[NorfolkRN]

I am sure this is a very common topic on this forum but I'm going to ask anyway.
I am working on a research paper for an English class (I'm trying to get my prereqs for my RN-BSN) that is a proposal for nationwide mandated nurse-to-patient staffing ratios. I have quite a number of scholarly articles and stats and all that good stuff but I want some stories from the frontlines to show my classmates what really goes on in the hospital.

[flygirl43]

I nurse to 13 fresh postops

[Smackdown]

The one that comes to mind for me is this one.... I work in MICU in a Level 1 trauma center hospital...we are supposed to only have 2 patients each. A couple of weeks ago we were so short staffed and had a high census that each nurse had 3 patients AND our charge nurse took 3 patients, and they were still calling us admits. My charge nurse called the house supervisor to tell her that nurses were going to have to take 4 patients each IN AN ICU! The supervisor replied "That's too bad, the entire hospital is short." Some of us ended up with 4 patients, on ventilators, insulin drips, pressor drips, etc. None of the patients received good care that night and every nurse was disgusted with staffing.

Some of these patients were in a very critical state and needed special attention but it was all we could to do keep them alive till 7:45. I know that I was ready to hand in my resignation after running my ass off that night. The thing that bothers nurses the most isn't how hard we have to work on a hard night, its the feeling of that you couldn't provide the care that patient needed and deserved, and feeling like a failure because of it. It's pretty easy for management to say "Take 4 patients in an ICU, get over it" when they aren't the ones risking their liscense and it's not their mom in that ICU bed.

[NorfolkRN]

I can't even imagine. . .Thanks for replying. I really appreciate it!

[NorfolkRN]

You hit the nail on the head, its not the work that makes it so stressful, its knowing that you can't provide the quality of care that the pt needs, especially in the ICU. I was an ICU RN before leaving the hospital setting and the most that I had to take care of was 3 and that was a nightmare but 4 is unimaginable to me. Well, I am definitely going to be quoting you in my paper. Thanks for replying!

[Nurse4years]

I have twice worked 24 hours straight. First time-working 16 hour shift at LTC through agency- relief called in. Agency couldn't/wouldn't help- admin for LTC wouldn't even answer phone.
2nd time- same @#$%, different day (and place). This was a RCF for severe MRDD. 12 hour shift turned into 24 hours.
You can't leave. Nothing you can do- Just hope you don't hurt anyone.
16 hour shifts have turned into 20 hours due to relief being late. This has happened more times than I can count.
Prefer 12 hour hospital shifts- I have seen management come in and work at hospitals. I never saw this at LTC for short staffing or late calls. Only when most of the staff quit does admin have to take to the floor.

[oramar]

One case in particular that comes to mind was an incident where I was caring for a doctor's mom. I had eight patients and my unit had no aide, a situation that occures much to often. Anyway, the doctor was raging because his mom needed a lot of care and wasn't getting it because of short staffing. I sympathized with him about the poor care and I agreed with him that his mom needed one on one attention. I just couldn't do it nor could any of the other nurses on the other shifts where staffing was even worse than it was that dayshift for me. Anyway, he was really giving me a hard time and making my life miserable but I kept pointing out to him that he needed to talk to managment. Finally he did go to managment and demanded to see a staffing grid of all the units in an attempt to find one that was adequately staffed. There was none, not even one unit in the hospital had a 4 or 5 patient to one nurse ratio let along 6 or 7 to one ratio. Every floor had an 8 to 1 nurse ratio or worse. So he calls his mom's attending physician and demands that the attending transfer his mother to ICU where presumable staffing would be better. Well the attending complied and wrote the order to transfer his mom to the intensive care unit. BUT, they forgot to check ahead of time to see what staffing was like in ICU. After the woman was transfered I can't vouch for what happened but I heard that they got his mom down in ICU and found out the ICU nurses had 4 patients a piece. I also heard that he went ballistic and had her transfered again to where I don't know. Anyway some people will say he is a doctor, couldn't he afford to hire private duty? I heard that they did eventually get her private duty but it took them a while to even find a nurse to do that. Also, I want to say that I can provide good care to 8 patients when I have my own aide and fair care when I have 1/2 an aide. However 6 or more by myself I just can't do it. If I can't do it no one can because I am pretty darn good . I hesitated to even post this because doing so forces me to admit that sometimes my patients were not getting topnotch care. I hate that, I hate even thinking about it, it feels like a failure. Sometimes I even blame myself, thinking if I was younger, smarter, stronger, quicker or more organized I could get the job done correctly. I can't think about it to much because inthe past it has sent me into a depression. PS I am not currently working in nursing, took myself out of the frey about a year ago, just got to be to much. I am really happy I did because I it feels so good to be alive, something I can't say when I am working at the bedside.

[NorfolkRN]

People used to 24 hr shifts @ a hospital in CA where I worked and I thought they were crazy but being forced to work because there is no one there to relieve you is a nightmare. Its sad that things like that happen every moment of every day in this country because I think that alot of administrators at places like where you were think nurses are disposable. Thanks so much for the input for my paper. I really appreciate it!

[scarymary]

[quote=NorfolkRN;2808824]People used to 24 hr shifts @ a hospital in CA where I worked and I thought they were crazy but being forced to work because there is no one there to relieve you is a nightmare. Its sad that things like that happen every moment of every day in this country because I think that alot of administrators at places like where you were think nurses are disposable. Thanks so much for the input for my paper. I really appreciate it![/quote



The absolute worst I ever had was as a newly qualified nurse working in a 4 bed HDU. I had been qualified 3 weeks and was left in charge of the HDU overnight with another nurse who had qualified with me. Only by the grace of God that nothing awful happened.

[NorfolkRN]

What an interesting story! The idea that nurses are being denied the opportunity to give the kind of care they know their patients deserve to because of staffing in hospitals and LTC facilities. It makes me so angry because I know that what it really comes down to is money, the hospital doesn't want to spend the money to hire the nurses. And what that really says to the people of a community is "we care more about money than about our patients."
Your story perfectly illustates the point I am trying to make in this paper. I too have left the bedside and am so much happier even though it makes me sad because I loved caring for patients in the hospital, I didn't love all the bullsh*t that i had to deal with but I loved my patients.
Thanks for the great input!