Working in MedSurg with ONLY RNs...

Sour Lemon · Jul 23, 2018

Hi! i'm a new grad Canadian nurse working on a medsurg floor in a main hospital downtown Toronto. The entire floor is RN only, so we don't have any techs, RPNs (LVNs) or anything of the sort.. Which boggles my mind because I have to balance giving meds, cleaning up bowel movements, brief changes, and even feeding between 4-6 patients depending on whether I work a day or night shift. Day shifts I usually have 4 patients while on nights I take care of 6.. My friend who lives in the US (Texas) says most floors in the hospitals there have techs and LVNs who take care of the cleaning, feeding, taking vitals, etc. Are RN only units common in Canada or something? Is there a funding issue? Because the burnout is ridiculous....

We had techs in Texas, but they had 20-30 patients each and sometimes ran out crying mid-shift. RNs had eight of their own patients and an LVN with eight to cover. We had to get report and give report on all 16. This was acute care (ortho!!).

Your circumstances sound awful, but don't glamorize Texas.

I love working with RNs only, but only if we have three or less patients, each.

oceangirl1234 · Jul 23, 2018

I work on a RN and LPN unit, no aides. I do my own chemstrips, vitals, bed baths, etc. It's just a part of my shift now, though.

Rebekulous · Jul 24, 2018

I have only worked on units with RNs and techs, but I have a friend who works in Oregon on an RN-only unit. He loves it. They do have a reduced ratio tho -- I want to say only 3 to 4 patients, depending on the shift.

Fiona59 · Jul 24, 2018

I work surgery in Alberta. I am an LPN. I carry the same workload as the RNs on my unit. We don't have techs (do you mean Nursing Assistants). Personal care is every nurses responsibility. It isn't delegated to the LPNs so RNs can be free. We do our own vitals, chem strips, dressing care, meds. Basically you look after your own patient.

It's five patients on dayshift and seven/eight on nights.

The only difference between the RNs and LPNs is piercing the travisol bag and Charge duties, oh and $15/hour.

KelRN215, BSN, RN · Jul 24, 2018

Most hospitals in my area of the US do not have LPNs at all. They have all but been phased out in acute care. I've only encountered 2 LPNs working in acute care in the last 12 years and it was 12 years ago in the community hospital I worked at as an aide one summer.

When I worked in the hospital, we had aides but we had 3 on days and 2 on nights for 26 beds and you didn't always get an aide to help you. Unless I had a total care kid with no parent at the bedside, I preferred to just do total care myself at night. Half the time the aides didn't get the vitals in a timely fashion anyway. My best nursing school friend worked on a unit for 10 years that was RN only and she loved it.

Horseshoe, BSN, RN · Jul 24, 2018

I work surgery in Alberta. I am an LPN. I carry the same workload as the RNs on my unit. We don't have techs (do you mean Nursing Assistants). Personal care is every nurses responsibility. It isn't delegated to the LPNs so RNs can be free. We do our own vitals, chem strips, dressing care, meds. Basically you look after your own patient.
It's five patients on dayshift and seven/eight on nights.
The only difference between the RNs and LPNs is piercing the travisol bag and Charge duties, oh and $15/hour.

That is a huge salary difference based on only TWO small differences. What is the difference in educational requirements in Canada between the two?

Swellz · Jul 24, 2018

One anecdote doesn't mean we are universally better staffed in the US, unfortunately.

I knew of a hospital that went to the all RN model. The problem was they didn't increase the nurses to lower the nurse-patient ratio - they just got rid of the techs. I never worked there but I never knew a nurse who did who was happy. On a travel assignment, I floated a lot to a floor that gave up techs in order to have only four patients (vs six on other floors). The problem was they didn't staff their own techs, but they ended up with 1:1's, so other floors would lose their techs to staff our 1:1s. LPNs haven't been common where I've worked, but they always managed their own patients; they just had to have stuff cosigned by the charge nurse and the RNs had to help with the tasks they weren't allowed to do (hang blood, certain IVP meds, discharges, etc). The only time I had an LPN do tech stuff explicitly was when we were overstaffed with nurses and they were trying to avoid sending someone home.

EDNURSE20, BSN · Jul 24, 2018

I work in NZ. We have only RN on the floor too. Day shift is 4-6 pt, normally 5. And night shift 12-15. And we do everything, feeding, bathing, tolieting ect. It's tough! But you get used to it. Time management and prioritising skills are developed quickly.

TruvyNurse · Jul 24, 2018

We typically ran with 2 to 3 RNs on Med Surg with 1 CNA. Our census was typically 12-15 patients. Boy those days with just 2 nurses.. whew...

Triddin · Jul 24, 2018

I've never heard of techs in Canada; you might have a care aide, but there is generally one for the entire floor. R patient is a common Canadian ratio. As you learn, you become faster and become more confident with your decision making. I think all new grad nurses feel overwhelmed. It will get better

Pepper The Cat, BSN, RN · Jul 24, 2018

I work in the GTA. Our unit is a mix of RNs and RPNs. We have one PSW to assist with care, empty garbage,,laundry, stock carts etc.

I have 5 pts on a day shift. The PSW will do ADLs for 1 pt and I do the rest, plus all,other care. This is normal.

4 pts on days is actually a good assignment.

Once you get your time management skills in hand, you will do,better.