Our place is 30 beds, 3 ICU beds, 2 birthing rooms, with 7 GP's and one general surgeon, outreach cardiology, neurology, oncology, urology, orthopedic, ophthalmology, ENT. One CRNA full time and 2 others from neighboring towns that share call with her, daytime RT, PT, OT, ST.
We are currently concerned about our future, due to some infighting and unrest and business problems among the docs associated with their clinic. The hospital board is stepping in with some business assistance for them (they privately own the clinic as "partners") because if they go under, our patient base goes with it and we won't be able to make it.
We run short staffed as a rule. 2 RN's per shift is typical, with most of the patient care done by our great LPN's and CNA's as the RN's are spread thin with Charge, OB, ER, etc where an RN is imperative. Typical nurse
atient ratio is 1:4-5. Nursing admin/supervisors who are supposed to be on call for emergencies and questions often must work the floor just to cover adequate patient care coverage, and 2:3 do so without complaint, making less money than we do due to no OT or bonus for extra shifts picked up, etc.
It actually, is an invigorating place to work! I believe you become accustomed to the adrenaline rush of such a place. I would not enjoy going back to a large place and have to "pick a floor" and stay there. It is exhausting, but all nurses say that. I feel really wrung out after most shifts, and hard to drag myself back if I didn't get 7 hours of sleep in between, but the energy is always back up there by the time report is half way over.
We do use locums to cover about every 3rd weekend to give the docs a break (our ER is quite busy, and they cover all weeknights and all other weekends), but they don't like to give up the $, so locum help is received in a lukewarm fashion, and the "locals" like a familiar doc to see them in the ER. Nurses do a lot of placating and apologizing for the docs, but they are good people for the most part.
Change is in the air....I only hope it will be good!