I am a nurse in NC at a small hospital on a medical-surgical floor. We also have telemetry patients as well. Our facility is implementing "swing" beds which according to our administration only counts as "half of a patient" in regards to nurse to patient ratios. This is a status change on a patient so they can stay in their same room to continue with rehab therapies until ready to go home. Well, we have decided that the care is not changing, they are still patients that require nursing care as well.
That's only the beginning...
They have now done away with a house supervisor and a charge nurse.
They gave us 7-8 patients each yesterday on day shift. HELP!!
Can I refuse this patient load? Can I just not clock in? This is UNSAFE for patients.
Most BONs leave it up to the nurse to refuse an assignment that the nurse deems unsafe; if you fail to refuse and something happens, the BON will still hold you liable.
As others have said, refusing an assignment can result in disciplinary action from your employer. But better you lose a job than your license.
I know that TX's BON has a Safe Harbor provision that would protect you from liability in most cases--as well as protect you from employer retaliation--but that has to be activated before you accept the assignment.
We had "swing beds" in a small rural hosp in California. That was one thing I did not understand. California has ratios, but we could have up to 7 patients. Manager also said, swings did not count.
Sounds horrible! Totally unsafe, hope you get the help you need and get the heck out of there. I have this crazy dream that some day there will be more states with safe patient ratio laws!! Good luck to you.
A swing patient is a patient that no longer meets criteria to be "acute" but is not well enough to go home. It's like a "skilled" patient but supposedly the hospital receives more money for these patients.
However, they require just as much care...sometimes even more so!
I think I would just report them and jump ship. If you already have another job lined up, I wouldn't spend one more day on that floor. Every day you are there you are risking your license! Very scary.
You all keep talking Board of Nsg; call your State Survey Dept of Health (maybe the Ombudsman Office). Safe standards of care are being compromised and that can be stretched/considered to be neglect. If enough of you call with specific details, you can raise an alert.
Like I said, I have another job but I am working out my 6-week notice but I might not be come Monday. I just cannot handle that many patients on our floor and give safe nursing care.
Why six weeks notice? Seems like a lot. Is it in policy?
What a nightmare. Again the only reason they pull this crap is because they know they will find someone to work in those conditions. You know damn well they wouldn't want to be one of the 13 patients who only has 1 nurse. I wish you and your coworkers the best of luck.
Meriwhen, ASN, BSN, MSN, RN
4 Articles; 7,907 Posts
Most BONs leave it up to the nurse to refuse an assignment that the nurse deems unsafe; if you fail to refuse and something happens, the BON will still hold you liable.
As others have said, refusing an assignment can result in disciplinary action from your employer. But better you lose a job than your license.
I know that TX's BON has a Safe Harbor provision that would protect you from liability in most cases--as well as protect you from employer retaliation--but that has to be activated before you accept the assignment.