[nurseodra]

aspan's recommendations are just that. recommendations. and that's how hospital's get away with it. they recommend that two licensed staff be available, so many pacu's have one nurse and then use the OR staff is available if needed excuse.

what you're doing sounds really scary and dangerous.

[glasgow3]

Originally Posted by Michigan RN

I would tell them that if they do not give you another nurse to work with on weekends then you will be resigning. I agree with the poster above me. Contact risk management or JCAHO or CMS. Management will change their tune quickly.

Why not also report them to the Board of Nursing and/or the ANA? I was waiting for that one next.

I don't wish to be unkind, but if a call to these organizations did any good, do you really think we'd still be having these staffing disasters throughout the United States?

These organizations are useless!!!! In fact they are WORSE than useless because most mandate more paperwork for an already swamped bedside nurse force. Others actively oppose meaningful safe staffing standards. Still others punish the individual nurse when serious errors are made, yet historically disregard the supervisors (licensed by the same board) who continually make blatently unsafe assignments.

Think I'm being too harsh? Show me some cases where JCAHO came in after an employee complaint and the facility beefed up their staffing. The ONLY time JACHO comes in (other than to collect tens of thousands of dollars every 3 years) is AFTER the inevitable disaster has struck---repeatedly,,,AND the news media has determined that there is sufficient shock value. Only then will those useless dregs reappear (Oft times ignoring the fact that their crack survey teams may have given the facility in question a clean bill of health just weeks or months before).

The ONLY answer to unsafe staffing is minimum nurse-patient ratio legislation. And the ONLY way for such laws to pass is for bedside nurses to organize.

[SurvivorRN]

That is an unsafe working environment.. I would advise you to look for another job and report them to the Board of Nursing.

[Michigan RN]

BON maybe. Forget ANA, they are useless and what would they do anyhow. CMS would be another organization to call. Anytime a sentinal event occurs, this organization comes in. Speaking with risk management at the hospital would also help.

[lindarn]

The Facilities and Licensing Division of the State Board of Health is a better bet than JCAHO or the BON. This is the facility that LICENSES THESE FACILITIES!! This is someting that they would want to know. This was told to me by an attorney who works for the State of Washington Department of Health. They have counterparts in every state. Give them a call as well. And I would also call the papers and the news.

Lindarn, RN, BSN, CCRN
Spokane, Washington

[peacefulpeach]

The standard ratio when caring for any patient in PACU is two RN's. There must be a second RN in the unit, not on call. Also, we only care for two clients at a time. If we care for an ICU patient, we would only care for that one patient. You must have an extra RN in case of code.

[Ortho_RN]

Everyone says Aspan standards are quidelines and that they are more like suggestions on how to run the units.. But when a lawyer gets involved what do you think a lawyer is going to pull out and use... Our hospital dances around this also...

Lately we have been running a PACU with 3 RNs with 25-30 case loads and these cases range from simple cystos to craniotomies and everything in between.. We are suppose to have no more than two appeach... We get intubated patients VERY often and they are "suppose" to be 1:1 until airway is out, but ha they arent.. Peds cases are suppose to be 1:1... ICU cases are suppose to be 1:1... But it never works that way because we are so short staffed... Night coverage is one person, with a backup person for an emergency.. We are to utilize the OR nurse if needed.. Hard to do if they have another case... We all love our jobs but are tired of getting the shaft and putting our licenses on the line and we are looking at who we need to contact ourselves

[lindarn]

Originally Posted by Ortho_RN

Everyone says Aspan standards are quidelines and that they are more like suggestions on how to run the units.. But when a lawyer gets involved what do you think a lawyer is going to pull out and use... Our hospital dances around this also...

Lately we have been running a PACU with 3 RNs with 25-30 case loads and these cases range from simple cystos to craniotomies and everything in between.. We are suppose to have no more than two appeach... We get intubated patients VERY often and they are "suppose" to be 1:1 until airway is out, but ha they arent.. Peds cases are suppose to be 1:1... ICU cases are suppose to be 1:1... But it never works that way because we are so short staffed... Night coverage is one person, with a backup person for an emergency.. We are to utilize the OR nurse if needed.. Hard to do if they have another case... We all love our jobs but are tired of getting the shaft and putting our licenses on the line and we are looking at who we need to contact ourselves

Get your ducks in a row, and a group of you make an appointment with the senior partner of the law firm who defends the hospital. Bring documentation, any incident reports involving "misses", and "near misses". Make it clear that if something goes wrong that you are prepared to provide the patient's families with this documentation to sue the hospital. And you will be testifying on behalf of the families. Start writing Letters to the Editor pf your local paper. Get the public involved. That is what teachers do, and that is why they always get what they want.

Start NOW writing up incident reports on the unsafe staffing. MAKE COPIES OF ALL THE REPORTS FOR YOURSELF!! You MUST start a paper trail on this unsafe staffing to protect yourself and your licenses. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN
Spokane, Washington

[TalldiNY]

You didn't mention how many beds ae on the unit? Aren't there any staffing ratio's? We at least have the ratio's so we can file grievances. Grievances at least cover your behind when the law suits start. ( I hate to sound so negative but I feel it is inevitable in a situation like this). I would get out of there and make it clear on the exit interview why I am leaving the unit. If the ratio's are as bad in the other units it is time to find somewhere else to work entirely.
Good luck.