Tele unit staffing

  1. I work in recovery but have a question for you. I recently took a pt up to telemetry where the recieving nurse said "this is my 10th patient, and I am giving blood to 2" Is this shocking only to me?
    Last edit by sharann on Sep 27, '02
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  2. Poll: 10 pts on telemetry

    • Unsafe

      31.17% 24
    • Insanely unsafe

      66.23% 51
    • no problem.ok.

      2.60% 2
    • other

      1.30% 1
    77 Votes / Multiple Choice
  3. 22 Comments

  4. by   MollyMo
    Unfortunately, in some places it's typical. The first hospital I worked in it was not unusual for nights to have 8-10:1 primary care. Sometimes we were fortunate and got enough LPN'S or PCT'S and could revert to team nursing. But not very often. Diagnosis and acuity weren't taken into consideration either.
  5. by   Sleepyeyes
    Whoa, Molly! 8-10 on PRIMARY!!!

    Got me there, I thought that many with a tech (on night shift, no less!!) was too much!!

    I usually have 5-7 with a tech on 11-7 shift, and I think that's good, though once in awhile I'll have to take another admit to make 8. But on our unit, everyone helps, so you're not totally off on your own with this, you know??
  6. by   KC CHICK
    Yep, insanely unsafe....especially w/blood running on two pts.
    We have 5-7 with the occasional 8 if ER is hoppin'.

    Anne
  7. by   Joycean
    Wow, I feel really blessed! We have a 4 bed assignment on Tele. 5 on occasion. Do you do gtts as well?
  8. by   KC CHICK
    Joycean, you sound like you have dayshift assignments. I'm on nights. Yes, we do Cardizem, Amiodorone, and Heparin gtts. where I work.

    Anne
  9. by   Sleepyeyes
    Originally posted by Joycean
    Wow, I feel really blessed! We have a 4 bed assignment on Tele. 5 on occasion. Do you do gtts as well?
    Yup; what KC said.

    I had 2 heparin gtts last night. What I think is time-consuming is when I have a cardiac-GI pt, and all their meds are IV pushes, drips, and piggies....wooohooo! I remember I stood at one bedside easily 30 minutes just giving IV pushes, I kid you not. Then the docs made the pt. po the next morning. :stone doncha love it..... :chuckle
  10. by   Joycean
    You're correct about being day shift, but our nurse to patient ratio is the same for nights. We also have 2 CNA's each shift for a 30 bed unit. The difference at night is no secretary after 2300. I will never complain again. Thanks for the insight!
  11. by   Bermuda
    Definitely UNSAFE... I work 7a-7p tele unit and have a standard assignment of 5-6 and we do drips: Amiodorone; Cardizem; Heparin; Nitro up to 50 mcg; Dopamine; Dobutrex and of course all pushes are IV... and it is primary nursing...I don't even get to pee most of the time.. I can't even imagine 4-5 more patients...take off your own orders; round with the docs; assess q4h; strip interpretation q2h; and don't forget the cardioversion going on and the doc waiting for you to do the thoracentesis after you get the direct admit coming up from ER waiting in the hall as soon as you asses your fresh cardiac cath just wheeled back from the cath lab and before you go home did you do all your chart checks to make sure you didn't miss any orders and of course you checked all your labs including the enzymes and notified the docs...Yet; we will all go back to work tomorrow..
  12. by   dhogan
    Sounds like we work at the same place Bermuda. I have had as many as 6 pts on tele. And I wonder why we continue to do it. But what choice do you have when you are already there and they have to send a nurse home and no one will come in to replace her. Can't really blame them because most have already worked 3-4 12 hour shifts already. Thankfully the new grads start on their own in one week.... most won't be there in 6 months. Then the cycle continues.
  13. by   rn2binmay
    On our tele unit we have 6 pts to a team, 2 covered by an LPN, 4
    by the RN. I heard we will no longer have lpn's after 6 months or
    so and if that's true I will definitely quit and go to another unit. I have worked too hard to get my license and will not risk losing it because they feel like giving me too many patients. Tele patients are very sick. When it comes down to it the hospital is not worried about you keeping your license. They are worried about staffing the floor. COVER YOUR A--
  14. by   Bermuda
    Wow.. 6 patients to a team... that is luxury.... We have 6 per RN and you are it the PCT's have about 12-15 patients... they take Vitals and assist with personal hygiene (etc)... They may answer a light once in awhile:chuckle Meanwhile you solo are IT... and we only have 2 LPN's on the floor they use RN's due to all the IVP's gtt's Central lines...and like you say the acuity level is so high... all tele patients are death/dying or pretty darn close... (so it seems)...and the turnover is so great...patients come direct admit from the ER have a stat cardiac cath; PTCA; stents; and go home all in the same shift and then the bed isn't cold yet and here comes your transfer from CVICU or admit from the Dr. office or ER dumps out after holding the patient most of the day... it is truly a fast pace area and you definitely must be moving full time and common knowledge is no break ... but the shift goes fast... 12 hours more like 14 is over before you know it... and at days end there you are unbelievable what you have done all in a day's work...beats sitting at a desk on your behind:chuckle Dangerous....can be... that's for sure...always be on the alert...I am spent after 2 days in a row...welcome the break then get back on the horse and go again... the challenge is good...
  15. by   HeartRNJenn
    Wow! Unbelievable! I work 7a-7p on tele cardiac step down complete with almost any gtt you can think of, day 1 open hearts, and fresh cath labs a dime a dozen- we have 3-4 on days with an occasional 5 patient assignment. While I was on nights 6-7 was typical, 8 maximum. 10 would be INSANELY UNSAFE!

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