How many patients is/are too many?

Nurses General Nursing

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In a med surg setting, when would you refuse the assignement? What if you were a new grad? What are the repercussions for refusing ann unsafe assignment? If I refuse an unsafe assignment I fear I am going to be fired, if I keep taking on the assignment that is clearly too many patients I am prob going to lose my license or make a dangerous mistake. I am stuck between a rock and a hard place. When interviewed I asked the patient ratio and was told 5, maybe 6 patients. I have yet to have less than 7 and the norm has been 8. There is no way to properly care for this many patients, what can I do? I can't afford to quit, as a new grad jobs are hard to get. I also cant afford to lose my license. The patients are not being cared for properly. The staffing issue keeps getting worse and the PRN nurses are all quitting. (three this past week) so now it is going to be worse this week. Other nurse will not float to our floor, they all refuse the assignment & run away leaving us to deal with the unsafe patient loads. Can I annonymously complain somewhere?

Neuro/Tele floor. Max is usually six, average is five, lucky if we get only four, would flip out or walk out if I had eight;)

Maybe instead of quitting and instead of refusing assignments which could jeopardize your job you could find someone on your floor who is handling their patient load well and ask them for advice on how to handle the load. Maybe they could turn into a mentor for you. I say that because you're a new grad and you will certainly improve in your ability to handle difficult loads so what seems impossible to you now may be doable after you've had more experience.

You can always keep your eyes open for other jobs while you're getting experience on this one.

Ok, here is my take if I were you as a new RN:

1. Refusing an assignment should be STRICTLY and SOLEY based on documentable facts regarding pt. safety.

2. If you can document that to the State nursing boards standards, DO NOT take the asssignment.

3. Know that most nurses, and most of your supervisors; are not cognizant of the state mandate; MAKE SURE that YOU are.

4. NEVER take an unsafe assignment believing that to refuse it will cost you your job. Your license is worth a LOT more than ANY job, and just because "EVERYONE" else does it, does NOT make it right, safe, or prudent.

Sometimes new grads see things that "ought to be" , and sometimes they see things they simply were never prepared for. Learn the difference, and complain accordingly.

As we say in Brooklyn, they're about as useful as tits on a bull! JMHO and my NY$0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

And THAT'S why CNA seceded from ANA !

Specializes in Cardiac, Thoracic, Vsg, ENT, GU.

I failed to mention in my previous comment.....IF, God forbid, something negative does occur to one of your patients during your shift or you missed an order and there are negative consequences on following shifts,

please feel free to write up a report of your original complaint re your patient load and what, if any, assistance was given to you.

Management in any hospital has had a rough road to travel and their #1 problem has to do with under

staffing. Any manager who does not do everything in her/his power to staff reasonably is asking for problems

and I don't mean problems JUST for the primary care giver. The manager can be considered a part of a

complaint and resulting outcomes.

Specializes in MED/SURG.

What shift do you work? In my hospital day/eve shift is usually 4-5 pts.Nights they can have up to 7.

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

One patient is too many sometimes, especially when ur doing a 1:1 special!

I know a CN who worked in Sydney & she had to care for 12 post op patients. The only thing she had time for all day was to do obs, then when she got home she phoned her agency & quit. She said it was a nightmare.

I find 7 post op patients just too many. Especially when u have to run down to theatres to get them, listen to report, wait for orderlies, etc. Then u still have other patients waiting 4 u on the ward.

I would love to walk into work & they would say - u only have 4 patients today!

I dream of this....

Specializes in Cardiac, Thoracic, Vsg, ENT, GU.

You're right that even ONE patient can almost be too much. With fresh heart transplants that used to be the case on our floor. According to a former co-worker things haven't changed.

On the Cardiology floor I think the head nurse used to get her nurses in a race to see how many post cardiac

cath patients they could admit and discharge in one day. Of course, lose one, gain one was the rule. At the end of the day, if you hadn't fallen down by then, your total patient count could have totaled 13 easily! Admitting, caring and discharging 13 patients was insane!

Another place I worked for ONLY 5 months assigned two RN's and two HELPERS (LPN or a very good Aid) to the

40+ patients on the floor. 18 patients were nothing unusual for my assignment. At the end of my shift I sometimes had a hard time even recalling what every patient looked like.....how would like to have your loved

one admitted there?? Not me!!

So many nightmarish stories we nurses can share. My only advice is to do your best and focus on the patient.

Try to drop the gloom doom attitude until the end of the shift (or at the beginning) and write a report detailing

what and how many patients you were assigned. My standing joke was "I can vomit really fast if need be and

be sent home." For real. Nurses are only humans afterall.:uhoh3:

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