6:1 ratio in ER....abusive?

  1. 0
    I need help.

    I started a travel assignment with Parallon 2 wks ago at understaffed Northwest Medical Center's ER in Margate, FL. Their ratio is 6:1...their average ER pt's age is 85. Almost with no exception, they are full workups, and half of them unstable: CVAs, MIs, OR, etc. I am not being targeted, most nurses have 6 pts.

    I am considering sending in my resignation, but since this is my first travel assignment, I do not want to appear "weak". On the other hand, I would rather have my pride hurt rather than my license.

    Am I being unreasonable?

    Are predetermined ratios guaranteed in a travel contract? If not, how do you object to unsafe ratios? I do not recall receiving a written contract when Parallon flooded me with initial paperwork!

    Thank you!
  2. 12 Comments so far...

  3. 0
    I would consider 6:1 unsafe. On the other hand, when I sit in on ED RN interviews, I suggest hiring RN's who have worked in the south, as they usually have great time management from 6:1 and higher ratios. The most I have ever had was 8:1 non-critical, 4:1 acute and criticals. Now I am in California where the legislature helps us out. Definitely easier, safer, more enjoyable. Still busy.
  4. 1
    No doubt that 6:1 ratios are unsafe under the conditions you describe. However the liability is on the hospital, not you. If you apply your knowledge and experience appropriately and work to the best of your ability, your license should be safe. That is not an absolute, but just look at the number of staff nurses and travelers working in similar situations in Florida. The nursing board couldn't possibly hold all those nurses responsible.

    Try to stick it out if you can. You will be a better nurse afterwards.
    cosmicmama likes this.
  5. 1
    "The liability is on the hospital, not you".... if you sincerely believe that, I have some swamp land to sell you. All kidding aside, one of the first things I always advise a new nurse is to purchase malpractice insurance. Although a hospital or facility will usually say that you are covered...who covers you when you are fired, sometimes coinciding with an impending lawsuit? When lawsuits are brought.... usually everyone who had anything to do with the patient becomes listed in the lawsuit. Use your own judgment with regard to accepting patient ratios. Hospitals and health care facilities are run as a business by business professionals, not medical practitioners which means maximizing profits and staffing levels come into play with regard to profit margins.
    AWanderingMinstral likes this.
  6. 0
    Professional liability insurance runs around $100 a year (except in Texas). That should tell you how likely it is that a particular nurse will need it. Any insurance that is cheap is usually a ripoff. That said, it is so cheap as to say, "Why not?" Fair enough and there is actually a better reason to get it: legal representation if your license is threatened by a board of nursing. That happens a lot and it is telling that the benefit amount is much lower than for malpractice.
  7. 0
    Thank you all for your input.
    Just so I understand, I should:

    1. get professional liability insurance ($100/yr) in case the Board of Nursing tries to de-license me. This would not cover me if sued for malpractice by a patient.

    2. look into malpractice insurance in case I hurt a patient. (Much more costly).

    I was always told that when suing for malpractice, the attorneys leave nurses pretty much alone unless they carry malpractice insurance. Is there any truth to that?
  8. 0
    California seems much more regulated, also with their generous overtime rates. It seems perfect for a traveler who does not have to pay their astronomical state income taxes...or do we, even if we live in another state and the assignment is less than a year?
  9. 0
    "[Now I am in California where the legislature helps us out. Definitely easier, safer, more enjoyable. Still busy.]"

    Great, California seems much more regulated, I love their 9th hour overtime concept but would hate to have to pay such high state income taxes. If we live in another state and work in CA for less than a year, we do not have to pay California taxes, do we? Only our home state income taxes?
  10. 0
    ">Now I am in California where the legislature helps us out. Definitely easier, safer, more enjoyable. Still busy."

    Great, California seems much more regulated, I love their 9th hour overtime concept but would hate to have to pay such high state income taxes. If we live in another state and work in CA for less than a year, we do not have to pay California taxes, do we? Only our home state income taxes?
  11. 1
    When I referred to malpractice insurance in a previous post, I was referring to profession liability insurance...yes it is inexpensive, relatively speaking, but does provide you with a level of protection in the event of a lawsuit. The best advice I can give would be to visit websites that offer this insurance for more detailed information. In regard to taxes, you might want to find a tax specialist that specializes in travel professions...they do exist...good luck!
    BARNgirl likes this.


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