Staffing Question

[rnbusmgr]

I am curious as how others feel about this subject. Last night there were two patients on our medical floor (our census has been very low). One patient was a middle aged, large man that needed some assistance and the other was a pediatric with an abcess. When I arrived to work I found that I was assigned to that unit without a cna or anyone else, I asked them to at least call in a tech but the supervisor said that he was never told that an RN could not work alone on a unit if there were only a small number of patients. It ended up after everything was said and done that the unit was combined with another one. I would like to know what some of you may think about that situation. Are there regulations about this sort of thing (a unit with only one employee assigned to it). I would think that a nurse should never work alone on a unit. What do you guys think?

[Mashira]

Agreed. This should never happen, it's a safety issue. I would safe harbor that if it came right down to it.

[FLArn]

I worked in a 15 bed inpatient hospice building and was never alone with even 1 patient. However when I worked in a multiple unit building, I was often alone on my unit with up to 4 patients but was able to get help from staff on another unit. I am sure that was their expectation that you would get help from another unit as needed. In your post you stated it ended up with your unit was combined with another, that tech was supposed to float between the 2 units and help you too.

[kool-aide, RN]

In my hospital there is to be a minimum of 2 licensed nurses on 1 every unit at all times, unless there is a census of zero.

[Calabria, BSN, RN]

So, if this patient coded or otherwise rapidly deteriorated, would you have been by yourself?

Our policy is to have at least one other nurse on the floor at all times, in case the above should ever happen.

[Flo., BSN, RN]

Our policy is two RNs.

[classicdame, MSN, EdD]

two is safer for the patient and for you. How do you get someone to witness drug wastes? Or witness any type of event?

[classicdame, MSN, EdD]

I just remembered that years ago I worked in a facility where the pedi floor (7 beds) sometimes had one RN only but the nursery, PP and L&D were near. Finally the Pedi nurses complained to the MD's and they got it changed.

[QuenymamiRN]

I work in a LTC facility. I am the only nurse on my floor at night. One of the other wings has only one nurse as well. The third unit has 2 nurses (because it is sub acute). My wing has a census of 52 and I have 2 - 3 aides. The supervisor may have the house or she may be doing the house and a wing. I am expected to call her if I need help, other wise I am alone.

[brownbook]

I have no idea about the regulations. But common sense says it depends entirely on the layout, floor plan, of your hospital.

Is your unit just down the hall from other units? How far away are other nurses, the supervisor, etc. Our peds unit was at the end of our med/surg hallway. The peds nurse was often alone but a loud shout or even pushing a code button would have brought plenty of staff within seconds.

Of course I can hear all the responses, complaints: "How can a nurse call for help or push a code button when she is doing chest compression." or "What if the patient tries to get out of bed unassisted." etc.

No where, no way, in life can we always plan for and staff for (without breaking the budget) every possible contingency.

[nrsang97, BSN, RN]

Two RN's on the unit at all times.

[CapeCodMermaid, RN]

Am I missing something? Two patients and you can't handle it?