How many patients can I legally have?

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    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.
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  4. 0
    In California it is not legal in an ICU setting. I dont know about it in your state though. Sounds illegal though, or very dangerous.
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    While California has safe-staffing laws in place, most states in the US have not yet come that far. It's unfortunate, but true. I'm in one of those states. In our ICUs, it's common to have two vented patients, but three is not acceptable.
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    I was always under the impression that it is up to us to decide if we can safely handle the pt load. I realize that it could risk your job but if you accept an unsafe assignment aren't you held legally accountable? IF so how do you get out of it right then on the spot? Just curious. Great question and topic.
  7. 0
    Quote from bellcollector
    I was always under the impression that it is up to us to decide if we can safely handle the pt load. I realize that it could risk your job but if you accept an unsafe assignment aren't you held legally accountable? IF so how do you get out of it right then on the spot? Just curious. Great question and topic.
    I have refused to take another patient if I feel it would be unsafe for my existing patients. My job was never threatened over it, and if it was, I would quit after my shift that day.
  8. 0
    Quote from pricklypear
    I have refused to take another patient if I feel it would be unsafe for my existing patients. My job was never threatened over it, and if it was, I would quit after my shift that day.
    Agree 100%. If you feel the assignment is unsafe, refuse the assignment.
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    First, there is no law limiting the number of patients that can be assigned to you in CT.
    If you feel assignment is unsafe refuse the assignment. If the employer insists that you take that assignment then you are in a quandry. Question, was the assignments of your fellow workers on that unit similar to yours? Were you the safest person to give the new patient to? Question the logic of why you were selected for the new admit.
    If you feel you must refuse go ahead but understand the potential consequences to both yourself and new patient. There are however plenty of ICU's in CT and if this type of assignment is common in your unit I would begin to look elsewhere. Also there is whistle blower protection for RNs in CT
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    Phew....in the end the nurse in charge ended up taking the assignment, despite being in charge and having two other ventilated patients herself, and the fact that I was next in line for the admit. I ended up helping her out as it was so nuts, but when I went to check on her other patients, one of them had had no vitals signs recorded from 8pm to 2am, and no meds given at all, and the other had a leak in his ET tube and a mouthful of tube feed. How is this safe? How is this "more safe" than any other unsafe assignment? How long can we keep doing this as an accepted practise? Maybe because I come from another country where there are accepted standards and this is illegal that I am so shocked and appalled. I would happily refuse an assignment if I thought it was unsafe, and I'm sure I would lose my job over it, but who wants a job like that? If that had been me with the two neglected patients, who's to say the nurse in charge would have done me the same favor I did her? Would she have kept her mouth shut and sorted things out as I did, or would she have reported me for patient neglect? I'm not prepared to find out. 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.
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    It sounds very unsafe. I would discussed it with my charge nurse before taking the assignment, let her know that you are uncomfortable and is not fair for the patient not to get the care he or she deserves. I have this type of problems where I work and usually one nurse will step and take an extra patient and make you look incompetent
    then she would look good for administration. , But I am not looking to be a "Hero".,
    some nights we don't have any "Hero's" so then the supervisor has to look for extra help from nursing agencies, etc. We as nurses need to step up to what we believe is the best thing to do. I feel for you (nurse in texas)
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    Here in Florida unfortunately we have no mandated ratios.

    The BON expects us to refuse assignments we feel are unsafe. Because if we accept the patient, and there's a bad outcome, we hang, not the institution, but the nurse.

    Good luck.


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