Need opinions

[RNready4change]

I work as an RN on a 25 bed med surg/peds unit. Over the last months several coworkers have left including 2 CNM's. No help or replacements have really been hired. We have 3 RN's on schedule and 3 LPN's on schedule. We usually do team nursing but recently it is falling on our LPN's to do primary care. As of the last two weeks I have worked 3 shifts as the only RN on the floor. My last shift there was 22 pts. I had team with 1 LPN and two other lpn's did primary. My acuity level was very high as I sent two pts to ICU. One LPN had been pulled from a different unit and never done primary before. Am I overreacting or is this dangerous to my patients? I am thinking its time for a new job. I have been asking for more help for 3 months.

[TheCommuter, BSN, RN]

I am thinking its time for a new job. I have been asking for more help for 3 months.

I think it is time to vote with your feet. As long as you continually tolerate substandard working conditions, your managers will continue to work you and your remaining coworkers like service dogs.

[Avid reader]

I think aside from looking for a new job you need to politely speak to your supervisors or managers, then email yourself noting the time, person and content of the conversation, paying particular attention to the accuity level, staffing levels and their responses. Do this every time so any incidents, you maybe covered. You could also if it's safe to do so, email the supervisors, BCC yourself re your concerns. You are accepting the dangerousness of the unit every time you take charge so you need to cover yourself!

[Amentothat]

I think aside from looking for a new job you need to politely speak to your supervisors or managers, then email yourself noting the time, person and content of the conversation, paying particular attention to the accuity level, staffing levels and their responses. Do this every time so any incidents, you maybe covered. You could also if it's safe to do so, email the supervisors, BCC yourself re your concerns. You are accepting the dangerousness of the unit every time you take charge so you need to cover yourself!

This is good and correct as it follows the vaunted chain of command and should be construed as a constructive approach to protect the patients, nurses and hospital from legal retribution if something goes wrong as a result of the deficiencies you have outlined.

Unfortunately in my experience the road to hell is indeed paved with good intentions. So expect to be censured for your honest input and run out of town.

After you are gone some administrator, nursing or otherwise, may make changes, take credit for what you have pointed out and then receive an employee of the year plaque at the annual hospital employee recognition dinner.