How many patients can I legally have?

[Rocknurse]

I need to know how I can find out how many intubated or non-intubated patients I am legally allowed to care for in the state of Connecticut. I have 2 intubated ICU level patients right now, on pressors and Propofol, and now I am about to take a third who is post-arrest from the floors. Is this legal? I feel very stressed.

[pricklypear]

The previous day shift nurse was mandated to stay until 3am...and then the next days RN was mandated to start her shift at 3am to take over. It's inhumane and dangerous. I am so going to quit! I talk with my feet. It's an outrage that there are no laws to protect both the nurse and the patient. In England if there is no staff then beds are closed and surgeries postponed. It makes so much sense.

:cheers: I say get out while you still have a license to practice with!!! Not all ICUs in this country are like the one you are in right now. Between the mandated OT and unsafe patient ratios, that place doesn't deserve you!

[flashpoint]

OK...I don't think any nurse should have to accept an unsafe assignment, but what is the alternative? When I work ICU, I rarely have more than two patients...usually it is only one. But...when I float to med-surg, it is usually because they are really short and I've had up to ten! I can usually do six or seven if the patients are pretty stable and don't have a lot of meds or treatments, but when we start getting eight, nine, or ten each, I start to feel pretty overwhelmed! Another hospital isn't really an option because the closest one is 75 miles away...and I've had it with nursing homes. :)

So anyway...what are your alternatives when everyone has ten patients and another admission comes to the floor? Someone has to take the patient and management can't be there to help cover 24/7. We have a few nurses that refuse, so they will end up with eight, while the rest of us have ten or twleve...that seems wrong to me.

[schroeders_piano, RN]

I have to agree with everyone who said to find another job. I recently left a job in a rural hospital ICU. It was common for each ICU nurse in this hospital to have 5 or more patients. The staffing stayed the same no matter what; 2 RN's period. It was dangerous and unsafe for every patient in the unit. It also was physically, emotionally, and mentally draining on the nursing staff. I moved on to a PICU where I never have more than 2 patients at any given time. Sometimes I only have one. I was hating nursing, but once I moved to the new hospital I have found the joy of nursing again.

Schroeder

[mysticalwaters1]

if my coworkers refuse an assignment the supervisor tells us we are getting them regaurdless then what? And if everyone refuses then what? We are unionized and we fill out a protest against assignment form but we are still caring for that pt but I am confused that people can just refuse the assigment? What if there is nowhere else to go?

[Tweety, BSN, RN]

OK...I don't think any nurse should have to accept an unsafe assignment, but what is the alternative? When I work ICU, I rarely have more than two patients...usually it is only one. But...when I float to med-surg, it is usually because they are really short and I've had up to ten! I can usually do six or seven if the patients are pretty stable and don't have a lot of meds or treatments, but when we start getting eight, nine, or ten each, I start to feel pretty overwhelmed! Another hospital isn't really an option because the closest one is 75 miles away...and I've had it with nursing homes. :)

So anyway...what are your alternatives when everyone has ten patients and another admission comes to the floor? Someone has to take the patient and management can't be there to help cover 24/7. We have a few nurses that refuse, so they will end up with eight, while the rest of us have ten or twleve...that seems wrong to me.

I think in a case like this it needs to be documented that you followed the chain of command that the the supervisors and managers are aware of the unsafe assignment, and you notify risk management with an incident report. That way if there's a bad outcome from an unsafe ratio, you have some defense. It can get touchy when you go into an environment that has established entrenched unsafe ratios.

I'm feeling you because there are times when I have 7 patients on day shift and they ask me to take an 8th, I feel I have no options if everyone else has 8 and the admission is on the way, the ER is full or on divert, etc.

My unit has on several occasions has bypassed managment and went to risk management in person to discuss unsafe conditions and fortunately found an advocate there.