Most admissions you personally had during shift or most your floor had.

Long Term Care Columnist / Guide · May 10, 2004

One night on our 34-bed med/surg unit, we had only 6 patients, so staffing was cut to two nurses: a new grad, and me. No aides, no standbys........naturally, we got slammed. We ended up admitting eleven patients between midnight and 7 AM :eek: Talk about unsafe staffing!! That was truly the night from Hell........both of us quit not long after that.

While staffing is still far from ideal, I've seen much improvement since I've been back.......at least the supervisors will call people in now when we're drowning, and NEVER do they staff only two nurses for an entire floor, even if there are only a few patients. We also have a couple of new assistant managers who will actually get out on the floor and help with admits, difficult IV starts, even taking pts. to the bathroom if necessary, which has probably done more for our morale than anything else. :)

Of course, there are days when we could have 20 staff on the floor and it wouldn't be enough....... :uhoh21:

Repat · May 10, 2004

35 bed telemetry unit - 9 admissions between 3p and 7p. I have had, in one twelve hour shift, 4 discharges, 3 admits and a transfer.

*Peanut*Vennie* · May 10, 2004

I had an assignment of 6 people, discharged 3, and ended up getting 3 more within the hour. Needless to say that was a crazy afternoon

PeninsulaRN · May 10, 2004

One night on our 34-bed med/surg unit, we had only 6 patients, so staffing was cut to two nurses: a new grad, and me. No aides, no standbys........naturally, we got slammed. We ended up admitting eleven patients between midnight and 7 AM Talk about unsafe staffing!! That was truly the night from Hell........both of us quit not long after that.
While staffing is still far from ideal, I've seen much improvement since I've been back.......at least the supervisors will call people in now when we're drowning, and NEVER do they staff only two nurses for an entire floor, even if there are only a few patients. We also have a couple of new assistant managers who will actually get out on the floor and help with admits, difficult IV starts, even taking pts. to the bathroom if necessary, which has probably done more for our morale than anything else. :)
Of course, there are days when we could have 20 staff on the floor and it wouldn't be enough....... :uhoh21:

Holy unsafe staffing Batman!

In situations like that, when our staffing is drastically low, we block off rooms that cannot be used. So, if our maximum ratio is 1:6, and there's 2 RNs, we can only end up with 12 patients, total.

If they want to admit more than that, send us another RN. Or suck it up and board them in the ER.

Repat · May 10, 2004

Holy unsafe staffing Batman!
In situations like that, when our staffing is drastically low, we block off rooms that cannot be used. So, if our maximum ratio is 1:6, and there's 2 RNs, we can only end up with 12 patients, total.
If they want to admit more than that, send us another RN. Or suck it up and board them in the ER.

So, what happens to the ratios in the ER then?

PeninsulaRN · May 10, 2004

So, what happens to the ratios in the ER then?

With all due respect, that's not really my problem. The ER is generally staffed with more RNs and physicians/NPs/PAs, and they are more than capable of handling it. If they are overwhelmed, they go on diversion. Of course, the ER staff need to prioritize with their more traumatic cases but the people being admitted to med/surg are generally stable enough not to need constant care.

If you open up the possibility that you can exceed the maximum staffing ratios that we have worked so hard to achieve, it becomes the norm rather than the exception, and that's something we don't want to see happen.

MelissaRN · May 10, 2004

One night I came on at 7:00 and didn't have any patients and I was put down to take two admissions and two transfers. I was able to hold off the transfers until I got the admissions settled and then the night charge nurse helped me settle in one of the transfers.

Friday night I had two admissions and a post op during my 12 hour shift. I didn't stop moving all night!!

Tweety, BSN, RN · May 10, 2004

On my shift it's unusual to get a lot of admissions. The most I personally admitted was three. The most the unit admitted while I was there was 8. Took a lot of teamwork. The ER was awesome in staggering the admissions as the we were able to handle it. :)

Marie_LPN, RN, LPN, RN · May 10, 2004

17 admissions on an 8 hour 11p-7a shift (i'm talking on the whole floor). Local college frat had a major party, which involved a huge game of Quarter Bounce. The float pool was drained by 3 am. :stone

(We only had 17 of our 36 rooms filled before this incident)

RN-PA, RN · May 10, 2004

I wonder, is this a facility policy or state-sanctioned? Have you worked other places in your states where LPNs are authorized to do admissions?

I've only worked at one other hospital in the area in my 10-year career, and LPN's weren't allowed to do admissions there either. (In fact, we had to do assessments on their patients as well as our own.) I don't know if it's the policy of the hospitals or the state.

BittyBabyGrower, MSN, RN · May 10, 2004

Ah, we are feast or famine in the NICU...last July we went from a census of 19 to a census of 33 in a mere 8 hours...granted a few were multiples, but I have never seen so many babies coming out the woodwork in my life EEK!

Repat · May 10, 2004

Someone educate me! What is quarter bounce?