I've been at a hospital for 4 months now and am working on a general medical floor. Like every facility, there are problems. However, there have been a lot of staffing issues that scare me. I recently had a day when I was assigned 9 patients at the start of shift, with an LPN taking the team with me. However, our facility doesn't allow LPNs to administer any medications through central lines of any kind or ports and 5 of the 9 had this type of access. She also had broken her wrist the night before and was extremely limited in being able to administer medication. They are also not allowed to do assessments, admissions or discharges. Over the course of the day, I had 5 discharges, 2 admissions from ER and an ICU transfer. 3 of my patients got blood tranfusions oredered within about 1 hour of each other and my LPN couldn't do those either. I kept asking for help and was told they couldn't do it. But we had one nurse who had been on-call all day and another that was sent home in the middle of the shift because she had discharged her whole team! The 3 transfusions were insane, along with my other patients who were all very acute (no walky-talky patients here!) I've never had such a situation where I was asking for help and refused because "you have an LPN with you" but she was barely able to function and I made this known. I was NOT safe that day, broke down twice in tears. I can't find any info about ratios in Oklahoma. Does anybody know about patient limits? I've talked to several people who say their facility has limits on the number of blood transfusions that can do at the same time while taking care of other patients. We don't have that. This is not an isolated incident, but is my most recent. I'm taking my concerns to administration but was wondering about other facilities.
Sorry this is long, I've just been very upset about the working conditions and staffing lately.
Apr 27, '09
Wow Lana. I have no idea about ratios, and that is such a good question. Have you called and talked to someone at the BON...I would imagine they should know?
I graduated a year ago with my RN and got out of the hospital asap....I really do understand your concerns.
Let us know what you find out.
Apr 30, '09
I'm sorry about your experience. I'm a LPN that works at a hospital that doesnt really care whose a LPN or a RN. That could be a good thing, but a bad thing. One night they tried to give me two patients with transusions, I threw a fit. That is just too dangerous.
Apr 30, '09
Yes, most hospitals have ratios... They are really just more of recommendations though in my experience. (Especially in the ER) I'm sorry that happened to you. It is really a patient safety/license safety issue. Throw a fit! If your charge nurse didn't respond in an appropriate manner to your direct request for help because of a safety issue. Go to the manager then director then whoever else. Yes, it is painful, but if you feel strongly about this, stand up for it. Because eventually, you will get used to it and it will feel normal to you to be abused like that, and it shouldn't be that way. Same thing happened to me for 7 years.... You don't realize how wrong it is until you experience something different! Good luck!
May 5, '09
I am a new grad and was offered a position and was told the ratio was 1 nurse to 7-9 patients... I walked away and took another position at a different hospital that offers 1 to 3... it's out there and you need to leave that dangerous situation. Good luck!
May 5, '09
Thanks everyone. I talked to our clinical instructor and manager about this and they say it's being addressed. I would love to leave this position and find something else, but that would mean at least a 45 minute drive since this is the only hospital and we're in a small town. But I'm keeping my eyes open for other options.
May 15, '09
Hey. . .I simply wanted to add my $0.02 on this issue.
I am a Texas LVN/LPN who attends an RN program in Oklahoma City. There are absolutely no legally mandated nurse/patient ratios anywhere in the entire country with the exception of California. California is the only state with ratio laws. The remaining 49 states have no legally mandated ratio limits at all.