Legal issues with only having one RN on the floor

[photocodo]

I already posted this but I wasnt sure what section to include it under so I reposted it here.

I am currently a new nurse working on a Telemetry unit in NC. We recently changed to an acuity based scheduling system. It is a small (8 bed) unit and the way the staffing is set up, there is a possiblity that we could have 5 to 6 patients with only one nurse and no CNA. I know this is not ethical for the nurses or the patients but my question is are there any legal issues with the staffing? I have searched the internet and was unable to find any actual laws in reguards to patient/RN ratios or if you can only have one RN on the floor. It just seems that it would be a very bad idea to only have one RN on the floor, even if they are stable patients things can go down hill very fast. Thanks for any advice for this situation.

[fallinnstyle]

Accepting this kind of an assignment is asking for the board to take your license, a family to max out the payout on your malpractice, and for you to burn out STAT!

I know jobs are hard to come by these days, but WHY???? would someone accept such working conditions? Yes, maybe you have a good year and nothing major turns up, but it is the ONE time when **** hits the fan and you are the only staff member in the unit, and can not get help, or get help quickly enough.

For your safety and for the safety of your patient, it is paramount to have a second person on the unit with you at all times. Any manager that states otherwise is not worth the paper his/her license is printed on.

And like someone asked, how is the unit explaining to the labor boards your not getting a relief for your mandated lunch break? Maybe you should call them to 'consult' about the situation, just to poke the bear. KWIM?

[backtowork]

I work in an inpatient hospice and even if there is only ONE patient, we still have 2 RNs on duty 24/7. We don't even call codes (obviously) and we are staffed better than your unit. If my company can afford decent staffing, so can yours.

[caliotter3]

I was hired as the only licensed nurse in a LTC facility at night. When I asked about this, I was told that I could call the ADON or DON at home for problems. I was also told that this was legal as there were only 52 residents, 22 of which were subacute. When I had a particularly horrendous night, I called the ADON for some help. She didn't answer her phone. So, I'll have to say that I believe there are many instances where unsafe situations are not only allowed to exist, they are sanctioned by regulation or policy.

[sapphire18]

This is not legal. You need a break during your shift. And it's obviously unsafe for reasons listed above. Even if our unit only has 1 pt, we have to have a minimum of 3 nurses at all times, as we are the code team.

[Music in My Heart]

Beware that any laws pertaining to staffing, breaks, etc are most likely to be codified under state statutes rather than federal ones so statements on AN must be screened through the state-by-state filter. What is permissible here in California may not be permissible in Washington, for example.

On occasion, we staff a single nurse up on med/surg, though usually (but not always) with an aid. On the rare occasions that it happens, there is a nurse and a tech in the ER who, depending on their patient load, can help out emergently.

Overall, however, it's not safe IMO to ever have a solo staff member working without someone within earshot; it certainly shouldn't happen as a matter of policy.

[nurseprnRN, BSN, RN]

as an aside, the word "unethical" has been tossed around here willy-nilly almost as often as "hipaa violation!" and "license at risk!" ... and about as well.

a situation may be unsafe, may be illegal, may be downright wrong, but situations cannot be ethical or unethical, as situations cannot make choices about anything.

people act and make choices about how to act. they may make ethical or unethical ones; the person behaves in an ethical or unethical way as demostrated by the choices made.

off soapbox

[Multicollinearity, BSN, RN]

By law you have to get a break if you are working atleast 8 hours so how do you get a break? If you sit down to eat and something goes wrong you are going to be in soooo much trouble because you have to show that you were relieved of your assignment by another nurse and give a hand off report and keys if necessary. I would never accept this because its ALWAYS gonna be the nurse that gets thrown under the bus.

I routinely work 13 hour shifts, am the only healthcare worker on site, and receive no official break. It's not required in my state.

[sapphire18]

I routinely work 13 hour shifts, am the only healthcare worker on site, and receive no official break. It's not required in my state.

Had no idea this was state by state/not required everywhere. Real safe.

[MJB2010]

You must be in my state! When I called to inquire about the laws while working 16 hour shifts I was told a 30 minute meal break is not mandated by law, but a 15 minute rest period was. Funny thing was, they didn't seem to concerned that my employer was also taking the 30 minutes x 2 meal breaks that I never got (even once) out of my check and that is fraud. Whetehr I worked 14 or 16 hours, I still got paid the same cuz my manager would just deduct more breaks that we never got in order to "balance the books". ANd they seemed so surprised when I quit.

Crappy labor laws with no enforcement = bad working conditions.

[rn/writer, RN]

Not sure if OSHA has something to say about mandatory breaks (that are really breaks). If they do, the federal nature of OSHA would overrule state laws.

MJB2010, you might have a federal case on your hands if you were not paid properly. Worth looking into.

[MJB2010]

Not sure if OSHA has something to say about mandatory breaks (that are really breaks). If they do, the federal nature of OSHA would overrule state laws.

MJB2010, you might have a federal case on your hands if you were not paid properly. Worth looking into.

I certainly notified my manager in writing via email (11 times total) that it was illegal to keep deducting breaks that I did not get , I don't work for free. They did it to everyone in my clinic. When I quit they owed me more than 2 weeks worth of pay due to all the breaks they deducted. I discussed it with the district manager who shrugged her shoulders and said she wished I could be more of a team player.

[rn/writer, RN]

If there are a number of employees involved, this might be ripe for a class action suit to recover lost wages. I'd suggest speaking with an attorney well-versed in employment law.

How big a facility/company is this? Who knows how many people they stiffed over how long a time. Keep those emails, and encourage others to keep records, pay stubs, correspondence, etc., that will document that this is a regular, long-standing way your employer uses to "balance the books."