CNA shortage! All care on a Neuro/Ortho/Medsurge (dump all) floor

[Wilhelmainah, ADN, BSN]

So I recently started at a large hospital in a rural area. I want to start by stating that I am a new nurse but have worked in health care for 7 years and have understood that its a hard job and I am not here to just complain about being busy but rather the unsafe practices. I am union and we are in the process of trying to get changes but its a long and timely process and we have been filling out ADO's to support our reasoning with each shift.

Sooooo when I started on my unit (Neuro/Ortho/Medsurge) just 4 months ago our ratios were 5:1 days and 6:1 nights with a tech and the tech ratios were 10:1 and 12:1. There were like 10-15 in training at the time d/t the shortage of nurses and some traveler contracts ended before we had completed orientation so there was a few nights where the night shift had to take 7 patients. I was still orienting of days so this did not effect me...yet. Now Im on nights and in my position and we have been short techs (CNAs) and do whats called surround or all care. So we do everything for the patient ourself but with 4 patients at night and 3 during day. This past week we started having to take 5 patients at night with no tech! We often have insulin drips on our unit d/t our hospital protocol to start them on anyone with a BS greater than 150 (i think) after surgery, our hospital has no psych ward so neuro it is! Frequent use of restraints, stroke center so many of our patients can't properly walk, are not cognoscente, incontinent, and impulsive. Our Ortho patients are frequently hips and MVA which need 2 person assist for bed mobility and frequent pain meds. Our unit is HUGE! I have never seen a unit so large with so many sections, we have 35 rooms, with about half being doubles. Thats not a ton of rooms but the floor plan is large and outdated making you run soon far from the farthest patients room to the kitchen or supply area. We have a fall almost every night d/t this. Most nights there is one tech and 9 nurses, no secretary to answer call bells, and often no resource nurse which works 11a-11p when there is one, there is just not enough feet on the ground with our acuity and our surveys frequently come back stating how they waited a long time for their call bell to be answered, had to wait a long time to use the BR or be changed or wait a long time to for water. Yet management still doesn't seem to see the connection. So frustrating, many staff are starting to apply elsewhere and they are going to be right where they where before they hired all us new grads.

I am wondering how often are other nurses are seeing this "all care" being done in hospitals?

[Sour Lemon]

That's not a "shortage", that's just intentionally poor staffing. Management is not unaware, they are uncaring. I wouldn't stick around any longer than absolutely necessary.