Mandated Nurse-Patient Ratios - page 4

Ashley sank into a chair in the breakroom on her MedSurg unit in a large hospital in Florida. It was 0330, 8 ½ hours into her shift. She had not yet taken a break of any sort, including a bathroom or... Read More

  1. by   billswife
    Our staffing was just cut again at the recommendation of the the"efficiency" consulting group hired by our hospital administrators. We already rarely had lunch breaks, and never had those two 15 minute breaks they say we should be taking daily.
    Most of our younger staff (and this includes some extremely talented nurses) are leaving. Why should they stay? Our state has one of the lowest nursing pay scales in the country, and now we leave every day knowing we haven't performed as well as we would like. Some of us are older and have family in the area so we will stick out out, but those who don't are leaving in droves. Management says there is "no problem" and attributes the exodus to "natural attrition".
    We are physically unable to complete all the tasks required of us each day. It cannot be done. Soon our patient satisfaction scores will drop, and perhaps administration will care about that, as they certainly don't care about staff retention. I suspect they will just blame the nurses for not working hard enough. If we attempt to discuss this with our unit management they tell us we "shouldn't be so negative". I would retire tomorrow if I could!
  2. by   foxden1126
    Will LTC nurse- resident ratios fit into the April visit to Washington? Your opening story brought a PTSD response from my 15 plus years as LTC staff nurse. I often see the "look" in the eyes of nurses AND the CNAS in the halls of the rural LTC facilities do education consultant work for. Will mandated LTC patient nurse AND CNA ratios ever be established? I would be interested in more information on this, where and what I can contribute to help, and I will be contacting my state legislators.
  3. by   DachshundTXRN
    This. This so much this. As I sit down in a dealership with my husband I sit back reflecting at my last week of work. 6 patients each day. Surgical patients with wound vacs that need changing. 2 CHF patients with fluid overload. 1 on visitele and 1 on restraints that is a feeder. 4 total care. I about lost my mind. I never cry. Ever... I'm weird in where I get angry and fume. Never tears though. I was so overwhelmed that I fought back tears yesterday. I missed orders and had patients screaming at me in the hallway. I came very close to a med error. Thank God for scanning patients.
  4. by   LadysSolo
    I am sad to see it hasn't gotten any better since I left the floor after becoming an NP. I worked oncology, giving chemotherapy and blood every night. 5 patients was best, 6 was doable, and if I was day 4 of my 4 day stretch and had already had the 6 patient for 3 days I could usually add a 7th (but it was REALLY hard) if I was already used to the 6. I was usually charge, and if someone had to be screwed, I preferred it to be me. We had one nursing assistant for the whole floor, thankfully they were excellent. They wanted to cut our staff more, I went to the hospital board and asked for someone to come follow us for a shift before cutting our staff. One board member came, and made it for 4 hours and left, saying no cuts would be made as he didn't see how we could do it with the staff we had. Success! (in a way)
  5. by   Crush
    Quote from AngelKissed857
    Also needs to include correctional facilities! Try delivering safe care with a ratio of 1:850!
    Holy moly! I can only imagine what med pass must be like. Wow!
  6. by   Meriwhen
    Quote from kcochrane
    I haven't finished reading all the posts...but will that mean they will do away with techs or CNAs in order to cut costs?
    I know several facilities in California have done away CNAs/techs and gone the primary care nursing route. Others still have the support staff but stretch them very thin.
  7. by   Nurse Beth
    Quote from foxden1126
    Will LTC nurse- resident ratios fit into the April visit to Washington? Your opening story brought a PTSD response from my 15 plus years as LTC staff nurse. I often see the "look" in the eyes of nurses AND the CNAS in the halls of the rural LTC facilities do education consultant work for. Will mandated LTC patient nurse AND CNA ratios ever be established? I would be interested in more information on this, where and what I can contribute to help, and I will be contacting my state legislators.
    The nurse-patient ratios in LTC are abominable. Where is the soul? I believe mandating acute care ratios is a start, and LTC will follow.
  8. by   Wisco50
    I hope you and your fellow staff realize that according to Federal law you are required to be comped by the hospital/employer for 30 minutes of meal time during an 8 hour shift?! The hospital I worked at did not make this well known, it was not applied fairly and there was a fine and a legal firm (local) brought the case as class action. We got financial compensation for past wages that should have been paid. So please be aware and do NOT be afraid to speak up. You can always report it anonymously. I can't remember the exact name of the Federal rule but I believe it is the Department of Wages and Hours or something like that.
  9. by   Wisco50
    I think staff are considered more expendable by far. You can always "make do" with staffing shortages. You cannot recruit patients as easily. These days many insurance plans mandate where a patient can receive care including negotiations with hospital/s. Patient satisfaction is the driver behind success.
  10. by   jenkt
    Am I crazy to argue 1:4 on med/surg, ideally 1:3??

    I am talking a ratio that can significantly reduce medication errors, increase patient satisfaction and prevent nurse burnout in the long term ...

    Nurseatient ratios is something I thought a lot about when I worked on a busy acute spine surgical floor. The ratios were not as bad as some of the comments on here, but for me and many of my colleagues, our ratio of 1:4 (sometimes 1:5) was extremely overwhelming and unsafe much of the time. The patients were acutely ill, required total care, had complex dressings and medication requirements, etc. etc..

    Of the 4 other RNs that I started with on the unit, 2 of them left within the year. One of them left the hospital entirely and the other started on a dialysis unit (she says it was much more chill). It was a good team - the only thing I could associate mine and my colleagues burnout with was the nurse to patient ratios.

    I believe there is a STRONG link between the ratio and patient safety and burnout. When management is looking to improve, this should be the first thing they change.
  11. by   Doris Carroll
    Thank You Beth Hawkes! We are so thrilled to have you speak on April 26th 2018 in DC. We love your support. Nurses across the country must act. No time to waste. Talk to your colleagues. Come to DC. Stand up for patient and nurse safety. Your voice DOES matter. #NursePatientRatiosNOW
    Sign and share Nurse Patient Ratios | Petition For National Nurse Patient Ratios
    nursestakedc

    Doris Carroll BSN
    NTDC Organizer
  12. by   Nurse Beth
    Quote from Doris Carroll
    Thank You Beth Hawkes! We are so thrilled to have you speak on April 26th 2018 in DC. We love your support. Nurses across the country must act. No time to waste. Talk to your colleagues. Come to DC. Stand up for patient and nurse safety. Your voice DOES matter. #NursePatientRatiosNOW
    Sign and share Nurse Patient Ratios | Petition For National Nurse Patient Ratios
    nursestakedc

    Doris Carroll BSN
    NTDC Organizer
    Thank you, Doris Carroll, for your passion and commitment to patient safety! I will finally get to meet you in Washington, DC on April 25th & 26th!!
  13. by   LadysSolo
    Nurses are always expendable in the name of CEO bonuses for cutting "expenses." We are not necessary, we are an "expense." I have heard an MD state that "trained monkeys can do the job of a nurse." (yes he is an a**.) But some CEOS seem to think this way also.

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