How many patients is too many & addressing staffing issues.....

Published

I am a new nurse. I work on a Stroke-step down floor, but we receive all different kinds of patients. All of our patients are on heart monitors, but we have no ventilators on our floor. We do have patients that have cardiac and heparin drips from time to time. On a typical day-shift, we are required to provide care for six patients. This seems like way too many (four would be ideal.) Does this seem like a huge patient-load to you? Oh, and we also work without a nurses-aid frequently.

The other nurses that work on my floor are always complaining about the patient load (both seasoned nurses and newbies.) Since I am new, I'm not sure how responsive our unit director is to these complaints. What other steps can be taken to increase the awareness to other hospital administrators about how unsafe everyone feels about caring for six patients at once?

Thanks for your advice!

Up Vote Up Vote ×
Specializes in Med-Surg.

Six is about the top end of what we usually have, but lately that's what we have had to do. Just been a lot of sick people lately.

If it is six walkie talkies, and are "good" patients, it isn't that bad. But we have a lot of total cares at our facility, and a lot of just needy patients. I definitly have to run hard to get everything done, and I do worry that I miss things. Ideally, four is great.

Up Vote Up Vote ×

Rarely are our six patients walkie-talkies.....at least three of the six are total patient cares....

Up Vote Up Vote ×
Specializes in icu, er, transplant, case management, ps.

I wonder when nurses are going to stand up to the administrators and physicians who fail to recognize the negative impact that having too few nurses, taking care of too many patients, working double shifts and days off. And how long we are going to continue to put up with it. None of these administrators or physicians or even us, would fly on a plane where the pilots and flight attendents had worked double their allowed time. The air line industry has long had limited work time for pilots and flight attendents. But no one thinks a thing about expecting us to do what we will not allow pilots to do.

Woody:twocents:

Up Vote Up Vote ×

we only have 3 RNs on night shift now...our patient load is usually 4 or 5 but there are some nights 7 has come into play. i wont take any more than that...too dangerous and it is my license on the line!!!!:uhoh3:

Up Vote Up Vote ×
Specializes in PCU/CICU.

We usually take a max of 5 but I have taken 6 before. Most of the time I will draw the line at 5. Although the other night I couldn't take more than the 4 I had. 2 of them were bed hoppers. It's just too unsafe.

Up Vote Up Vote ×

How many is too many? I work in a LTAC. It seems many don't know what we do. Here is my last shift. I work in our ICU/HiOBS area. My hobs side(9 pts) i have 3 nurses, 2 rn and 1 lpn, 2 on insulin gtts, 1 neo gtt, 7 on vents, no tech. My icu side(10pts), 4 Rns, 1 Lpn, 8 pts on vents, 1 dobut gtt, 1 q2 bs and the train wreck. This pt ended up on maxed dopamine, maxed levophed and maxed neosynephrine with saline and PRBCs pushed as fast as we could. We finally got him shipped out to an acute care facility. This was a night of "hell" as this patient tied up most of the available staff on the ICU side. i can only say that if it wasn't for the staff i was working with this night would have been total hell, the staff made it work, Despite our PTB new staffing guideline for our facility they feel we are overstaffed. Go figure.

Up Vote Up Vote ×

I used to get 15 patients, no nurse's aide and it wasn't a bad load. And that's the problem. Management remembers those days, those were the days when you didn't have to be close to death to get admitted. Most of management has no clue as to how things have changed. I had 6 patients last night, I was overwhelmed. I think we need acquity based staffing but not like my hospital is doing it. At my hospital you give so many points for an IV, well there is a big difference between Normal Saline and Nitroglycerine but they get the same points

Up Vote Up Vote ×
Specializes in Med-Surg.
I used to get 15 patients, no nurse's aide and it wasn't a bad load. And that's the problem. Management remembers those days, those were the days when you didn't have to be close to death to get admitted. Most of management has no clue as to how things have changed.

And added to that is the fact that everytime I go to work it seems like they have brought in one more form of documenting to tie up more time that could be spent with patients. At least half my day is spent documenting.

Up Vote Up Vote ×
Specializes in Critical Care, Capacity/Bed Management.

I find it funny that some people say things i draw the line at five patients or six.

I work in a urban hospital and lately so many nearby hospitals have closed that our census has sky rocketed to FULL everyday.

Nurse's come on the floor with eight patients a piece and still recieve an admission or transfer. Yes, I know its crazy, unethical, and dangerous but sadly that is what health care has come to in New Jersey.

Governor Corzine thinks he is making things better by forcing hospitals to close but in reality he is making the health care crisis worse than what it already is

*sigh* I myself usually take care of 15 to 17 patients a shift and 14 of them tend to be total care patients. :cry:

Up Vote Up Vote ×

Yeah really. They do that where I work too. Every day it's a new paper to fill out.

Up Vote Up Vote ×
Specializes in Med/Surg, Neuro, Orthopedics, Cardiac.
I used to get 15 patients, no nurse's aide and it wasn't a bad load. And that's the problem. Management remembers those days, those were the days when you didn't have to be close to death to get admitted. Most of management has no clue as to how things have changed. I had 6 patients last night, I was overwhelmed. I think we need acquity based staffing but not like my hospital is doing it. At my hospital you give so many points for an IV, well there is a big difference between Normal Saline and Nitroglycerine but they get the same points

I agree about the managers not having a clue to what is going on! Look at the time of stay with an average CABG, and how long the hospital stay is now, when compared to years ago - The Ice Age.

I care for my patients like they are family, and think about how I would want to be taken care of. Sometimes, I am able to find the right timing, and educate people on the basic fact that 1+1=2... Meaning..... If I have 6 patients to care for each hour, then that equals out to less than 10 minutes spent per patient out of every hour. Also, let us not forget that we have to chart that time also..... We are being set up for failure when we have to work with these numbers. I don't know about the rest of you, but I do not usually get 6 patients who can care for themselves and not need me any less than 10 minutes out of the hour.

Then, there is the charting which should be done at the time of our services. Go ahead in front of a Jury and explain that you can remember everything to the last second out of the past 6-8 hours before getting the chance to chart on 6.... no.... lets make that 8 or 9, because we had to discharge and admit new patients during this time. Remember: How would you expect to be cared for.......

Up Vote Up Vote ×
+ Join the Discussion