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

[CareBayer]

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!

[jjjoy, LPN]

I want change! I have not exactly figured out how to do this, but the first step that I have taken is working at a staffing agency to see what all the other hospitals are like in my area.

Let us know what you find in your area. I applaud your going out there and seeing first hand what's happening in regards to local staffing.

The bottom line is that the public needs to have input in this. Does the patient/family really understand that their nurse only has about 10 minutes to spend with them out of every hour at these staffing numbers?.

That WOULD be an interesting and eye-opening public awareness campain! And that 10 min per patient per hour doesn't account for documentation, prep work, calls to pharmacy/MDs/etc, having to spend a bulk of time with another patient to deal with a pressing issue, etc.

And how about how much time the nurse has with a patient in LTC? I calculated 4 min per patient to pass meds (which includes an eyeball assessment, some g-tubes, etc) during my short stint in LTC. And if anyone needs anything extra during that time? A verbal warning for not managing one's time well enough!

[NurseCherlove]

Well, we all know that really it's $$ that matters most to the powers that be. So I think we just have to beat them at their own game. Hear me out here.

In "their" minds, customer service = increased revenue. It's a logical assumption, as this is the basic principle at work in most free enterprises. However, nurses are some of the primary agents executing this lofty ideal. This only serves to feed the public perception that nurses are mere servants who mindlessly follow doctors' orders.

What MUST happen then is a shift in the public perception. We MUST somehow get the truth out to the public - about the incredible responsibilities we have (and the resulting stress), the smarts required to be an exceptional nurse, etc. - basically indoctrinate the public with the truth that we are indeed professionals who command respect.

Most decent people (patients and families - "customers") would be disgusted if they *really* knew the truth about how overworked nurses are. In fact, I would bet that most would completely change their opinion about "that nice hospital" where their mother was - kinda like those who refuse to purchase clothing items (regardless of how nice they look) from known "sweat shops". There are enough people out there who would have those kind of principles.

Another extremely important idea to get across to the public would be how overworking nurses inevitably leads to a decreased quality in patient care.

The public should know about all of the money being spent on "ensuring" more money comes in, instead of being spent on more nurses to have more time to care for them or their loved ones. The public should feel downright insulted by this charade.

Thus, I propose that nurses become the gauge of "how nice" a healthcare facility is - NOT the bells and whistles used to dazzle you under the guise of "customer service". Therefore, the "good" facilities would have the nice nurses who all appear relaxed and seem to love their jobs. And of course the "bad" or "ghetto" facilities would have the very frazzled nurses.

Why would this work? Because people are not stupid. I don't care how much scripting you use, if you are overworked and/or miserable and/or stressed, most people are going to pick up on that. As they would also perceive genuine happiness from their nurse.

Fellow nurses, I believe this truly is the key to changing our future.

So who's with me? What are we going to do about it? Thoughts?

Curious...If say someone were to organize something where we could have some air time on a major TV network, and it costs say $400/person, would you do it?

[Miami NightNurse]

Well, we all know that really it's $$ that matters most to the powers that be. So I think we just have to beat them at their own game. Hear me out here.

In "their" minds, customer service = increased revenue. It's a logical assumption, as this is the basic principle at work in most free enterprises. However, nurses are some of the primary agents executing this lofty ideal. This only serves to feed the public perception that nurses are mere servants who mindlessly follow doctors' orders.

What MUST happen then is a shift in the public perception. We MUST somehow get the truth out to the public - about the incredible responsibilities we have (and the resulting stress), the smarts required to be an exceptional nurse, etc. - basically indoctrinate the public with the truth that we are indeed professionals who command respect.

Most decent people (patients and families - "customers") would be disgusted if they *really* knew the truth about how overworked nurses are. In fact, I would bet that most would completely change their opinion about "that nice hospital" where their mother was - kinda like those who refuse to purchase clothing items (regardless of how nice they look) from known "sweat shops". There are enough people out there who would have those kind of principles.

Another extremely important idea to get across to the public would be how overworking nurses inevitably leads to a decreased quality in patient care.

The public should know about all of the money being spent on "ensuring" more money comes in, instead of being spent on more nurses to have more time to care for them or their loved ones. The public should feel downright insulted by this charade.

Thus, I propose that nurses become the gauge of "how nice" a healthcare facility is - NOT the bells and whistles used to dazzle you under the guise of "customer service". Therefore, the "good" facilities would have the nice nurses who all appear relaxed and seem to love their jobs. And of course the "bad" or "ghetto" facilities would have the very frazzled nurses.

Why would this work? Because people are not stupid. I don't care how much scripting you use, if you are overworked and/or miserable and/or stressed, most people are going to pick up on that. As they would also perceive genuine happiness from their nurse.

Fellow nurses, I believe this truly is the key to changing our future.

So who's with me? What are we going to do about it? Thoughts?

Curious...If say someone were to organize something where we could have some air time on a major TV network, and it costs say $400/person, would you do it?

I'd be willing but what exactly could we do, that the public would listen to? Maybe make movies of nurse's running around like chickens with their heads cut off crying. And saying something like Would you want this nurse who is overloaded and overwhelmed taking care of your family member.

[Jynell]

My hospital went to all beds being telemetry beds. When this happened, they did not give any extra consideration for time added to a nurse's job, nor did they add any extra CNTs. Now if a patient is on telemetry it is 4 hour vital signs, and a nurse may have up to 6 patients. Usually, the true cardiac patients are still on one floor, but there is a problem with the other floors. They did not require ACLS with the other floors. If you see a rythm on the monitor, you have to know how to treat it...