Mandated Nurse-Patient Ratios - page 8

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   liz0105
    I have worked in the ICU at large teaching hospitals both in New York City and California. The difference in patient ratios blew my mind when I arrived in CA nearly two years ago.

    Back in NY, if we had empty beds, we admitted patients regardless of our staffing situation - the ICU attending would just shrug and say, 'The nurses will deal with it'. One day, I found myself with FOUR patients, two of which on vents, the other two fresh mastectomy DIEPs with hourly flap checks and unrelenting nausea. Took one break and ate my lunch standing up in 15 minutes.

    That night, I applied for my RN license in CA.

    In CA, we do not admit into empty beds without appropriate coverage. My first break is 30 min, and our second break is 45min-1hr, depending on how 'hot' your ICU looks that day - and we ALWAYS get breaks. Ratios in the ICU are either 1RN:1 pt or 1RN:2pt, sometimes even 2RN:1pt (ECMO, Rotaprone).

    I cannot STRESS how much more supported and how much happier I am as a nurse in California. I understand that some CA nurses have their issues with their respective institutions, just speaking from my personal experience...
  2. by   Nurse Beth
    Quote from liz0105
    I have worked in the ICU at large teaching hospitals both in New York City and California. The difference in patient ratios blew my mind when I arrived in CA nearly two years ago.

    Back in NY, if we had empty beds, we admitted patients regardless of our staffing situation - the ICU attending would just shrug and say, 'The nurses will deal with it'. One day, I found myself with FOUR patients, two of which on vents, the other two fresh mastectomy DIEPs with hourly flap checks and unrelenting nausea. Took one break and ate my lunch standing up in 15 minutes.

    That night, I applied for my RN license in CA.

    In CA, we do not admit into empty beds without appropriate coverage. My first break is 30 min, and our second break is 45min-1hr, depending on how 'hot' your ICU looks that day - and we ALWAYS get breaks. Ratios in the ICU are either 1RN:1 pt or 1RN:2pt, sometimes even 2RN:1pt (ECMO, Rotaprone).

    I cannot STRESS how much more supported and how much happier I am as a nurse in California. I understand that some CA nurses have their issues with their respective institutions, just speaking from my personal experience...
    Yes!! This.
  3. by   unknownjulie
    Thanks for the repost and let's keep this at the top of the pile. It's a good reminder.
  4. by   Jessy_RN
    Yes it is. Can only keep wishing this would finally happen and not just be a conversation ya nurses keep having.
  5. by   Devnation
    As a new RN, I worked in a level I trauma ED in the inner city. On one particularly hellish shift, We were short-staffed and every other nearby ED was on diversion if not closed. I had a trauma, a code, a hot appy needing urgent OR, and a complicated fracture, among my TEN patients. Yep, I said ten patients. When I asked the charge nurse for help, she moved both of vented patients into the same room. Thanks a lot!

    I look back on this now and think about how absolutely insane that was. I would never want my loved ones to be cared for by a nurse with that sort of assignment, especially a new nurse. At the time, I was just absurdly grateful to have an ED/trauma job, but I cried many a day after work. And I am not a crier.

    A fellow newbie and I both commiserated about how we both wished we had been hit by a bus so we would not have had to come to work. Although, since we would have been trauma patients, they probably would have just rolled us into the facility and put us to work!
    Last edit by Devnation on Jan 26 : Reason: Clarity
  6. by   Sunshine.nurse
    Quote from smartassmommy
    If the "Medicaid doesn't pay enough for resident care but we can afford lobbyists " ltc industry can be beaten.
    I disagree with you on this. LTC and sub acute nurse patient ratios need to be focused on now. Having up to 40 to 1 ratios in Florida is dangerous for the patients. Placing LTC as a lesser priority shows, at least to me, the mindset that our geriatrics populations as less worthy of immediate action. And I just feel that maybe, just maybe, that by working on LTC's nurse patient ratios to a safe level, the return to hospital percentages would come down because LTC nurses would have time to actually do their other nursing duties like HT assessments instead of passing pills for 8 hours.

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