Nurses: Staffing levels are dangerously low

  1. When Cathy Caruso went back to nursing in 2001 after a 10-year hiatus spent raising her kids, it was clear to her things had changed for the worse.
    As a nurse at MetroWest Medical Center in Natick, Caruso said, she routinely had to care for seven patients at a time, a level many nurses consider unsafe. Caruso resigned within a year to take a lower-paying job as an elementary school health teacher.
    "If one person had a bad day or a bad turn, and required my attention, that meant six patients weren't getting my attention," she said. "(I was) very concerned for what wasn't being done for the rest of my patients."
    That's why Caruso and many others want the state to require what they call safe nurse-to-patient ratios. The Massachusetts Nurses Association argues hospitals are understaffed, increasing the risk of patient complications and deaths.

    Full Story: http://www.dailynewstranscript.com/h...rticleid=30878
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  2. 22 Comments

  3. by   Cherish
    Wow, that is a pretty frightening situation if you are the patient or nurse. Every state should do an investigation and possibly a policy on this issue. Just the thought that: "The study said surgical patients are 31 percent more likely to die if they are cared for by a nurse with eight patients than they are if cared for by a nurse with four patients -- the requirement under pending legislation".

    That in itself should have EVERYONE alarmed. I thought hospitals 'react' when situations of possible legal suits can arise. It's amazing most people haven't thought of that, surprised there is no legislation or policies. If more people knew about this then definately, management and BON, would enact a policy (Hopefully I think they would!).
  4. by   RNbug
    I work at Wilkes Regional Medical Center on the surgical unit. We just had a "new staffing grid". This grid is UNREAL! The other night there were 7 patients to one RN and one CNA. That was all the staff that was on the floor! Also we can admit at any time. We have to have over 12 patients before we can call in a CNA or LPN. Right now we can have up to 10 patients per one RN! And Novant health's new guidelines only made things worse! I only have about 1 yr experience and I am very nervous and worried about my ability to take care of up to 10 patients at one time. I and many other nurses on my floor have voiced our opinions but then the management only makes things worse! Are the RN-patient ratios this bad everywhere else?
  5. by   oramar
    We currently have one RN, one LPN and one aide for 13 patients, that is only slightly better but manageble. It is wierd but when we hit 14 we get another person, so you get 4 personel to care for 14 patient but only 3 for 13, it does not make sense does it.
    Quote from RNbug
    I work at Wilkes Regional Medical Center on the surgical unit. We just had a "new staffing grid". This grid is UNREAL! The other night there were 7 patients to one RN and one CNA. That was all the staff that was on the floor! Also we can admit at any time. We have to have over 12 patients before we can call in a CNA or LPN. Right now we can have up to 10 patients per one RN! And Novant health's new guidelines only made things worse! I only have about 1 yr experience and I am very nervous and worried about my ability to take care of up to 10 patients at one time. I and many other nurses on my floor have voiced our opinions but then the management only makes things worse! Are the RN-patient ratios this bad everywhere else?
  6. by   nurseholly421
    Quote from brian
    When Cathy Caruso went back to nursing in 2001 after a 10-year ...hiatus spent raising her kids, it was clear to her things had changed for the worse.
    As a nurse at MetroWest Medical Center in Natick, Caruso said, she routinely had to care for seven patients at a time, a level many nurses consider unsafe. Caruso resigned within a year to take a lower-paying job as an elementary school health teacher.
    "If one person had a bad day or a bad turn, and required my attention, that meant six patients weren't getting my attention," she said. "(I was) very concerned for what wasn't being done for the rest of my patients."
    That's why Caruso and many others want the state to require what they call safe nurse-to-patient ratios. The Massachusetts Nurses Association argues hospitals are understaffed, increasing the risk of patient complications and deaths.

