Nurse to Patient Ratio

Nurses Safety

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:mad:RATIO 11 TO 1 AND ONE CNA...NOT SAFE....HOW DO YOU STOP IT AND WHAT CAN YOU DO!!! UNSAFE AND POOR PATIENT CARE....PLEASE HELP!

Specializes in OB.
Advice: Walk away and save your license.

What other help can we give?

I totally know how you feel. I have frequently been to the point of tears out of pure frustration. I have been nursing for only 4 years, my first year i worked nights on a med/surg floor with 12 patients a piece, many of whom were extremely intense patients. I used to cry having to go to work out of fear of the unknown, it was so stressful being responsible for that many pts. I left and took a night position in a post partum unit with mothers and babies. The particular hospital is the busiest in the state if not the country i think in regards to deliveries. I kind of became used to the "business" but recently it has gotten to a point that i feel is so unsafe. We have generally 12 pp patients but many are not your run of the mill "well" moms, they are very sick antepartums, we very frequently have pp hemorrhages, complications from csections, ruptured uteruses from failed VBACs, diabetics, preterm labor, magnesium infusions, etc. and in general they can be very needy due to the hospital being a high risk center. At times, we are so much to capacity that we fill our 70 beds and our 10 bed overflow area. Even with that, we still have people in delivery rooms with 3 stretchers in each, and the line for triage is out the door. At the same time, when in the nursery one nurse can be responsible for up to 15 of her own babies and if the other nurse is on a break there can be 30 or more in one sectionn that we then have to take care of, admit, assist in circumcisions, administer vaccines to, and even answer to the whims of the moms who bring the baby in because the diaper is dirty and they don't want to do it. It is really so frustrating and I do also feel for the management because they have to deal with having beds available for the constant influx of deliveries. They will often ask us to discharge moms by the morning so we can get the bed clean and before it is even dry, another mother is being rolled up into it, someone who may have delivered the day before and will be going home the next day. I really love maternal child health and i definately want to stay in this area, but I get such anxiety being at work and feel like I cannot dedicate my time adequately to my patients. I feel that we are not really doing what we intended to do as RN's, that being said, we all try our best and work our butts off but then we might get called in by a manager or someone to point out a flowsheet or something that wasnt documented. Id like to see them being pulled in every direction and see if they dont miss a darn flow sheet or a prenatal vitamin once in a while. Ive expressed to my husband and family that I really just want to throw in the towel and try something new because I am feeling very unfulfilled and although the $ is good, i think we are worth more than being gophers, we have worked so hard to be nurses and should be giving the kind of care our patients deserve, not just churning out patients for the hospitals to make $. My husband would hate for me to give up the job and the $ because lets be honest, in this economy we are lucky to even have a job, but the toll it is taking on us is not worth it to me and a lot of my coworkers feel the same. I just dont know if i have the balls to do it and walk away. But, i think we deserve better than having a job where u get anxiety and dread going to each day. I know this is long, and please forgive me, but I really needed to vent because i know a lot of you understand where i am coming from....love you all! So what do u think? LoL

I totally know how you feel. I have frequently been to the point of tears out of pure frustration. I have been nursing for only 4 years, my first year i worked nights on a med/surg floor with 12 patients a piece, many of whom were extremely intense patients. I used to cry having to go to work out of fear of the unknown, it was so stressful being responsible for that many pts. I left and took a night position in a post partum unit with mothers and babies. The particular hospital is the busiest in the state if not the country i think in regards to deliveries. I kind of became used to the "business" but recently it has gotten to a point that i feel is so unsafe. We have generally 12 pp patients but many are not your run of the mill "well" moms, they are very sick antepartums, we very frequently have pp hemorrhages, complications from csections, ruptured uteruses from failed VBACs, diabetics, preterm labor, magnesium infusions, etc. and in general they can be very needy due to the hospital being a high risk center. At times, we are so much to capacity that we fill our 70 beds and our 10 bed overflow area. Even with that, we still have people in delivery rooms with 3 stretchers in each, and the line for triage is out the door. At the same time, when in the nursery one nurse can be responsible for up to 15 of her own babies and if the other nurse is on a break there can be 30 or more in one sectionn that we then have to take care of, admit, assist in circumcisions, administer vaccines to, and even answer to the whims of the moms who bring the baby in because the diaper is dirty and they don't want to do it. It is really so frustrating and I do also feel for the management because they have to deal with having beds available for the constant influx of deliveries. They will often ask us to discharge moms by the morning so we can get the bed clean and before it is even dry, another mother is being rolled up into it, someone who may have delivered the day before and will be going home the next day. I really love maternal child health and i definately want to stay in this area, but I get such anxiety being at work and feel like I cannot dedicate my time adequately to my patients. I feel that we are not really doing what we intended to do as RN's, that being said, we all try our best and work our butts off but then we might get called in by a manager or someone to point out a flowsheet or something that wasnt documented. Id like to see them being pulled in every direction and see if they dont miss a darn flow sheet or a prenatal vitamin once in a while. Ive expressed to my husband and family that I really just want to throw in the towel and try something new because I am feeling very unfulfilled and although the $ is good, i think we are worth more than being gophers, we have worked so hard to be nurses and should be giving the kind of care our patients deserve, not just churning out patients for the hospitals to make $. My husband would hate for me to give up the job and the $ because lets be honest, in this economy we are lucky to even have a job, but the toll it is taking on us is not worth it to me and a lot of my coworkers feel the same. I just dont know if i have the balls to do it and walk away. But, i think we deserve better than having a job where u get anxiety and dread going to each day. I know this is long, and please forgive me, but I really needed to vent because i know a lot of you understand where i am coming from....love you all! So what do u think? LoL

