I work in a peds acute inpatient unit (ages 5-17). Management decided to up our nurse to patient ratio to 1:18. We do all our own discharges and admissions (Admissions take 2 1/2 hours per pt. Usually 1-2 admits a day shift and 3-5 a night shift).
The kids are usually pretty acute: lots of active little fellers running around bugging the teens; sad future borderlines trying to cut themselves or bang their heads; psychotic teens having their first break, kids who come to us in shackles from juvie lockup and have to be watched so they don't jump another pt. Typical inpatient psych.
Boys and girls and littles are supposed to be separate, but I usually have just 2-3 techs, so it is just plain hard to keep everyone separate and keep eyes on constant observation pts. Conflicts arise among the pts because of this.
The unit is sooooo busy-with treatment teams, constant phone calls, helping calm pts through a crisis to avoid holds and seclusions, passing meds, calming somatic tummies, confirming orders, just listening to a kid vent, doing medical nursing tasks etc,. I usually have to stay late--sometimes very, very late-- to chart and finish an admission.
I have 1 1/2 years experience. I wanted to stay inpatient, but I am wearing out. I love working with kids and try so hard to make a difference in these kid's lives. Sometimes there is even a breakthrough-insight gained, behavior modified, a depressed teen sees they have a reason to live--but I still usually leave every 12+ hour shift feeling rushed, inadequate, and defeated.
Every nurse and tech has complained about the load. The whole hospital is short staffed every shift. We all feel it isn't safe. We all work well together, but there are not enough nurses or techs. Critical thinking is a luxury--I feel like I am putting out fires while running on a treadmill. Management listens sympathetically, but the end message is always, "Deal with it. It's going to get worse before it gets better. This is what healthcare is like."
So...is 18 patients the new normal? Is this what I have to look forward to for the rest of my career-14 hour days and never feeling like I've done enough? Any comments are welcome. Thanks for listening.