    Full Story: http://www.dailynewstranscript.com/h...rticleid=30878


    hello my name is holly and im an lvn workin in a nursing home in texas. i take care of 40 to 60 pts depending on staffing. i have also been debating on whether or not i want to remain a nurse. i love what i do with all my heart but the patient to nurse ratio is sooooo bad that it scares me that im going to lose my license anyways for not being able to give proper care to all of them.it upsets me greatly to go into work and am busting my butt to do all i can do knowing that alot of things are still being missed dt not enough time and too many pts.i was also wondering if there are any government laws regulating patient nurse ratio or if it varies from state to state.id appreciate any comments thanks
  7. by   sjlynn
    [QUOTE=nurseholly421]hello my name is holly and im an lvn workin in a nursing home in texas. i take care of 40 to 60 pts depending on staffing. i have also been debating on whether or not i want to remain a nurse. i love what i do with all my heart but the patient to nurse ratio is sooooo bad that it scares me that im going to lose my license anyways for not being able to give proper care to all of them.it upsets me greatly to go into work and am busting my butt to do all i can do knowing that alot of things are still being missed dt not enough time and too many pts.i was also wondering if there are any government laws regulating patient nurse ratio or if it varies from state to state.id appreciate any comments thanks[/QUOTE

    I WORK 12 HOUR SHIFTS ON THE WEEKEND , IF WE ARE LUCKY WE HAVE MYSELF. AN RN, 4 CNA'S AND A MED TECH, AND WE H AVE 61 PATIENTS, AND IT IS A SKILLED FACILITY, AND I KNOW WHAT YOU MEAN. YOU ALWAYS GO HOME KNOWING YOU FORGOT SOMETHING. AND TO TOP IT ALL OFF, 99% OF THE TIME THE STAFF IS NOT SCHEDULED OR THEY CALL IN , AND THEN I HAVE TO SPEND THE REST OF THE DAY TRYING TO GET COVERAGE JUST TO MAKE STATE REQUIREMENT. AND SOME W HERE IN THAT TIME YOU HAVE ALL TH E CHARTING AND TREATMENTS AND ANY UNFORSEEN INCIDENT THAT MIGHT HAPPEN. I CAN UNDERSTAND WHY SOME ONE WOULD WANT TO GO INTO ANOTHER FIELD.. THEN YOU HAVE ALL THE RULES AND REGULATIONS OF STATE AND OF THE FACILITY. I WOULD LIKE FOR THESE PEOPLE TO FOLLOW ME AROUND A COUPLE DAYS AND SEE IF THEIR REGULATIONS ARE CORRECT AND SERVE A GOOD PURPOSE. YOU JUST CAN'T GIVE SAFE CARE. YES I WISH THE REQUIREMENTS WERE BETTER.
  8. by   powel_44
    Quote: ...I WORK 12 HOUR SHIFTS ON THE WEEKEND , IF WE ARE LUCKY WE HAVE MYSELF. AN RN, 4 CNA'S AND A MED TECH, AND WE H AVE 61 PATIENTS, AND IT IS A SKILLED FACILITY, AND I KNOW WHAT YOU MEAN. YOU ALWAYS GO HOME KNOWING YOU FORGOT SOMETHING....


    may i ask what setting are you in? coz here in philippines, if you are assigned on Surgery Ward, 2RNs, 1nursing aide, and 1IW working in a 8-hour shift for a sixty patients (only the two RNs most do the job specifically referring, charting, giving meds, monitoring, giving interventions). And if you were assigned on OB ward is has a 100 or more patients with same number of personnel like in Surgery ward. Nursing care will be very very low. Time is divided into a very little part. That's why nurses here in Philippines are having an overtime in order to suffice the satisfaction of the patients. On the other side, nurses may feel stressed and only having a very low salary. That's why they depart this country in order to find wealth/fortune in another country. Most of nurses here in philippines, their most-likely destination is US.
  9. by   tiona
    In CA we have safe staffing legtislation; AB 394. Hospitals are mandated to observe specific ratios depending on the acuity level of the patients in a given area. For example the ratio on a med/surg floor is 1:6 licensed staff, with 1:4 recommended. Many CA hospitals have phased out LVN's and some have even phased out CNA's in order to be able to absorb the cost. This means that RN's do everything...even ADL's. Given the nursing shortage, hospitals are forced to use travelers and registry nurses at huge expense.

