I work in a step down unit with many protocols. Our staffing ratio is 5:1, and if census is low we have no secretary or nursing assistant. We do all the paperwork, phlebotomy, and are required to obtain our own vitals at one on the four hour intervals. In addition, we have to enter our own I/O's. Drips, drains, secretarial and CNA work. Our shift ends at 645 and cannot get our work done in time. We are there for 14-15 hours a shift. If we have 10 patients we have 2 nurses, and that is the staff, period!! There is no one to help with call lights and no code buttons in the room. We hang cardizem drips, amiodarone drips,insulin,etc. Healthcare at its greatest!!!