patient/nurse ratio

[Mona77]

Hello to everyone,

I am interested in patient/nurse ratio, e.g. at a medical/surgical unit.

Are you supported by RPNs and unlicensed care personnel?

Is primary care provided regularly? (In Germany very rare, because cost-intensive)

When is nursing considered to be unsafe, regarding patient/nurse ratio?

Has nursing shortage already an impact on patient safety?

Thank you for your answers!

[Mona77]

That sounds really challenging, and I feel deep respect to the care you have to provide.

I can imagine that some IENs were shocked as such surgical patients need constant monitoring, special knowledge and technical skills.

Hope that my emergency experience will help me to cope with such "extremely" normal patient situations.

Every IEN thinking that working in a foreign country will be easy (because of the nurses`professionality in their home countries) isn`t realistic.

On some days I feel scared and unsure if I will be able to meet all expectations, not only my employer`s but in particular the patient´s expectations on best practice and high quality care.

I can`t judge if patient/nurse ratio sound good, not knowing exactly all your responsibilities.

Is it your duty to file reports with your union?

[NotReady4PrimeTime, RN]

The Professional Responsibility Complaint (or Professional Responsibility Report as it's called in BC and the Nursing Staffing/Workload Report in Manitoba) was developed as a tool for the employer and the staff to document staffing issues. When they're used appropriately they can be a very useful method of officially reporting such things and have been helpful in increasing baseline staffing on a lot of units. They're also very helpful when things go off the rails and a staff member or patient is hurt as a result of staffing shortfalls, because they serve as evidence that management was aware of the issue and was unable to correct it for that shift. They've been effective in protecting the staff in those sorts of situations from any repercussions from the regulatory body as well. The Canadian Nurses' Association's Code of Ethics includes a statement that the registered nurse has a responsibility to advocate for safe patient care, and this form of reporting fits the bill quite nicely. But the problem with them is that they're not automatic. Someone has to decide to file them. On some units management views them as personal attacks and the "instigator" will then become a target for subliminal or even quite obvious bullying, so the staff on those units are very reluctant to put themselves into the crosshairs. Couple that with units where management really has no idea what's going on at any level and there's a recipe for high workloads all the time. I could give many examples but due to privacy laws and AHS's infamous Code of Conduct, I'd be asking to lose my job, so I won't share thsoe details, but I will say that ratios are not a panacea for staffing issues.

[Mona77]

We have sth. similar to the Professional Responsibility Complaint, same problems as you outlined above.

Most managers value these complaints as a direct attack on their employment and financial policy!

Complaints are filed by the employee representative committee, often without results.

As long as patients don`t take legal actions, there aren`t any financial resources to increase staffing.

Currently you won`t find enough employees to fill your vacancies except for RNs who haven`t worked for the past 10-15 years and did no qualification programms.

Nurses benefit from reporting complaints to the committee, they are protected legally, as long as negligence or malpractice isn`t proved.

If you have to decide whether to write a complaint or to stay employed, I think

most will decide to keep the job, knowing that the employer has more pull.

Especially in those times of nursing shortage and financial restraint.

Reality can be very discouraging and sad.