Nurses 6:1 Patient Care Techs 25:1 in an Acute Care Setting. Is this fair??

Nurses General Nursing

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I've been a long time lurker and I love you all. And if this is in the wrong forum please forgive me...

But I've been working at my current job as a Patient Care tech for 2 years while in nursing school. My floor is an acute care/overflow stepdown unit that primarly focuses on Pulmonary/Stroke/Seizure Medicine. The staffing on my floor has suddenly changed to become more budget friendly so they cut back the staff. Nurses will be 6 and 7 to one and PCT's are most of the time 20-26 to one. The PCTS do vital signs, fingersticks, admissions, and cleaning. Nurses are swamped and the PCTs are worked to the bone. This is a heavy floor with 95% of our patients being high fall risks.

I feel this is unfair to both nurses and the nurses aides. I was just wondering if any of you lovely nurses experience this poor staffing as well and tips for me and my nurses to help us not wanna rip our hair out at the end of stift!

Specializes in Acute Rehab, IMCU, ED, med-surg.

It will change when the rate of falls jumps sharply. Until then...

Sounds like most hospitals. Is it safe? No. But as long as healthcare is more about profits rather than actual healthcare, it is what it is.

I think that is awful. Our aides have 8 or sometimes 12 if on our sister unit. Depending on the patients it can be crazy when people are total care, and some nurses will help while others will not. I was never an aide before being a nurse, and while I find jobs that help others very rewarding I could never imagine being an aide with 25 patients making $8 or less an hour. The Aldis cashiers make $11 and benefits with significantly less stress (I would imagine). Its really a shame.

It certainly costs hospitals more. With 25 patients is everyone really being turned and positioned every 2 hours? Getting to the commode when they need to? Being repositioned in chairs? Getting their call bell answered or trying to get up by themselves? This leads to increased falls, pressure ulcers, whole bed changes, which is a lot more expensive than hiring another aide. Not to mention poor patient satisfaction and decreased employee moral. Maybe healthcare needs a lesson from Aldis. :o)

I suspect nursing turnover will go way up and the cost of replacing those burnt out nurses will eliminate any savings in staff reduction.

It won't happen at first. First you will get more emails and reminders from management about turning, proper documenting reassessments and following the very stringent rules for restraints. When the workload becomes unmanageable, things get dropped, corners are cut, standards go down and nurses are unhappy.

I know what it is to work in a place where you work all day, seldom sit down and leave (late) knowing in your heart that your patients did not get the care you would have liked them to have.

It certainly costs hospitals more. With 25 patients is everyone really being turned and positioned every 2 hours? Getting to the commode when they need to? Being repositioned in chairs? Getting their call bell answered or trying to get up by themselves? This leads to increased falls, pressure ulcers, whole bed changes, which is a lot more expensive than hiring another aide. Not to mention poor patient satisfaction and decreased employee moral.

Which instead of adjusting staffing, they'll just do as RNperdiem said, send more emails reminding everyone to do everything they would do if staffing was good. After all, it "only takes a minute" to do all those things...

Specializes in LTC, Psych, M/S.

Getting scary. Sounds like this is happening everywhere.....

We routinely have 7-8 patients on days and nights on a busy med surg floor with telemetry. Each RN works with an LPN. The RN is responsible for am vitals, accuchecks and assessments and of course, RN interventions. The LPN's do the noon and pm vital signs and all the meds and IVPB. It's very hectic and the supervisors walk the halls asking for discharged patients so new patients can be promptly admitted. It's just crazy!!!!!

Specializes in Certified Med/Surg tele, and other stuff.
This is why ADLs get so overlooked in the hospitals. The techs or PCTs or whatever are so busy checking vitals on 30 pts that bedside care falls to the wayside.

And the frustrating thing about this is the family does not understand why grandma isn't groomed. I had one family member ask why there were not back rubs, and all the niceties that used to be the normal evening routine that hospitals were known for. Nurses and techs are too busy taking care of other patient tasks. Patients are so much more acute than they used to be. Gone are the broken legs, mylograms, simple back surgeries and hysterectomies.

I had 10 pt's as a CNA tonight and could not focus on their respective ADL's.

Looking back I don't even know where the time went...

Specializes in ED, ICU, PSYCH, PP, CEN.

Welcome to the world of nursing. Been out there 10 years and it just keeps going downhill every year. Fortunately I might be able to retire in about 7 years. If I am still alive

Specializes in Pedi.
I suspect nursing turnover will go way up and the cost of replacing those burnt out nurses will eliminate any savings in staff reduction.

It won't happen at first. First you will get more emails and reminders from management about turning, proper documenting reassessments and following the very stringent rules for restraints. When the workload becomes unmanageable, things get dropped, corners are cut, standards go down and nurses are unhappy.

I know what it is to work in a place where you work all day, seldom sit down and leave (late) knowing in your heart that your patients did not get the care you would have liked them to have.

High alert emails: "This is a reminder that we MUST document that we have changed the site of the O2 sat probe q 4hrs, documented pain scores q 4 hrs, documented turning patients q 2hrs, skin assessments q 4hrs and IV site assessments q 1hr in order to comply with JCAHO standards. Documentation must be real time and should be done at the bedside."... meanwhile Nurse Manager who is sending this email is in her office shopping for shoes. (Yes I've seen my Nurse Manager doing this when I worked in the hospital.)

High alert emails: "This is a reminder that we MUST document that we have changed the site of the O2 sat probe q 4hrs, documented pain scores q 4 hrs, documented turning patients q 2hrs, skin assessments q 4hrs and IV site assessments q 1hr in order to comply with JCAHO standards. Documentation must be real time and should be done at the bedside."... meanwhile Nurse Manager who is sending this email is in her office shopping for shoes. (Yes I've seen my Nurse Manager doing this when I worked in the hospital.)

Q1 hour IV Site?

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