outptsurgeryrn 838 Views
Joined: Jul 7, '11;
Posts: 5 (60% Liked)
; Likes: 3
roser13, how many pts per nurse? this sounds good to me. I would be for it. We were told to "come up with a better solution".....
inshallamiami....there is no hope of union, too small and most have given up and just want out
War is coming and the lines have been drawn. Management says we need to cut payroll. Flex people off. We are being looked at by "Corporate" for low numbers and high payroll. I work in a hospital in a very very depressed area. Most patients are medicare and medicaid if any ins. at all. I work in outpt surgery area and Endoscopy area. 5 yrs ago a nurse had 3 pts to check in for surgery and take back postop. Some went to recovery if general anesthesia used and others returned to out patient surgery if IVM anesthesia. This week they want 5 patients per nurse. Nurses are angry, upset and saying that is not safe and they dont feel safe! Trying to check in two pts due at 615 to get ready for surgery at 715. Taking your postop pts back while trying to check in more preop pts. Its horrible. Supervisor for area ready to quit and so are the others. But it was made VERY clear in the staff meeting (first in months) that $$$ is the deciding factor. Too much payroll for the "numbers". Bottom line, cut payroll.
CAN THE NURSES REFUSE THE ASSIGNMENT? Would they be fired, written up because they dont feel safe, because they are not giving pts (preop and postop) the attention both types of pts need??
Example: be checking in a 10am pt and have a ivm postop pt come back directly to you with nausea, pain of 8 then have a postop pt come within 20 min of last postop doing fine - already have had a postop pt waiting to be discharged--and another preop patient expected to arrive within 45min.
Whispers of a walkout or going around. Whispers of people looking for another job but very few can do that since the next closest hospital is 40 min away and owned by same company. Next closest is 1 hr away in different state or 1 1/2 hr same state.
This post condensed down so not to take up so much of your reading time. Thanks for the forum.
Here is an example of our day:
we have 4 RNs each with a 615 pt for a 715 surgery time. Each nurse has about 3-4 pts at various incoming times. We get them ready (iv, shave, hang abt, teds, etc). OR nurse comes at 0715 to pick up pt. Then pt goes to OR, we get ready next pt for surgery. Then maybe your first pt comes BACK from surgery as you are trying to get 3rd pt ready for surgery. Then you have to stop and take report on that pt and go back to getting ready 3rd pt. Then another pt comes back as you getting 4th ready. Depending on type of anesthesia they may or may not go to PACU, so you could get 2 pts back at same time while admiting a pt!!! Then you hope someone will come help you! The nurses hate it and we want change. But HOW??? OR nurses work only in OR. PACU only in PACU and outpt can crosstrain to PACU if they want to learn it. I would LOVE to get ideas on different setups of outpt dept and hopefull take to administration for change!
We have 3-4 pts each rn. I left a post about outpatient staffing (please read it, you will see my situation). I am like you and not feeling safe. Management thinks we should do more/take more pts. How to juggle getting one ready for surgery, monitoring a postop pt, taking report on new postop pt and then monitoring a sedated pt getting ready to go to surgery?!?!!
Need help from other ambulatory surgery nurses. How are you staffed? how does your unit run? nurse/pt ratio? What type of preop teaching/assessment done (before surgery or day of)?
My ops dept also includes area for endoscopy. Nurses work were needed. In the outpt surgery area we are assigned 3-4 pts each starting at about 0600. Pt's may or may not have come for preop teaching and must be done that morning when they arrive thus taking longer. Everyone gets and IV and some may go to the recovery room where anesthesia does blocks/spinals etc. Majority pts all get po versed prior to going to surgery. Also, you may have a pt returning from surgery at the same time you are getting a pt ready for surgery. We run all day, literally RUN! 2 rn's are assigned to stay late. That means somewhere around 1130 the situation is assessed and people either go to lunch and stay until able to leave late shift with 4-5 postop pts or leave. Staying late means you may leave at 3pm or 10pm at night. We treat peds also. Also, the endoscopy area is also a "treatment" area meaning giving blood (alot of blood pts), IV med pts, injections (rabies, rhogam, etc), and urology pts receiving treatments. If any of this runs over past 2pm...the late shift from surgery covers this also. Needless to say, no one is happy and we have had a major walk out and there are rumblings of another. Did I mention we also do call? Endoscopy call is done and we cover "backup" call for recovery room as a 2nd RN (not the main RN for recovery).
Looking to find out if its like this in all outpt depts.....our manager says thats how it was where she was from. Looking for options on how to change things or present changes to management before everyone quits. Manager thinks we need take MORE patients!!!
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