Mandated Nurse-Patient Ratios - page 9

Ashley sank into a chair in the breakroom on her MedSurg unit in a large hospital in Florida. It was 0330, 8 ½ hours into her shift. She had not yet taken a break of any sort, including a bathroom or... Read More

  1. by   Jessy_RN
    Every year, at my facility we have to attend mandatory 'pep-rallies' at work. Year in and year out they go over how we need to be more giving, work short to save $$, excuses why we're so poor and can't get a raise, why we can't get acceptable equipment that works, how we need to smile more and give more etc.

    At the end they provide statistics of nurse turnovers and go around the room asking what we could do to "support our baby nurses (new grads) to stay because statistically X% don't make it past a year and X% are gone before year 2.

    Every year we tell them it's getting scarier and scarier to work on the floor. Patient's are sicker and sicker and the expectations/demands greater and greater. We have broken equipment, always short staffed and when we are even barely staffed appropriately, they quickly send people home because were "over staffed"! No one gets an uninterrupted, away from pt care area lunch, ever. When someone requests time off for a vacation they deny it for whatever reason, they have no incentives and no merit pay. They did away with retirement plan, benefits are poor and expensive, they did away with shift differentials and there is no weekend pay differential either.

    They blink a few times then turn it around and say the senior nurses just need to be nicer, more patient and supportive of them. That we all have a job to do and they probably are leaving because the senior staff are just not being nice, supportive and ensuring they stay.

    I wish this was a joke but it is not.
  2. by   JKL33
    Quote from Jessy_RN
    Every year, at my facility we have to attend mandatory 'pep-rallies' at work. Year in and year out they go over how we need to be more giving, work short to save $$, excuses why we're so poor and can't get a raise, why we can't get acceptable equipment that works, how we need to smile more and give more etc.

    At the end they provide statistics of nurse turnovers and go around the room asking what we could do to "support our baby nurses (new grads) to stay because statistically X% don't make it past a year and X% are gone before year 2.

    Every year we tell them it's getting scarier and scarier to work on the floor. Patient's are sicker and sicker and the expectations/demands greater and greater. We have broken equipment, always short staffed and when we are even barely staffed appropriately, they quickly send people home because were "over staffed"! No one gets an uninterrupted, away from pt care area lunch, ever. When someone requests time off for a vacation they deny it for whatever reason, they have no incentives and no merit pay. They did away with retirement plan, benefits are poor and expensive, they did away with shift differentials and there is no weekend pay differential either.

    They blink a few times then turn it around and say the senior nurses just need to be nicer, more patient and supportive of them. That we all have a job to do and they probably are leaving because the senior staff are just not being nice, supportive and ensuring they stay.

    I wish this was a joke but it is not.

    Any time you sit in a meeting and hear something that will never make sense in any universe ever, that should be your invitation to ask yourself what the real agenda is.
  3. by   Jessy_RN
    I am pretty sure anyone with 2 brain cells could put them together and figure it out. What is the other option? Not show up to a mandatory meeting? Quit and hope the next place isn't of the same mentality and with the same agenda? I suppose but there wouldn't be any gainfully employed nurses anywhere.

    What exactly does asking oneself what the read agenda is solving?
  4. by   wannabeny
    Jesus. If patient nurse ratios are truly this bad (those LTC numbers are truly dangerous and insane to even fathom much less know they are a REALITY!!), why has no one collectively as healthcare professionals staged walkouts and demand safer nurse patient ratios?! Nothing will change if people don't speak their minds.Saw alot of shortcuts being taken just to get through the day during clinicals and during my Med Surg rotation they had 8+ patients, poor nurses were running around like they were on fire just to get through the day and so grateful to even have us do something as simple as ambulate...and the stress on their faces was insane. Feel free to correct me if my thinking in incorrect. Still a rookie.
  5. by   JaelPadron
    At the hospital I currently work at the nurse to patient ratio is typically 1:5; which even then can be a handful for error. The most common concern is why isn't patient acuity taken into account? Don't get me wrong, I can't imagine what it feels like to have 7 patients. However, even when nurses have two patients less if the acuity of most of those patients are high it tends to feel like you have 6 or 7 instead of 5. Does anyone know if there are hospitals that take acuity into account when addressing staffing ratios? Thank you!
  6. by   Jessy_RN
    In my state currently teachers walked out since last Thursday and now got an email that school will continue to be closed due to inadequate staffing.

    The difference? They voted for this and planned it. We walk out and we are abandoning our patients. We request time off for a planned walk out and use our PTO and only 2-3 people will be granted the time if that.

    In a nutshell, they ave us by the galls.
  7. by   Nurse Beth
    Quote from JaelPadron
    At the hospital I currently work at the nurse to patient ratio is typically 1:5; which even then can be a handful for error. The most common concern is why isn't patient acuity taken into account? Don't get me wrong, I can't imagine what it feels like to have 7 patients. However, even when nurses have two patients less if the acuity of most of those patients are high it tends to feel like you have 6 or 7 instead of 5. Does anyone know if there are hospitals that take acuity into account when addressing staffing ratios? Thank you!
    The proposed legislation, S 1063 and HR 2392, takes patient acuity into account. For example, a Tele nurse can only have 4 pts, but if one of the pts is high acuity, her assignment can drop down to 3 or whatever is needed. It's just that it can never go above 4.
  8. by   MunoRN
    Quote from Nurse Beth
    The proposed legislation, S 1063 and HR 2392, takes patient acuity into account. For example, a Tele nurse can only have 4 pts, but if one of the pts is high acuity, her assignment can drop down to 3 or whatever is needed. It's just that it can never go above 4.
    It allows a facility to take acuity into account and go beyond the minimum ratios, but doesn't actually require staffing to be adjusted based on acuity in any meaningful way. It requires acuity adjustments based on the hospitals own definitions of how acuity is measured and at what point additional staffing would be needed.
  9. by   Nurse Beth
    MunoRN- The same is true of the opposing legislation, which calls for "Staffing Committees". The "Staffing Committees " legislation lacks accountability.

    However, and thankfully, S 1063 & HR 2392 make it against the law to give a nurse more pts than the law mandates.
  10. by   hppygr8ful
    Quote from SobreRN
    We had an ally as governor with Gray Davis. The hospitals (and republicans) delayed implementation by years and years.
    You think Governor Moonbeam Jerry Brown cares about nurses? Let me go vomit in my biodegradable grocery bag that costs me 10 cents.

    Hppy
  11. by   NurseBlaq
    When I worked Tele it was 1:7
  12. by   magellan
    The operators of the hospitals across the US would always rationalize that determining nursing staffing should be based on the acuity of the patients in the unit not by patient ratio. In my 23 years of experience in nursing, giving the nurses limit of patients that they can handle in a certain period of time will save lives as what California hospitals are doing right now. I have been to Texas, New York, Ohio, Arizona and Mississippi to work as an RN but I can't stand to practice that long in those states because I get tired handling a lot of patients. With these, the treatments that the patients should receive are not being given on time and much worse, not at all. If the administrations will continue to reason out that the care should be based on the acuity level of the patients, it means to say that we will only take care of those that are in need of care and just neglect the ones who are less sick or less unstable. However, if there is a nurse patient ratio law in place as I have mentioned, just like in California, all the patients will be given adequate care regardless, if they are stable or not.

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