I work in a cardiac unit on night shift, we also seem to get more than our fair share of med/surg overflow. Our main pt's consist of new MI's, dysrhythmias, active CP, CHF, CVA's, with the odd assortment of pnuemonia, dementia pt, etoh withdrawal, and of course everyone is diabetic. Most nights we have at least seven pt's, if you come in and find yourself with only five or six, sit back and enjoy the ride because you know your in for admissions and walking back and forth between wings (it is set up with three wings spreading out from the main desk/office). For example the other night I had 7 pt's, which consisted of two fresh MI's, one active CP pt, a pt with one failing kidney on numerous new bp meds going in and out of CHB (go figure), one new CVA pt (total care), and two pt's with COPD, one of which also has chronic anemia and is receiving two units of blood. Lo and behold I get a call for my eighth pt at 0200 and this is before I have had a chance to check MARS, do 24h chart checks, and oh yeah chart anything. So I get another pt who is having cp still rated a 5/10, but the ER is "so full that were going to bring them on up." Now here is my biggest dilema, they (meaning the powers that be) have decided to do away with our CNA's on night shift and our secretary. So that we can not only do all we do now, but primary care and if asking, typing ,and filling out tons of stuff isn't enough with a new admit on nights, put the charts together and complete all the orders yourself. There have been nights I have had nine pt's. Also our charge nurse has a team too. I want to know if you all feel this is safe staffing and I'm being whiney or if this is just expecting too much? I would really like to receive feedback on similar experiences or ratios in your units. This place is burning me out and I haven't been a nurse long enough for that yet...lol.
Thanks to all for listening to me rant a little and offers of advice/opinions!!!!