[sister--*]

Need your assessment.

Hospital. Two floor nurses.

6 pts., 5 heavy/total care requiring frequent transfers about every 15 minutes...bed to commode, commode to chair, chair to commode, return to bed, and then all over again. These pts. are at least two assist, thus tying-up both nurses. Meds every 1/2 to 1 hr. on most pts., blood transfusion, hematests, assessments, baths, nausea/vomiting, restless dying pt., pleural drain procedure, dressing changes, meal tray delivery, feeders, facility transfer, of course new orders and more new orders, paperwork and more paperwork.

No aides/orderlies/assistants. ALL care is Nurse provided.

Meeting called to discuss this day after Nurse first approached charge and then higher-up about "drowning" and needing floor assistance. Was told to expect increases in workload with no additional Nurses assigned or any guarantee of nurse aide assistance. Was told that each request for help may or may not be honored at CN discretion....including sending someone to help with physical transfers.

Now, we've been working this way for awhile now and today was just way over-board.

By the time the day ended we were exhausted (mentally and physically) and famished....no breaks, no lunch. It takes its toll when it's the norm VS the exception.

So, what's your assessment of this? I'd appreciate some direction.

[CHATSDALE]

if you do it one day then they assume that you will do it the next day and the next..if it is possible to get a transfer to another floor do so; if not you are putting your license on the line..hand in a two week notice with a letter attached explaining the precise working conditions you have endured

[Christie RN2006]

6 patients for 2 nurses isn't bad in theory, but when you add in all the care you have to give, sometimes that is a lot!

I only had 3 patients on a step down unit the other day and I was drowning. One was a new admission (came in right before I came on shift) who was getting blood, continuous bladder irrigation, lots of pain meds, turns, etc. and was just very needy. One was a recent belly surgery that was restrained. I no more than get report on those two and ER is on the phone wanting to bring me a patient... let me start by saying it was the worst report I have ever been given!?!? They didn't know anything about the patient... I found out why, it was because they hadn't done anything with her!! They brought a stroke patient to me and hadn't even bothered to start and IV or get the fluids running that the doctor ordered! She wanted up to go to the bathroom often and she was neuro checks and vitals every two hours... Neuro checks on her didn't take the normal few minutes, but instead a long time because it took her forever to get the answers out. She was scheduled for an EEG so we had to wash her hair, and she was having lots of tests done.

Who would have thought having only 3 patients could be so difficult! Oh and to top it all of I am an ICU nurse and that was my first night on step down, so having to figure out where everything is and how they do things made it even more stressful! They never bothered to orient me to step down...

[Christie RN2006]

Originally Posted by Christie RN2006

6 patients for 2 nurses isn't bad in theory, but when you add in all the care you have to give, sometimes that is a lot!

I only had 3 patients on a step down unit the other day and I was drowning. One was a new admission (came in right before I came on shift) who was getting blood, continuous bladder irrigation, lots of pain meds, turns, etc. and was just very needy. One was a recent belly surgery that was restrained. I no more than get report on those two and ER is on the phone wanting to bring me a patient... let me start by saying it was the worst report I have ever been given!?!? They didn't know anything about the patient... I found out why, it was because they hadn't done anything with her!! They brought a stroke patient to me and hadn't even bothered to start and IV or get the fluids running that the doctor ordered! She wanted up to go to the bathroom often and she was neuro checks and vitals every two hours... Neuro checks on her didn't take the normal few minutes, but instead a long time because it took her forever to get the answers out. She was scheduled for an EEG so we had to wash her hair, and she was having lots of tests done.

Who would have thought having only 3 patients could be so difficult! Oh and to top it all of I am an ICU nurse and that was my first night on step down, so having to figure out where everything is and how they do things made it even more stressful! They never bothered to orient me to step down...

To finish my rant The only difference between my drowning and yours is that the charge nurse knew I was drowning, so she came in and checked/entered orders for me and sent a float nurse to help with things. The other nurses and aides were also great about jumping in and helping me with whatever they could.

[Rizpah]

If the hospital isn't concerned about lawsuits, they aren't going to be concerned about your license. I'd leave. Sad for the patients though.

[bigsyis]

Not only for pt safety but your own, I would look into a transfer or another employer. Our job is a physical one, but what you have been doing would strain a weightlifter! Literally, watch your back!