So we filled out the unsafe staffing report last shift.
The truth is just about everyshift needs to be written up as unsafe staffing.
My ER is about 50 beds (adult ER) not including pediatric ER, fast track, and 4 bed trauma bay.
usual staffing: 10-11 RN's
2 RN's for each adult ER section (3 sections/6 patient slots per section)
2 Rn's for Pediatrics
1 RN's for Fast track
1 RN's for triage areas
2 RN's for trauma bay
Last shift was the last straw for us. Upon coming on were were told that we were down 2 nurses. Therefore the charge had to place only 1 RN in the trauma bay/critical care area.
Patient volume has exploded due to hospital closures in area over the last year and a half.
Also especially over the last 3 months we have been unable to take breaks. So literally we are working 12 hours with no break or a half an hour break minimum. Sometimes the charge asks us to take only half a break. Last paycheck I only got paid for one of the days I didn't get a break. I care about getting paid if I can't take a break, but I also care more about being able to take a break, this is illegal.
Often times we get upwards of 16 patients, hospital rarely goes on diversion. Management has also failed to set up staffing ratios and/or how fast one can accumulate patients. Sometimes triage sends you 4 new patients in less than 2 hours.
Not only is patient to nurse ratios ridiculous, acuity ratios (as I call it) are ridiculous. I've had intubated, hypotensive, ICU, crashing patients all while triage is sending me new patients/ or with atleast 6-10+ other patients.
If you're patient becomes an ICU evaluation, or an ICU accept nothing changes, you still have to manage that patient plus all your others.
Due to budget cuts we no longer have cnas to help us. Therefore we RN's and a tech (if they aren't busy themselves) have to change patients, give patient trays, urinals, assist to bathroom. And if we have even a single- one to one on the unit we are automatically down a tech which means you have no tech/no aide.
Trauma bay is critical area and is alloted for 4 patients, but has up to 7 patients at a time with only 2 RN's. There are no extra RN's to float.
Not to mention there is no extra nurse to cover breaks, so if it's too busy (which is always lately), no break. If each nurse has too many patients, no break, I refuse to cover my 10 patients, plus your 10 patients. NO!
Anyway that's only the surface of it. Alot of nurses I work with are planning on leaving. Worst part of that is that alot of those nurses just started here. Turnover rate is high. Some RN's want to transfer but think manager will try to block it.
We are all feeling the burn as a collective unit, even the assistant managers are. Has anyone ever been through this as a unit? Any suggestions?