Is this unit short staffed?

  1. I got pulled to a med surg unit yesterday, and was absolutely shocked at the number of staff on this unit. It is a small 20 bed unit, and had a census of 18, with one of the empty beds marked Do Not Use because the other patient in that room was paying for a private room. In addition to the charge nurse, there were three RNs, an LPN, and a CNA. The staff on this floor complained all day because they were so busy and short staffed. They felt they should have been sent another aide. I felt it was one of the easiest days I had ever had when floating out of ICU. This floor has a reputation for being coddled, the Unit Manager is the life partner of the Associate DON, and everyone thinks this is why they get the most staff. I can tell you that I have been pulled to other floors with a similar census who managed with less staff. Our Assoc. DON is usually very professional in every way, I can't believe that she would allow her personal life to affect how she does her job.
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  2. 15 Comments

  3. by   BBnurse34
    Sounds well staffed to me!
  4. by   Dr. Kate
    Even if you do the nasty and just count bodies, that's 3 Pts per body. Frightfully well staffed. Sounds to me like the licensed (and maybe just the RNs) didn't want to do baths and bedpans and that's why they wanted another aide.
    Is the acuity traditionally higher than it was yesterday?
    You hate to scream favoritism but sometimes it happens.
  5. by   sharann
    I don't know. You can't look at the number of pts, just the acuity which can change many times in the course of a 12 hour shift.
    Also, I don't call adequate and safe staffing coddling. We have gotten used to doing too much and doing it without help, we are now sounding like THEM. You know, the managers who say, "you ONLY have 6,7,8,12 pts...deal with it"
  6. by   RNinICU
    This is not a high acuity unit, just a general med surg floor. Most of the surgical patients were at least two days post-op, and the medical patients were a mix. "doing the nasty" and counting numbers, the staf patient ratio was even better than in CCU, where each nurse can have up to four patients.
  7. by   fedupnurse
    The med/surg floors and tele areas in my facility would think they died and went to heaven with numbers like those!! That is a 1:6 RN ratio. We are fighting for that where I work for the m/s floors. It is not unusual for each nurse to have a minimum of 10 with one PCA (Aide) to share among all the nurses!!
    They should be ounting their blessings!!
  8. by   shannonRN
    sounds pretty reasonable to me. we sometimes have 7 or more a piece with no aide on my med-surg floor...what shift were you working? our floor staffing varies. it is supposed to be 1:4 days, 1:5 eves, and 1:6 midnights. but those poor night nurses can get stuck with 10.

    i find that sometimes no matter how well staffed some of our shifts are the just ****** and moan.
  9. by   live4today
    Try having 13 patients per RN on a med/surg floor without any assist. Happened to me ONCE...never let that crap suck me in twice! :chuckle

    RNinICU.........IF the med/surg patients on that floor were that easy to care for, then indeed I would say the floor was more than sufficiently staffed.

    The best staffing I've ever had was 1:4 on a med/surg floor. This was at a seven day adventist hospital back in the late 1980's. The ratio was the same on all three shifts. Now......that's what I call excellent staffing!
  10. by   NICUNURSE
    Hope I wasn't reading this wrong, but I thought the original complaint was that there should have been another aide assigned to the unit. As a new grad nurse, who has done her time as a CNA, I agree that another aide or two would have been helpful. It looks like this aide had to care for all 18 patiens on a med-surg floor. I once had 18 patients on a postpartuum floor (which is admittedly less work than med-surg) and I was BUSY. Unless this aide had nurses who were willing to help her out(which unfortunately is getting rare), 18 patients is way TOO many. I think a lot of the time, management feels that safe and effective care does not apply to the unlicensed personel, but that's not true. Imagine being on a med-surg floor and having 18 patients with various things going on. I think all too often, the nurses rely on the aide as a second set of eyes and get a little relaxed about checking on thier patients. Good forbid a patient or two should go bad and a nurse was relying on this false sense of security. It could cost someone their life! Sorry to get so serious here, but this is one of those issues that really gets to me!
  11. by   Reabock
    If it was 7-3, yes, they could have used another aide for baths and helping turn pts. If it was on 3-11, it sounds about right, though another aide could help with the turning, pottying, etc. . Our charge does not take pts, but our LPN'S have an equal pt load with the RN'S and the Aide's do Accu chek BS's and turn, diaper and help to ambulate those that can to the bathroom, also keep our needle boxes in rooms changed and plenty of gloves in each room, run stuff to the lab, etc. (3-11) We opted not to have them do our Vitals on our shift, they do on days and nights. All of our aide's are great and willing to help us because we are willing to help them, teamwork!
    Back to the original question, does sound like their staffing was adequate.
  12. by   Nurse Ratched
    Agree that they would be okay assuming the acuity of the patients was not such that the nurses were overwhelmed with caring for, what seems at first blush, a pretty manageable patient load. Assuming that, the nurses also would need to pitch in with the personal care needs as I agree that 18 is way too much for a single aide if he/she gets no assistance. Is the aide expected to do vitals, baths, etc.? She's gonna need a hand (which I think many of us enjoy doing when time allows anyway. I truly miss the personal care when we get so busy with the more technical stuff and documentation.)

    BTW - totally unrelated question, but is the "paying for a private room" only an option as long as the census allows it? If the house is getting full, is the bed still considered held?
  13. by   night owl
    Reabock,
    Your aides do accu checks?!?!? {{{hmmmm}}}...That could lighten our load. Is that legal? I hope...
    Sounds to me like they were very well staffed!
    Last edit by night owl on Jul 21, '02
  14. by   RNinICU
    Yes, NICUNurse, you were reading it wrong. My point was that this floor was overstaffed. The aide did not do 18 baths, as a matter of fact, she didn't do any of my patients. The 18 patients were divided up between the 3 RNs and the LPN. Each RN had four patients, and the LPN had six. We all did our own patient's meds, any treatments, and all personal care. The aide was assigned to help with baths and do vitals, as well as running errands. She did not do all the lifting and turning herself. The charge nurse signed off orders for the LPN, did her assessments, and gave her IV push meds, so she had more patients than the RNs, who did these things themselves.

    And this patient was in a semi-private because all of the privates were full. We do this on occassion, but only if the census allows.

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