How short-staffed is short staffed?????

htrn · Apr 24, 2008

Let's see, CNA called in sick one night which left 2 RN's on the floor. There were 12 patients, 2 were fresh major surgicals and 5 were on bed checks and constantly trying to climb over the bed rails. We still can't believe we didn't have a fall that night. Can you believe day shift came in and was upset that we hadn't gotten the nightly "checks" done - ARRGGG

forrester · Apr 24, 2008

Let's see, CNA called in sick one night which left 2 RN's on the floor. There were 12 patients, 2 were fresh major surgicals and 5 were on bed checks and constantly trying to climb over the bed rails. We still can't believe we didn't have a fall that night. Can you believe day shift came in and was upset that we hadn't gotten the nightly "checks" done - ARRGGG

Even without the CNA calling out, this is unacceptable staffing.

I tried to get my tele floors to 5:1 during the day and 6:1 during nights, but met resistance at every turn. Finally, they prohibited me from going to the staffing office.

I have no problem with an emergency situation that calls for temporary action to control it. But when the problems are continous and predictable, it points to an administration that is aware but indifferent.

If no one else is going to step up, then we have to do it ourselves.

It finally seems that some of us are. :yeah:

Super Nurse JoshuA · Apr 25, 2008

Even without the CNA calling out, this is unacceptable staffing.
I tried to get my tele floors to 5:1 during the day and 6:1 during nights, but met resistance at every turn. Finally, they prohibited me from going to the staffing office.

:bowingpurYour awesome for that.

My floor yesterday was 7-8 to 1 RN on days, no LPN's on the floor. We did have two aids, 30 patients. Than they wondered why I refused to work evening shift and stay over....even when they were threating mandatory overtime. (After doing mandatory overtime one shift a week, for the last two weeks!!) :banghead:

virgil2915 · Apr 25, 2008

I'm sure this has happened. Ever had one of those days/nights when you came in to work and realized that you're supposed to have five nurses and yet there's just two-----and to top it all, your unit is full or will be swamped with admissions! Want to vent or just simply share that experience? How many RNs were supposed to be there that time and how many actually showed up?

I work in an ICU, facility has established a 2 patient to 1 nurse staffing level (target & minimum) with a 20% stipend if minimum is missed. Levels were established to avoid situations such as you describe. Management STILL staffs to minimum, then sends more patients than can safely be cared for. Mandatory overtime helps with numbers, but is wearing on staff from repeated mandation. We are fighting the good fight, but could use pointers from those who have been there before us.

forrester · Apr 25, 2008

It is readily apparent that our perception of "safe" staffing depends on our position.

Our nursing "management" abandoned us many years ago.

We can remain helpless....or we can act to protect our patients and ourselves.

ANYTHING worth having, however, costs. As we start this national movement to regain control of our work environment, let's remember to stay focused and stay calm. Slow and steady wins the race. :twocents:

Agency41 · Jun 18, 2008

I recently worked on a psych unit and we had geriatric, schizos, major depressed, police holds all on a narrow hallway (14 total in all). We got yelled at and chastised for restraining, were refused sitters and also got second guessed when prning the patients. Also, the boss took away the safety glass at the nursing station stating that it wasn't patient friendly. So, no privacy or safety. I have had security officers armed come up to the unit to help and tell me that they would not want my job for anything. There were 2 nurses and a clerk. So I know about understaffing. I am now awaiting a job for a prison--at least that's safe.

RNSir · Jun 18, 2008

I have read the comments about short staffed floors with a ratio of 5:1 or 6:1 with LPN's and CNA's. Where can I get a job like that?

I work on a General Medical floor on the night shift. We are a 50 bed floor. Days may see 6 RN's, 6 LPN's and 6 CNA's. Nights are sometimes 6 RN's 4 LPN's and 4 CNA's. Most nights are 4 RN,s 4 LPN's and 4 CNA's. Weekends usually wind up 4 RN's 2 LPN's and 2 CNA's. If we have one-on-one patients, we loose the CNA's to them.

ON our floor, we get geriatrics with or without Alzheimers, post-surgical, psyciatrics awaiting room at behavior health, patients moved from CCU to make room for patients in more need of that service, overdoses and withdrawal patients. We sometimes get patients from CCU who need a larger room for family members to spend the last few hours with their loved-ones.

This also includes as many as 4 new admissions per RN.

Now they are cutting overtime, closing the float pool, and cutting staffing in any way possible.

I would love a 5:1 ratio.

Please pardon any typos as I just finished a 12 hour shift with 12 patient including 3 admissions. I did have an LPN and for the first 4 hours a CNA.

aloevera · Jun 22, 2008

the psych hospitals (private) are the worst, I think.....I have had 49 pts. with 2 of us RN's, 2 LPN's (do meds and take off orders only) (but that is enough for them !!! ) and 2 mental health techs.....we had 4 admissions, we each did 2, assessed and charted on all 49, sent 4 to ER, and god knows what else I can't remember....it was horrible...no time hardly for the BR let alone meal....

the norm for us is 2 RN's to about 20-30 pts. which is still too many I think....but when someone calls out, we have absolutely no one to call in....they can't find any agency nurses (so they say) so I don't know what we are going to do....many of us are fed up.....how can they allow such unsafe nursing ratios???? I just do not understand

Agency41 · Jun 23, 2008

Wow! If you don't mind me asking, what region of the US do you live in? Can the LPN's take teams or I guess you would be overseeing them as well? In the prison where I'm awaiting a job, the LPN's can do everything except start IV's. There is also a med tech that passes meds. My job used to be nice but I have gotten used to and now appreciate now working there. Hope you find yourself something better. Hold your head up, we worked hard for our RN license.

RS0302 · Jun 23, 2008

Recently on the med/surg floor I work on nights has only had 3 Nurses for 37 patients when they call for 8. Evenings has only had 4 nurses for 37 patients on more than one occasion recently. Usually it is only 1 RN and the rest LPNs. Crazy!!

aloevera · Jun 23, 2008

No, the LPN's only give meds and take off Dr. orders....they stay very busy as well....if one of them calls out, I have seen one med nurse to 35-40 pts......horrible.......

yes, a lot of us are fed up....if salary was very good, we might could grin and bear it...but unfortunately we are at the bottom of the barrel, I think....we are on the East coast in the beautiful South....we are owned by a Corp. that owns over 90 hospitals....if that tells you anything....profit, profit, profit.....all they care about.....