staffing ratio for asc-outpatient

[jayleen.kay]

i work in a ambulatory surgery center which is connected to the hospital. we admit and discharge all outpatient surgeries and also admit inpatient surgeries and also do blood transfusions/iv infusions. we have on average 40 patients a day being admitted for procedures. usually we have 6 rns on staff. some days i take 15 patients and others take 7 for a 12 hour shift.

how do you make it fair for each nurse to have equal amounts of patients. some nurses are taking multiple breaks which =less patients. my charge nurse does nothing and my director will put it off as some people are slower than others... nurses are holding patients longer than needed so they dont have to admit or discharge another one. im so frustrated and obviously tired at end of shift. what do i do to stop this

[brownbook]

I am not good at logical intelligent interventions with others (charge nurses, bosses, etc.) especially when I feel strongly about an issue.I get too angry or emotional!

But I do feel your pain. I just wish I a wise "Dear Abby" answer for you!

Maybe for a few days or a week or so you can track how many patients you had and how many nurse X (or nurses X) had. Go to your charge nurse with facts. Show her how you are taking care of more patients than your co-workers so you end up with a lot more patients than they do.

Document when they are taking multiple breaks.

Just playing devils advocate, perhaps your co-workers are getting the "sicker" patients so they can't take another? Perhaps they have some disability or illness you don't know about and need more breaks?

In PACU we have each nurses name written down and write number 1 in a circle next to the first nurse to take a patient. Then immediately put an empty circle next to which ever nurse is next up for a patient. When patient 2 comes out number 2 is put in the circle by that nurses name and an empty circle is put by which ever nurse is next up for a patient. When your patient leaves your circle is x'd out. So you can look at the list and see who has what, and how many patients. When your up next for a patient it is okay to say..."I'm really busy with patient X...they need blah blah blah...can someone else take the next patient."

Ask her what she thinks you can do to make it more equitable?