Mandated Nurse-Patient Ratios

Every nurse has to decide whether to support mandated nurse-patient ratios or support the status quo. It's time to speak up for patient safety and nurse sanity. Nurses General Nursing Article

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You are reading page 6 of Mandated Nurse-Patient Ratios

pamstogner

4 Posts

We have to stop covering for the hospitals negligence. We are enabling!

Sunshine.nurse

21 Posts

They would simply hire agency nurses and make nurse managers work the floor until more nurses were hired.

sweet sunshine

64 Posts

We have 6 patients a day and can total 7 or 8 because as soon as you discharge one they give you an admit. It's awful and I dread going to work. All they care about is their patient survey scores. How can you provide safe care to that many sick patients? Things need to change. I've been a nurse for 25 years and this is the worse I've seen it. Greedy, for profit hospital. Making them rich on our backs. I think of the owners out on their boats and living a lavish life style while I I go all day without taking a break on my feet and it infuriates me. Something is seriously wrong in healthcare today.

LadysSolo

411 Posts

pamstogner, I m glad you put "nurse" in quotation marks, I can't think of a REAL nurse who would vote against safe ratios. She is shameful!

PurpleMyst

146 Posts

Specializes in Med/Surge.

Hi everyone, I have not posted in a while but since I received my BSN I've been working on a very busy medical/surgical/oncology floor(Magnet hospital). It took quite a few months to get used to taking care of as many as 6 patients and sometimes more because of discharges and admissions. I'm stubborn and outspoken and I complain a lot about being overloaded at work and so do many others, but nothing much changes and newly hired nurses just keep leaving. We lost a large number of nurses after my first year on that floor because of the overload and management issues on my particular floor.

Lately it seems that they just keep adding more stuff for us to do, like redundant additional documentation that is not for the patient record. I questioned the extra documentation and made a suggestion that we use our resources to make it easier but no one cared. I do love taking care of my patients but I feel like I can't give quality care, only just enough to keep them safe, and even that is debatable.

Since all these facilities are so obsessed with patient surveys on the quality of their care, why not make it mandatory for each facility to publicly, and in a visible area of each unit, post a daily nurse to patient ratio sheet?

These healthcare facilities are constantly emphasizing patient safety and education so why not educate the patient and/or family on how many patients each nurse has to take care of for that shift?

Many patients do ask me how many patients I have and I just tell them, but management doesn't even want us to tell them that we were busy with another patient and it's why we were delayed in answering their call.

sweet sunshine

64 Posts

PurpleMyst said:
Hi everyone, I have not posted in a while but since I received my BSN I've been working on a very busy medical/surgical/oncology floor(Magnet hospital). It took quite a few months to get used to taking care of as many as 6 patients and sometimes more because of discharges and admissions. I'm stubborn and outspoken and I complain a lot about being overloaded at work and so do many others, but nothing much changes and newly hired nurses just keep leaving. We lost a large number of nurses after my first year on that floor because of the overload and management issues on my particular floor.

Lately it seems that they just keep adding more stuff for us to do, like redundant additional documentation that is not for the patient record. I questioned the extra documentation and made a suggestion that we use our resources to make it easier but no one cared. I do love taking care of my patients but I feel like I can't give quality care, only just enough to keep them safe, and even that is debatable.

Since all these facilities are so obsessed with patient surveys on the quality of their care, why not make it mandatory for each facility to publicly, and in a visible area of each unit, post a daily nurse to patient ratio sheet?

These healthcare facilities are constantly emphasizing patient safety and education so why not educate the patient and/or family on how many patients each nurse has to take care of for that shift?

Many patients do ask me how many patients I have and I just tell them, but management doesn't even want us to tell them that we were busy with another patient and it's why we were delayed in answering their call.

Right! Imagine if that was one of the questions on the survey? Were you aware of how many patients your nurse had? LOL

LadysSolo

411 Posts

No, you are never supposed to be busy with another patient, you are supposed to make your patients think you have all the time in the world for just them. Some of my nursing homes that I go to DO post the number of nurses and STNAs on per shift. I think that's a good idea.

DF-LPN

72 Posts

The 1:4 or 1:5 really doesn't matter because they find ways around it. I worked for a facility that literally broke it down to seconds. It was nothing to go into work and there would only be 2 nurses and 3 cena's for about 115 residents, I had 4 hallways. I would have to count up our hrs, 8 for nurse, 7.5 for cena, take that sum and check the chart for how many hrs need to be covered for a particular number of res. Subtract to see how many hrs needed to be covered. But don't forget the 4 floor nurses that start at 06:30, that's another 2 hrs. Well lookie there I'm only short a 1/2 hr, so I would/could only mandate a cena to stay 30 min......at my least busiest time of the shift! Bottom line....health care is a business, and like any business, it's there to make money.

DC Collins, ASN

268 Posts

Specializes in ED.

If nurses support this kind of legislation, it MUST include the ED.

People ask how this can be done if an emergency comes in, especially when the worst emergencies sometimes involve more than one nurse:

1) Enough float nurses to cover the emergencies (and breaks, to include the 15 minute breaks, while we are at it - no more "buddy breaks", which would then violate any such ratios).

2) Eliminate "Pull Till Full" protocols where every room is filled regardless of staff availability. When an ED RN is tied up in an emergency, no more of that nurse's rooms are filled with non-emergent patients until that emergency is cleared.

2A) What if another emergency presents itself in the waiting room and that nurse's room is the only open room? See #1

3) Have a Triage RN at All Times. If there are no patients in the waiting room, the triage RN can help with tasks (clean rooms, medicate existing nurses' patients, etc.) until another pt shows up.

4) Have an "Ambulance Triage Nurse" (Whether that be the Charge Nurse, one of the floats, etc.) Just because a patient comes in by ambulance does not mean they cannot wait in the Waiting Room right along with all the other pts. Many times pts come to the ED via ambulance just to avoid the waiting room, and there are patients in the waiting room who are sicker than the ambulance patient.

These are just a few changes which can and should be made. I am sure others who have more.

Specializes in Community Health, Med/Surg, ICU Stepdown.

Keep up the fight! Even here in CA facilities have been resistant to change. As mentioned above my hospital went to the total care model so CNAs are only used as 1:1 sitters and although Med/Surg nurses have "only" 5 patients each we often have no charge, no break nurse and patients that belong in ICU as they have made the criteria for transfer more strict. We have to continue fighting on a national level as well as a local level and within our individual facilities. I personally could NOT handle the stress and the ratios of long term care and I have a huge respect for those that work in this specialty.

Specializes in SICU, trauma, neuro.
Nurse Beth said:
The nurse-patient ratios in LTC are abominable. Where is the soul? I believe mandating acute care ratios is a start, and LTC will follow.

Why not push for both concurrently? Am I missing something?

JBMmom, MSN, NP

4 Articles; 2,537 Posts

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

On our med-surg unit I have 7-8 on nights. They're talking about going to 3 PCTs for our unit (30 beds), but giving us one more nurse. So we'll have 5-6 patients, but only a partial PCT- currently we're assigned one nurse and PCT to our assignment. I don't think that will help much, as I am not very efficient at the PCT related activities and it will probably end up taking me longer- ugh. There are nights were 8 seems really unsafe to me. Our days and evenings cap at six, which I think is still too much.