Do the patients ever question the acuity of the unit? The pace of moving patients in and out like used furniture? I cannot help but feel that the patients MUST KNOW that they are being shortchanged, but don't know how to complain. Don't know what is normal workflow, and what is rush rush rush!

Are you folks unionized? Can you make a call to the press, the state, and make you complaints public? Patients should know/have a right to know, how their health care is being shortchanged, and endangered. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

Specializes in OB.

Yes, they have complained about how they are treated, they usually complain to us and think we are to blame, it is so disheartening as a nurse who is trying their best. Then they will call the patient reps who will demand that we give the patient anything they want to be happy. Its the old patient is always right mantra, which yes they should be happy, but so should the staff. We are NYSNA union we are in NY and besides having such a large population, the closing of many hospitals has definately increased our load. Its tearing me apart because I really hate having to work like this. I just feel like we all deserve better, but i don't think will it ever change.

Yes, they have complained about how they are treated, they usually complain to us and think we are to blame, it is so disheartening as a nurse who is trying their best. Then they will call the patient reps who will demand that we give the patient anything they want to be happy. Its the old patient is always right mantra, which yes they should be happy, but so should the staff. We are NYSNA union we are in NY and besides having such a large population, the closing of many hospitals has definately increased our load. Its tearing me apart because I really hate having to work like this. I just feel like we all deserve better, but i don't think will it ever change.

It will change if we join together in ONE NATIONAL NURSES UNION and SPEAK WITH ONE VOICE!! Not our individual state nurses associations. NY State had the option to join the National Nurses United, and chose to remain independant with their own state nurses association. You will never achieve what you need to by trying to make change alone.

Washington State, Oregon, and Montana, made the same mistake. Join and become one, instead of many.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

I work on an oncology unit without a unit secretary. Every other floor/unit has a unit secretary except the oncology unit. With that said we are also understaffed during the AM shift and majority of the time we run with one PCT which means we take VS and blood sugars. Help please!!!

Specializes in Med-surg, ortho, tele, float.

I was in tears over this this weekend. Calls to mgmt to report understaffing of 2-3 nurses are not returned. They must think we are like the check engine light on the dashboard - if you ignore it the problem will (hopefully) just go away!:mad:

Specializes in PCCN.

yep- pt mass production. And yes, my pts are aware that they are being kicked out asap.

Funny how lately we are seeing more people that have only been d/c'd a week or two before re- admitted:down:

Specializes in Utilization Management; Case Management.

I am living the 10 patient life as we speak...medsurg floor...unionized hospital...I've had my license for 8 months been working at this place, my first job for 5 months minus like 2 days....8 weeks of that was orientation...So I've been productive on my floor for a little over 3 months... It started with 8 patients then went to 9 now tonight we are doing 10 and what did they do to make it better? Give each nurse (3 of us total) our own CNA...bc th CNAs must be able to help me chart and assess, etc. This is not what I thought nursing was and this is NOT what I want to do. It is unsafe and I've been vocal on many levels...but it just keeps getting worse....

Specializes in Medical Surgical.

When I started working in 2006, I would have up 10 patients, 1 CNA in the swing shift. Possibly 1 more patient if there's a new admit.

Our hospital has since worked towards JCAHO accreditation and was just granted full accreditation last year.

Today, 5 to 6 patients is the average. But with all the charting and documentation that came with JCAHO, sometimes it still feels as if we do the same amount of work 5 years ago.

The most patients I ever had was 8 on a med-surg tele floor. The manager would try to get the staff nurses to sign up for extra shifts to "help out on the floor." We would show up only to be floated to other floors and still leave our floor short staffed. The nurses finally wised up and started declining extra shifts. I could use the extra money but I don't think it is worth my sanity/health/peace of mind.

Specializes in FNP/FPMHNP-BC.

Monday I had 18 patients. I work on a Med/Surg floor. it was crazy.

Specializes in LTC.
Monday I had 18 patients. I work on a Med/Surg floor. it was crazy.

This is why I want to move to an ICU setting where you aren't required to have quite so many people. I'm in LTC, where the facility wants to have more and more Medicare Rehab pts, so I have thirty patients that should be much more stable then they are. Over the weekend I had five admissions, 3 transfers to the hospital, one unexpected death, and family members jumping down my throat, because they are still in the "This is a hospital and I must have immediate attention to my family member" mode. The facility doesn't want to provide more than two CNA's, I don't have a RN supervisor, no unit secretary, I do and write all tx....

It's a little hectic at times. :3 You just take things as they come I suppose.

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