I "grow up" I can be half as cool and calm under pressure as she is.
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    I am not a Rn yet but i have been a Lpn for almost 11 yrs. I have 1 piece of advice for you. If you are not comfortable being on your own, and having that many people you really should tell your supervisor before the put you on the schedule to have your own assignment. If you except the task they expect you to do it. Nursing can be cut throat and no one will do your work for you. It's just like that. Don't cause an accident or make a mistake because you are afraid to let them know you need more of a orientation period. not to be harsh , but it's very easy to lose you license these days for dumb errors. Keep your head up ! God bless you and good luck. big hugs to ya, you'll do fine.
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    oh yeah, in a nursing home ( long term care) the nurse ratio is 25-30 patients to 1 nurse and 2 CNAs,, lol
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    I work med peds and our ratio is 7 to 1 with no CNAs. I mean no help at all. I have had seven patients many times and yes it's hard but you will learn time management skills. Just give it some time. Best advice I ever got was start meds early.
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    Thanks everyone!
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    If you graduate in May, that means you still have student concerns and a student mindset. Insist on the full orientation because being an RN is a whole different animal. Yes, you will know where things are and how to use their computer system, but other than that you will have the same challenges as any other new hire.

    Time management is one of those things that we all have to learn by doing. You find ways to combine errands, assess on the move, anticipate needs, and other things that help you become more efficient. When I started my current job, I was often overwhelmed and had to stay late to chart. With the help and encouragement of more seasoned nurses, I was able to breathe more often and pick up handy tricks and shortcuts that helped me make the most of my efforts without compromising patient care.

    The biggest thing is--don't panic. Keep your head down and keep moving. Even if you are positive that you can't finish your workload by the end of the shift, just keep chipping away at the list. If you stop to think about how bad things are, you're sunk. If you just stay focused and complete one task after another, you will sometimes be amazed at how much you can accomplish. Many times I have been certain I would have to stay late only to finish on time at the last minute.

    If tele is what you want to do, this sounds like a great opportunity, especially with the seasoned nurse to get you launched. I wish you the best.
    RUN_RN likes this.
  10. 0
    well said!
  11. 0
    There are a lot of things that factor into how bad a ratio is. Does this place have dedicated nurses to do the admissions/discharges? What is the tech : patient ratio like? Is there an IV team? Does the floor have a resource nurse? Is team nursing practiced? Is it 7 patients on day or night shift(I'm assuming night)? What is the opposite shift's ratio? How ill will the patients be that you'll have?

    Tele floors are usually 4-5 patients on dayshift; not sure of nightshift, but 7 patients is really pushing it if you don't have some of the above listed beneficial factors.


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