fighting for better ratios

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Hello

I work on an inpt medical oncology floor. We recently moved from a crappy old 44 bed unit (compleate with 4 bed wards and mold in the ceiling) to a spiffy new 29-bed unit that is all private rooms and very much better for our pts!

the problem is we were forced to keep our old numbers (and the old floor stayed open and kept the old numbers, even though they are now all medical and not running chemo). The 44 bed unit NEVER went below 30 so we didn't fight for good numbers below that- so now we are in a heap of trouble. Many good nurses and aides have left because of the poor staffing. Many floats request to not come to our floor because they can not handle the patient load on our floor.

We will be soon having a meeting with the powers-that-be about all this. I am being the rather vocal advocate for getting our numbers back to a safe level. I do feel like there is a big target on my backside, but how can I not speak up?

At this point I have checklists for our nurses and aides to documents what they are doing in a typical 12 hr shift. They are also writing narritive notes of all the delay in treatment troubles (because the bean counting powers that be care more about the bottom line so this might get to them). I also have done a survey of our floor staff and the float nurses about the staffing on our floor. I have printed study after study about how better nurse to pt ratios save money in the long term. I have been trying to think what more can I do to proove that we need the improved ratios.

Has anyone else ever fought the man? what did you do? any ideas from anyone on what more I can do to try and proove our case for better staffing? There are a lot of nurses who are going to leave if we can't get the ratios up and I fear more everyday for my pts safety.

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It sound like you are in this almost alone! How can you make sure management is aware that these views aren't yours alone - how can the nurses on your unit act as a group? If nurses really are about to quit, what would they have to lose by informing management of this fact, and the reasons, in detail? It seems like there might not be so much to lose from some kind of activism, if nurses are really about to head out the door due to poor ratios. All I'm saying, is it's really tough to do this alone, perhaps you could figure out how to recruit your peers in this fight.

In the long term, my first thought was, you need a union. That's what a good union does, negotiate with management on behalf of nurses. In my state, Washington, my union is lobbying the state legislature for safe staffing ratios, and advising members which politicians support nursing. But many people have negative views of unions, and not all of them are effective.

I'd love to hear how your meeting goes, or how it went if it's already over.

Best of luck

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The other nurses are pitching in, but many are rather scared for their jobs. I am too, but I'd rather loose my job fighting for the right thing then keep my job and let my patients suffer. We do have a union and I am getting everything I do pre-approved by them. They are going to be at the meeting. We are being stalled by our temp manager (who is a puppet for the upper management) because she has not put out our next working schedule. We can't exactly pick a meeting date without knowing when we are working! Our 'master pattern' is a joke because we are moved all the time to fill gaps in staffing- which is being worked on (by who- the floor nurses who are sick of never knowing when they will be working).

So anyways we're stuck in a stall at the moment and rather annoyed about it all.

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Well shut my mouth, I need to count my blessings more often. I can't imagine what it's like to have management so actively working against you, so I can't offer any advice from someone who's been there. Have you read any of Suzanne Gordon's books? She is a phenomenal voice for nursing, she has a book called Safety in Numbers, Nurse to Patient Ratios and the Future of Health Care (I've only read "Nursing Against the Odds"). Perhaps there are stories in there of nurses who faced your predicament and what they did about it. But really your story seems like a snapshot of what is happening all over the country in nursing. I am glad you are fighting, and I hope you can inspire others to do the same.

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Specializes in oncology, kidney transplant.

can I ask what your ratios are? Are they based on acuity or nursing care hours? Just curious!:heartbeat

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you'd think I would have all that ratios memorized by now! But there is only so much info my poor little brain will absorb

our numbers are based nothing on acuity (the charge is suppose to break up the hard pts between the nurses evenly)

for a 29 bed unit each day nurse has about 5 pts (charge has 2) and there are 2 techs. At night we have 6 pts (charge has 4) and have 1 pct. Only if we get to about 27-29 pts does days get a 3rd pct and noc get a 2nd pct. Our unit is HUGE. Like walking the lap of it is at least 1/8 a mile. You can not heard a bed alarm on the other side of the unit. Also because of all this junk alot of our own staff has left. This means we are staffed with many floats. Which is ok, but they are not chemo trained and can not take care of anyone 72-hr post chemo either. This means all the staff is running lots of chemo, usually blood too.

they treat us like we're gen med..heck several gen med floors have better numbers!

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