    I think that the safe staffing ratio mandate is wonderful, I just think it would be more cost effective to utilize LVN's to meet the requirement thereby saving a great deal of money which is now being spent on out of state nurses.

    A team nursing approach = good patient care IMHO
  10. by   sjlynn
    I Work In A Nursing Home, Skilled Facility. The Work Is Stressful And Demanding,there Are A Lot Of Decisions You Have To Make And You Don't Have A Lot Of Time To Make Them, Due To All The Other Duties, And On The Weekend You Have A Skeleton Crew Any Way. I Must Say Though That I Have Learned So Very Much,. The Pay Is Never Enough, The Hours Are Long At Times And At Times There Are Not Enough Hours In The Day, But Yet We Keep Doing It.
  11. by   heart queen
    "We are in the midst of a nursing shortage and need to address the disease -- not just the symptoms," Moore wrote in an opinion piece posted on his Web site. "We need to attract more nurses to ease the stressful burden on nursing personnel."

    How can these yahoo's write legislation and be soo far off mark? If there were adequate staffing levels, patient care would be provided, minimal burnout, decreased RN injury's and FEWER NURSES LEAVING!

    um, let's see.. if we fix the ratio's, many if not most nurses would stay.. NO, let's just keep bringing MORE in instead.. yeah that's it :angryfire

    Every legislature that votes on nursing issues should have his constituants demand they follow a nurse for a day.

    IMHO, and off the box
  12. by   southern_rn99
    Yes, the low census grid is ridiculous here in Texas too. I am a travel nurse working at Lewisville Medical Center in Texas and I have to say, these people are out of their minds. The acuity level should be no different here on a medical floor than a surgical floor in Cuba. Why should one floor (PCU or Surgical) have 6 floor nurses, 1 charge nurse, 2 aides and a secretary for 24 patients and we only have 2 floor nurses, 1 charge, and 1 aide for 20 patients. My floor is nothing but nursing home patients who are incontinent and demented. Last night with only 3 floor nurses, 1 charge and 1 aide for 24 patients, 3 of them fell. That could have been prevented. The people that are making these "grids" have probably never worked a day on the floor or has been years since they have or they may not even be in the medical profession. I am so disgusted with this hospital and almost disgusted and disappointed in the nursing field. It is not going to get any better unless we stand up and make them aware just how dangerous it is for us to be so short staffed.
  13. by   khine2mn80
    no wonder why ppl leave nursing. its a beautiful job but these issues are making it ugly. the last night shift i did was with 20 patients ...me and agency nurse only...cant sleep soundly after that...
  14. by   MrsWampthang
    I work in an LTAC where the patient to staff ratio is usually 6:1 on days and usually no less than 7:1 on nights. Usually on nights there is only one aid too. The facility staff bases the number of staff on the census. I have seen times where nurses had 8 patients and the charge had 3. It is ridiculous how hard they expect the nurses to work. I have to admit, days is worse than nights. I have seen some very bad medical errors made due to the nurses being too overwhelmed to double check the orders that the secretaries are putting in. One night they didn't have a trained charge nurse available so they threw the charge keys at the only ACLS nurse, who had never been trained to do charge, that was working that night and had her do charge, and she had 7 patients herself! It's just not a safe place to work nor it is a safe place to be a patient. The nurses do the best they can, don't get me wrong, but if you are overwhelmed, you're set up for failure. At any rate, I just accepted a position at an LTAC whose patient to nurse ratio is rarely more than 3:1. The perk is that the pay is better, but the down side is that it is about 30 miles further to drive. Guess I'll figure out after I am there for awhile whether it truly is worth it, but I think it will. I'm excited about it!!

    Pam

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