I am steamed

[sharann, BSN, RN]

Yesturday we had a very busy day in the PACU due to many scheduled cases in OR and other procedure areas. At one point we were down to 2 RN's and 7 patients. Two Were ICU patients and one of the 7 just arrived from OR and had a longer than usual extubation in OR. We had one nurse going to a class and another transporting. I asked for help just until we had our third nurse back. I was not comfortable with our ratios butr I wasn't even thinking that. I was told that in PACU we take 2 patients. I had 4 and the other RN had 3(and she is not an experienced PACU nurse though she works ICU). So what steams me is not that we didn't get help, we did immedieately, but the nurse who came in said "whats the big deal, I could handle this room NO problem". Well, I was ready to leave and let her but I held my tongue. I felt that if something were to go wrong with one patient, legally I would be in hot water. What is wrong with me, was I just blowing this out of proportion?

[porsch65]

. I was not comfortable with our ratios butr I wasn't even thinking that. I was told that in PACU we take 2 patients. I had 4 and the other RN had 3(and she is not an experienced PACU nurse though she works ICU). So what steams me is not that we didn't get help, we did immedieately, but the nurse who came in said "whats the big deal, I could handle this room NO problem". I felt that if something were to go wrong with one patient, legally I would be in hot water. What is wrong with me, was I just blowing this out of proportion?

Hi sharann,

I think that you every right to be "steamed" about that cavalier attitude. Sorry no room for 'tude like that! I don't work PACU but I do work OR. This is how it goes in our facility. RR nurses definitely have a nurse-pt ratio that is strictly adhered too. ICU pts go to ICU they bypass RR completely. When we are finished our case in the OR we MUST call RR first to let them know we are coming and do they have room for us. If they do not have staff or room for our pt, then the pt remains in the OR with a nurse and the Anaesthetist until such a time as they can accomodate our pt. On rare occassions (this is more likely to happen on weekends and on-call but has happened during the week) when RR is backed up the OR is put on hold and cases do not start until such a time as RR is caught up.

I can guarantee you that if our nurses had to work in that kind of situation they would be filling out an unsafe workload report to CYA. I definitley would also be concerned about the legal liability if a pt ever started to go sour. Only with documentation to support your unsafe workload, do you have anything to cover you. What does your Union or national association say and what are their "workload" guidelines? You can count on that being brought up in a lawsuit and whether you and your employer aspired to meet or exceed those guidelines.

Take care and hope things get better for you P65

[sharann, BSN, RN]

Thanks p65. No union here. But California law does say 1:2 in PACU, even though I was not making that case. I am fine with 3 stable patients, but not with ICU pts and fresh pot ops (as opposed to 30 minute post ops).

This nurse was a cath RN by the way and had a defenite attitude.

[kyti]

Thanks p65. No union here. But California law does say 1:2 in PACU, even though I was not making that case. I am fine with 3 stable patients, but not with ICU pts and fresh pot ops (as opposed to 30 minute post ops).

This nurse was a cath RN by the way and had a defenite attitude.

you were not blowing this out of proportion. The cath nurse is uneducated in our specialty and safe staffing ratios. I would feel the same way. :angryfire