One on ones are killing us for staffing!

Nurses General Nursing

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I'm all for the concept of avoiding the use of restraints, in theory, but in practical terms, pulling techs from the floor to sit with out of control patients is shortchanging the rest of the patients.

I worked a 12 hour shift on my regular unit, had one of my confused patients with a one on one, but no tech on the floor for over 20 patients because all the techs are being diverted to one on ones. Then I stayed over 4 hours of OT to help out another unit, a patient whom I was picking up was in the process of going ballistic, another one on one ordered, no tech for that unit either!

Now isn't this a typical American concept? The rights of the individual supersede the good of the group. Actually, that seems to sum up much of what is wrong with healthcare in America today.

Also, regulatory goals are made in a vacuum, with no consideration for the impact they have within the reality of the time/space continuum or their impact on allocation of available resources.

I don't think restraints should be a last resort when pulling a tech to sit with a patient will deprive other patients of needed care.

I'm all for the concept of avoiding the use of restraints, in theory, but in practical terms, pulling techs from the floor to sit with out of control patients is shortchanging the rest of the patients.

I worked a 12 hour shift on my regular unit, had one of my confused patients with a one on one, but no tech on the floor for over 20 patients because all the techs are being diverted to one on ones. Then I stayed over 4 hours of OT to help out another unit, a patient whom I was picking up was in the process of going ballistic, another one on one ordered, no tech for that unit either!

Now isn't this a typical American concept? The rights of the individual supersede the good of the group. Actually, that seems to sum up much of what is wrong with healthcare in America today.

Also, regulatory goals are made in a vacuum, with no consideration for the impact they have within the reality of the time/space continuum or their impact on allocation of available resources.

I don't think restraints should be a last resort when pulling a tech to sit with a patient will deprive other patients of needed care.

But then the pendulum will swing too far to the side of using restraints right away, without trying other measures.

Our techs had 13 pts each the other day because one tech was pulled, it was nigh on impossible to give great care under these conditions, especially when you have a lot of needy, incontient pt's. We the RN's helped out as much as we could but I understood the anger especially as 1 tech had 11 accuchecks

I'd rather have eleven accuchecks than eleven poopy patients.

Specializes in MS, ED.

I work as a tech, and the one-on-ones pulling techs off our floor is killing *us* (techs) too. When we have 5 on the floor, my patient assignment will usually be 10-13 and very manageable.

When we dwindle to 3, (as has been happening when techs are pulled to other floors to sit), I can have a whole wing of the floor to myself with a patient load up to 25. Nights like those leave me exhausted and frustrated, unable to give the care patients deserve without the hands to help or the time to get things done as they should be.

Now: we have techs who have signed up for OT and float duty. We also have per diem staff and even a new management idea to share light duty 'sitting staff' between floors. For some confounding reason, we continue to run short, and be run short, without these options being utilized or even discussed.

Hell's bells, it's gotten to the point where units without enough daily staffing will put in for a sitter; a unit will give someone up and send them along to help, only for that tech to find out they are there to staff two empty wings and work, not sit. :down:

I agree with you, Firestarter: it stinks for ALL of us, staff and patients.

Best,

Southern

When I worked on the floors, I sometimes wished the Nightingale wards were still around so I could see what all my patients were doing.

I had 6 well spaced private rooms and sometimes I would see a patient with one leg on the floor, one leg on the bed, one arm on the rolling bedside table and the patient leaning at a 45 degree angle.

Specializes in LTC, Med/Surg, Peds, ICU, Tele.

Maybe the Nightingale wards will make a comeback. I wouldn't mind.

When the doctor orders a sitter for a patient do hospitals get extra reimbursement?

I don't believe they do, unless the one to one is for suicide watch (least that's what I was told by a house supervisor when I had the nerve to question pulling staff from the floor, LOL). Therein lies the problem, I think. They don't get reimbursed, therefore they won't pay for extra staff.

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