Lots of changes at new job (vent)

[Little Panda RN, ASN, RN]

As most of you know I started a new job in psych a little over a month ago. Since I started working the DON, ADON resigned and is now gone. Two social workers also left (heard one was terminated) leaving us with one social worker for both communities (AD and Adol). Just heard that the infection control nurses last day is this Wed.

Last week the physician who started this hospital had their license suspended for over sedating patients under the age of 11:eek:. Not the first time something like this has happened, this hospital used to have a geriatic unit and specials unit. These units were shut down by the state for lack of staff. This is what I was told.

Now we have been low census and running :grn:on very short staff. We have 16 inpatients with one RN, one very new LPN (me), one MHT in low stim, one MHT with Alternative Adolescents and two MHT's with the large adolescent group. We had to try and cover lunches and breaks, find someone to supervise visits and phone times. Needless to say it was a challenge.

I was expected to run groups on the adult side, plus pass meds to both communities, run to low stim when pt was escalating, give prn's as needed, leaving the adults alone on their unit. I felt like a chicken with my head cut off!

I feel like they are running us so short that it is not safe for staff or patients. Something is bubbling under the surface at this facility and I wonder what it is. The joke is if you come to work and your badge doesnt work, you know you no longer work there.

Sure hope I didnt make a mistake with this company:banghead:. I really like the job, but I feel very uneasy about staffing and all that is going on.

Thanks for reading:)

[Little Panda RN, ASN, RN]

Just wondering if anyone could tell me, is this normal to have such a high turnover. What would you think if this what happening at your facility?

Any input?

[elkpark]

It's not normal, it's very scary; and, if I found myself in that situation, I would be frantically job-hunting.

[Little Panda RN, ASN, RN]

That is what I was thinking. I have been looking but I need my insurance that will be effective on the 1st. I could get a job in another city, but it is an hour away. That would be okay this time of year but during the winter the drive is hazordous. I live in a small city so the opportunities are few. I will keep looking and hope for the best.

[Mish56, BSN, RN]

ND__mom,

left you a note on your other thread, then saw this! Is this correct? 16 inpatients and 2 nurses, so a 8:1 ratio?? 2 mental health techs? It's hard to tell from here, but is your license equal to health insurance? What good will it do you when your dead from exhaustion? It's hard to tell from the info you give, BUT I worked acute inpatient, 26 patients (adult), 4 RN's, 2 psych techs, 2 patient care associates, a secretary, 1 attending MD and of course the resident on call via pager. This is good staffing for a holiday weekend. Do we run shorter staffed? sure, sometimes, but in a true emergency we have 2 other units in the building, plus security that will respond. You OK??????

[Valerie Salva, BSN, RN]

I think you can read the writing on the wall in this situation.

[Little Panda RN, ASN, RN]

ND__mom,

left you a note on your other thread, then saw this! Is this correct? 16 inpatients and 2 nurses, so a 8:1 ratio?? 2 mental health techs? It's hard to tell from here, but is your license equal to health insurance? What good will it do you when your dead from exhaustion? It's hard to tell from the info you give, BUT I worked acute inpatient, 26 patients (adult), 4 RN's, 2 psych techs, 2 patient care associates, a secretary, 1 attending MD and of course the resident on call via pager. This is good staffing for a holiday weekend. Do we run shorter staffed? sure, sometimes, but in a true emergency we have 2 other units in the building, plus security that will respond. You OK??????

Yes only us 2 nurses. 1 RN, 1 LPN, and 4 MHT's for 16 pts and of course a unit secretary, but they are not trained to deal with the pts. We do have a physician on call that we can get ahold of if need be.

It is scary at times because we know if anything happens there is only 3 of us who could respond to the situation. How do you take a pt down (if needed) with only 3 people?

We have no security on site. We would have to call 911.

[Little Panda RN, ASN, RN]

Yes only us 2 nurses. 1 RN, 1 LPN, and 4 MHT's for 16 pts and of course a unit secretary, but they are not trained to deal with the pts. We do have a physician on call that we can get ahold of if need be.

It is scary at times because we know if anything happens there is only 3 of us who could respond to the situation. How do you take a pt down (if needed) with only 3 people?

We have no security on site. We would have to call 911.

Well after re-reading my post I realized I used the wrong terminology. We do not take a pt down, but how do you get them under control with only 3 of us available for a show of force?

[wonderbee, BSN, RN]

I say the same thing. Some times that's exactly what is needed. The patient needs taking down for his safety and yours. It could be to give an IM. We had two days of safety training where we actually had to take grown men down in various scenarios. Most importantly, we wear personal body alarms that will alert a crew of 10 strong men who will be there in less than a minute. No security on site for you? That's just criminal.

We usually carry a census of 26. On days there are two med nurses and one charge. Our charge nurse does all accuchecks, gives report, admits and discharges and generally trouble shoots. I really think one more med nurse would be helpful. We usually always have someone on close obs so there are no less than 3 MHTs. Evenings staff two RNs. Nights staff only 1. I think we're running one nurse short on all our shifts. I think a lot of problems could be solved by staffing an 11-7:30 nurse to pick up the overflow. We're doing a good deal of hiring right now. If we can just retain, I think we'll be ok.

It doesn't sound good nd_mom. Do you see any light at the end of the tunnel? Are they planning on restaffing?

[Little Panda RN, ASN, RN]

I say the same thing. Some times that's exactly what is needed. The patient needs taking down for his safety and yours. It could be to give an IM. We had two days of safety training where we actually had to take grown men down in various scenarios. Most importantly, we wear personal body alarms that will alert a crew of 10 strong men who will be there in less than a minute. No security on site for you? That's just criminal.

We usually carry a census of 26. On days there are two med nurses and one charge. Our charge nurse does all accuchecks, gives report, admits and discharges and generally trouble shoots. I really think one more med nurse would be helpful. We usually always have someone on close obs so there are no less than 3 MHTs. Evenings staff two RNs. Nights staff only 1. I think we're running one nurse short on all our shifts. I think a lot of problems could be solved by staffing an 11-7:30 nurse to pick up the overflow. We're doing a good deal of hiring right now. If we can just retain, I think we'll be ok.

It doesn't sound good nd_mom. Do you see any light at the end of the tunnel? Are they planning on restaffing?

We actually have enough nurses, but do to low census they have been sending staff home. Hopefully soon we will be back to normal. When I first started there were 35 inpatients. We are a 67 bed hospital. The one thing that really bothers me is we have no security. We had CPI training for one day. I still do not feel prepared enough if something was to actually happen.