I got fed up!

Nurses General Nursing

Published

Hello there fellow RNs, LPNs, etc:

tonight I showed up for work as schedule. When I got there I looked at assigment board and realized I had 9 patient's to take care off, no Charge Nurse, and a floor secretary that makes huge mistakes constantly. Before I clocked in and took any report and turned in my badge and left since I believe 9 patients is an unsafe patient load. My question is: Can they call me up for abandoment even though I didn't clock in or didn't take report in any patient.

Thanks a lot for your answers....

Specializes in Hospice.

6-8 pts on a night shift, 3-4 on a day shift , 4-6 on a pm shift

Is there some kind of regulation/law that states what the ratio should be? Is 9 excessive?

@Slightly-wow 18??

Is there some kind of regulation/law that states what the ratio should be? Is 9 excessive?

@Slightly-wow 18??

I live in Fl. There isn't a regulation here as far as I know. Now, think about the true nursing care you offer when you have 9 patients. In reality you could take as many as you want, but as the number goes up the patient care quality goes down. Corporations do this to safey money and put more money on their pockets....BUT, my license and my patients are more important to me.

Specializes in chemical dependency detox/psych.
Is there some kind of regulation/law that states what the ratio should be? Is 9 excessive?

@Slightly-wow 18??

I wish that there were regulations on ratios in my state. Detox is different, though, from med/surg: Patients get a head to toe assessment at start of shift, and then you round q1-4 hours based on withdrawal scales, dispensing PRN meds for withdrawal s/s as you go. Vitals done with every rounding. It's mostly PO meds, with some IM injections thrown in there for fun. Occasional wound care d/t those lovely bar brawls and falling down while high. I usually have 1 IV q 1-2 weeks. Lots of therapeutic communication/dealing w/ psych issues, and trying to weed out the manipulative pts who just use you as as their personal Pyxis. Still need to chart on all assessments and meds given. It's never dull, even on "slow" days.

Specializes in Rehab, Med Surg, Home Care.

Better to cut loose from a truly horrendous, no-win situation than to lose your license forever. Although I think I would have immediately checked in with my malpractice ins co. to see if there was anything that needed to be done at that time to be pro-active.

Specializes in ER, Trauma.

You just have to wonder, though, when you're standing on a ship and all the other crew are jumping overboard, do you wait to find out what the problem is, or follow the other staff? I think you did the right thing. Don't let it bother you when they threaten to huff, and puff, and blow your house down. You've got the brick house. They're just learning a management lesson the hard way. Good luck in the future.

Specializes in LTC Rehab Med/Surg.

Vicarious satisfaction. Thank you.

Specializes in LTC Rehab Med/Surg.
I was wondering how many patients do you feel safe taking care of? What is the most any of you have been responsible for and what is the average number of patients in a shift?

10/1 15/1 on night shift. What I was responsible for. That hasn't happened for awhile.

7/1 max, what I feel safe with. The thing is, I could take more if they were all 30 something, ambulatory, O x 3, with cellulitis. But you don't know anything like that until after report, when it's too late to say "Are you crazy?"

With the aging of America the average age of my pts is usually 75. Older pts have multiple problems, that take huge amts of time.

10/1 15/1 on night shift. What I was responsible for. That hasn't happened for awhile.

7/1 max, what I feel safe with. The thing is, I could take more if they were all 30 something, ambulatory, O x 3, with cellulitis. But you don't know anything like that until after report, when it's too late to say "Are you crazy?"

With the aging of America the average age of my pts is usually 75. Older pts have multiple problems, that take huge amts of time.

Exactly...we used to have a charge nurse who assigned by room number...didn't even think about acuity. We could end up with eight patients who were total care or eight patients who were almost self-suficient.

I really don't blame you for walking out, but I have to wonder what it did to the staff that remained. I wish there was an easy answer, but SOMEONE has to take care of the patients...why does management not understand that sometimes we simply need more staffing? I know a lot look at agency staff as a bad thing, but that doesn't make sense to me. To me, hiring agency nurses shows that you care about your patients and your staff...and my mother (who is a retired accountant) says that in the end, agnecy staff isn't much more expensive than regualr staff. After you consider paying regular staff's taxes, benefits, vacation, etc. it all balances out.

Exactly...we used to have a charge nurse who assigned by room number...didn't even think about acuity. We could end up with eight patients who were total care or eight patients who were almost self-suficient.

I really don't blame you for walking out, but I have to wonder what it did to the staff that remained. I wish there was an easy answer, but SOMEONE has to take care of the patients...why does management not understand that sometimes we simply need more staffing? I know a lot look at agency staff as a bad thing, but that doesn't make sense to me. To me, hiring agency nurses shows that you care about your patients and your staff...and my mother (who is a retired accountant) says that in the end, agnecy staff isn't much more expensive than regualr staff. After you consider paying regular staff's taxes, benefits, vacation, etc. it all balances out.

The staff there is beat up all times and yet they believe it's OK. I heard they "made" one of the dayshift nurse stays; however, I believe that and good leader would have stayed and take all those patients. I didn't clock in nor did I take any report whatsoever. Someone has to let them know that's not OK overwork nurses, that's not quality patient care, that's unsafe, that's irresponsible. I think. Cheers.

Specializes in Pediatric/Adolescent, Med-Surg.
I'm an ICU nurse, well there I take 2. While doing Medsurg as Part-Time, I believe 6-7 is acceptable, anything over is unsafe for patient and RN, that's my humble opinion...

As a med-surg and peds nurse, I think 7 is alot. At my med-surg facility we have staffing guidelines, where we have a max of 6 pts on nights, less if you are working a step-down or telemetry unit. Most times I work nights I have 4-5 pts, so I think they try to avoid even going up to 6.

Run. Away. Quickly.

People forget that it is your life that is the most important and that no one, no matter how much they need it has a right to it but you. Nursing is a great proffesion but unless you are a saint do not treat it as a calling. Saints are dead. As long as we nurses tolerate these kinds of conditions then they will continue to create them. Why should they value your life any more than you do?

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