[Miami NightNurse]

We have 6-7 with a nurse's aide who has 13 patients and can usually never be found. You nurses that have 4-5 is that with or without a nurse's aide?

[NancyNurse08]

Originally Posted by AlexisRN46

We have 6-7 with a nurse's aide who has 13 patients and can usually never be found. You nurses that have 4-5 is that with or without a nurse's aide?

With a CNA that has 12-15 and can never be found. Lately we've had a lot of float CNAs that don't know how to put tele on the patients and don't know anything about post intervention care.

[travelinjones]

My last assignment in Orange County California at a 250 bed facility (night shift) we had 4 patients and our PCTs had 10. We had a free charge nurse over 45 beds(no patient assignments) 2 monitor tech/HUCs, and occasionally a resource RN. Day shift they had 3 monitor tech/huc, resource RN, clinical coordinator, and the PCTs had 8 patients.

When I was in Florida at a 175 bed facility, we had 6-7 patients on night shift, our pct's had 13-20 patients, a monitor tech for 36 beds, the charge nurse had a full patient load, and there was no secretary....and the hospitalist was notorious for not returning his pages. Day shift had a free charge RN and a secretary. Scary!

Between the two places, the acuity and patient population was comparable. The Florida facility had 100% private rooms, and the Cali facility had some isolation rooms (or VIP if needed), most were 2 bed rooms and some had 3 to a room.

[surferbettycrocker]

thanks for all the replys. we have 8 pts on yes, titratable drips, muscle flap precautions 24 hr. post open hearts, pre post eps, severe lytes embalances, chest tubes, trachs, cbi, pics dopa, dobutamine, lido, ditl, and no monitor tech. it has the highest turnover of any floor at the hosp. we have maybe one tech for a 44 bed floor nights. and that is a good night so yes, it is 8 pts. primary nursing model. the no monitor tech thing scares me. where i used to work, tele was alot of r/o MI's. that kind of fast paced nursing i liked. in any event i am running away from this floor.im not sure i can stick out even two weeks. every shift i pray to god that i can keep myself and my patients safe.
thanks for the feedback. i really thought ot myself this is not safe but being newer, i wondered is it like this everywhere? i know hosp. nursing is hard but if every exp. were like this i dont think nursing would continue to exist as a profession. i dont want to burn out so fast.

[adluney]

I work a CVU/Tele unit that has a 4:1 ratio. I will be going to a hospital that has a 3:1 ratio. I can't imagine the place you are in. But I would take the advise of all those who said "RUN".

[Spatialized]

We have 6-7 with a nurse's aide who has 13 patients and can usually never be found. You nurses that have 4-5 is that with or without a nurse's aide?

Yes, we have a nurses aide, but like you they can rarely be found. They can have up to 23 pts. at night, but they also have found ways to do as little as possible and get away with it.

Oh well.
Tom

[surfer betty crocker]

ditto to the remarks about having to spend time trying to 'find' ancillary staff. i end up doing most of my toileting, cleaning and changing myself. its not that i mind the primary nursing model but on 8 pts with more than half being total care its a HUGE time waster. how do you deal with ancillary that hides when call bells galore go off. ignore the bells? what if someone is really in trouble? murphy's law is always lurking!

[Miami NightNurse]

I always tell the nurses aides at the beginning of the shift to please not leave the area without telling me, I don't care where you go, you can even go take a nap if you need too just please tell me. They are usually pretty good about it and stay in the area. Of course most of them are afraid I'll freak out if they leave and don't tell me and I will. Although some disappear no matter what you do. But I am done playing with them. The minute they disappear I let the charge nurse know. I don't get paid to run off and hide and neither do they. I love nothing more than watching them become nurses and realise we are not just sitting there playing with the charts

[bluesnurse]

I agree -- RUN don't walk out of there. 7-8 is outrageous at that acuity level. When I worked tele (in Colorado) the accepted ratio was 4:1; sometimes it would start at 3 with the first admit going to that nurse. 5 only if we were short-staffed, and acuity was taken into account when the charge RN made that assignment.

When we moved to NC, I was offered the first job I applied for in tele. Great pay, 7:1 ratio. I all but laughed in the manager's face. NO way was I even considering it. No amount of money is worth my license.