illegal, unethical or both?

[nurs3ros3]

Dear fellow nurses:

I am looking for some advice on a current situation that seems to be trending in my place of work. I work in a rehab/ltac. Normally if there are more than 8 patients on the floor there must be at least 2 licensed nurses on the floor at all times or at least thats what i was told before. The way our facility works is that there are several small units within the hospital each with 2-3 nurses on each unit. There is one supervisor for the whole building that comes and breaks the nurses on units with two or less people. However tonight my supervisor told us to break ourselves meaning that there would be one nurse responsible for 11 patients some of which are trached and vent dependent for about an hr. She has apparently been doing this a lot lately when things are "quiet". My question is this: is this illegal for the rn supervisor to do this or just not ideal? And where do my responsibilities lie as a floor nurse? If something was to happen would i be in some kind of trouble or just the rn super for making that decision? I refused to do this and the rn super is now angry with me. I dont want to cause problems but i want to stay safe... what can i do? Help!

[NRSKarenRN, BSN, RN]

Having been the only night nurse on a 14 bed Resp/Telemetry unit, I hear your concern load and clear. Drag out the Policy and procedure manual re or lookup if online. A few state Boards of Health have requirement for staffing units with ventilators, only California has mandated ratios. Situation is not ideal. Supervisor would be partially responsible with You held to major liability for accepting more patients that can be safely monitored: at minimum need a CNA who can help answer call lights, pop-in another room with alarming vent while you are in middle suctioning another patient....

Let us know the outcome.

[Esme12, ASN, BSN, RN]

U have nothing else to add other than maybe speak to your manager confidentially as it appears that the supervisor if neglecting her duties. As I have supervised at a LACH in the past the supervisor is responsible for occurrences in the house..it is her responsibility as well as the nurses on the floor. She is ultimately the one responsible.

[xoemmylouox, ASN, RN]

How scary for you. I left a toxic and scary environment similar to yours. I doubt that there is anything "illegal" about this, but sounds dangerous regardless.