New California Nurse to Patient Ratio

[painmeds]

Thanks in advance for reading. I am told the new normal for California nurses will be as follows:

1:3 ICU

1:5 emergency room

1:5 telemetry

1:6 or 7 medical/surgical

Due to staffing shortages for COVID?  What's it like in your California hospital? 

[klone, MSN, RN]

I'm in a FB group for healthcare professionals to discuss Covid, and those are the ratios that CA nurses are saying they're working under, so that sounds about accurate.

[Sour Lemon]

7 hours ago, painmeds said:

thanks in advance for reading.

so, I am told the new normal for california nurses will be as follows:

1:3 ICU

1:5 emergency room

1:5 telemetry

1:6 or 7 medical/surgical

due to staffing shortages for covid?  what's it like in your california hospital? 

I've been working in the "clean" med surg hall alone. No other nurse, no CNA, no clerk, etc. So far, I've had five total cares max ...the sickest of the sick, and the most helpless, because no other people are coming in at the moment. I also run supplies and medication to the parallel covid unit since they're not supposed to come out.

ER did ask me to take an extra patient or two, and I agreed as they are more overwhelmed, but the admissions fell through for some reason.

Lots of corners are being cut. The phones ring constantly because families cannot come visit. Unfortunately, I'm not able to answer a LOT of the time.

[ruby_jane, BSN, RN]

@Sour Lemon thanks for sharing your experience. You're a great nurse - you took pts because the ER was more overwhelmed than you.  Hugs.

[Nurse Beth, MSN]

I asked our admin to hire CNAs- as many as possible- to help nurses (and they are!). RNs could do so much more if they weren't spending so much time doing non-RN duties

[Sour Lemon]

1 hour ago, ruby_jane said:

@Sour Lemon thanks for sharing your experience. You're a great nurse - you took pts because the ER was more overwhelmed than you.  Hugs.

The patients didn't actually come that time, but I'm sure it will happen eventually. I thank you for the compliment, anyway. ?

[Sour Lemon]

1 hour ago, Nurse Beth said:

I asked our admin to hire CNAs- as many as possible- to help nurses (and they are!). RNs could do so much more if they weren't spending so much time doing non-RN duties

My hospital has been hiring a lot of CNAs, too. It's not enough to keep up with the demand, though. Some of them quit in a hurry once they realize what they've gotten themselves into.

[ruby_jane, BSN, RN]

27 minutes ago, Sour Lemon said:

The patients didn't actually come that time, but I'm sure it will happen eventually. I thank you for the compliment, anyway. ?

Doesn't matter. You had a choice and you chose service over convenience! 

[JBMmom, MSN, NP]

I'm not in CA and I've heard it's much worse there, but those ratios are where we are headed at this point, too. We're trying to keep our ICU to 1:2, especially when we have no techs, or only 1. (we're a 12 bed unit) When we've got so many patients vented and proned, people end up in one COVID room for a while and there's a chance for the old KVO of death in their other room when the pressor runs out. 

Management is stuck because for a while we were mandating nurses to keep ratios down and nurses screamed it was unsafe. Now they're not mandating nurses and those left on the short unit are screaming it's unsafe. Even management can't conjure up nurses to fill staffing holes, so we're just at the mercy of whatever the day brings. It's been rough, but my thoughts are with all those that have it MUCH worse than me.

Sour Lemon, thanks for sharing your experience, hoping you stay well and thanks for your hard work!

[JKL33]

1 hour ago, JBMmom said:

Management is stuck because for a while we were mandating nurses to keep ratios down and nurses screamed it was unsafe. Now they're not mandating nurses and those left on the short unit are screaming it's unsafe.

Well...in my heart I'm trying to use proper netiquette (other thread ?) but in my very humble and polite opinion we should make sure to not imply that the nurses were wrong and are just screaming no matter what admin does.

Both the situations ARE unsafe. It sounds like these admins first tried to work their very stressed workers even more, and when that was not well-received they then tried to be vindictive by not mandating and simultaneously not trying any other solution either so that those "complainers" would have to eat their words.

Nurses can't be conjured up, true. They have to be hired, paid appropriately and treated appropriately. Until all those things are happening then no one can really shrug and claim that there are none to be had.

Management is "stuck" because if they can't shovel downhill, they're not interested.

[TwoLayi, ADN, BSN, RN]

In the long-term acute care hospital I work at in CA all the nurses have been at 1:6 for tele and 1:7 med/surg every day, every shift for the last two weeks, with CNAs at 1:20. Alot of nurses think our facility is taking advantage of the situation because we don't have an ER, so technically we don't have to keep admitting patients without enough staff. Plus word on the street is that general acute care hospitals in our area are not or are rarely increasing the ratios. Plus most of the time, the charge nurse/relief nurse has patients so we don't get a break either. 

[Sour Lemon]

2 hours ago, JKL33 said:

Well...in my heart I'm trying to use proper netiquette (other thread ?) but in my very humble and polite opinion we should make sure to not imply that the nurses were wrong and are just screaming no matter what admin does.

Both the situations ARE unsafe. It sounds like these admins first tried to work their very stressed workers even more, and when that was not well-received they then tried to be vindictive by not mandating and simultaneously not trying any other solution either so that those "complainers" would have to eat their words.

Nurses can't be conjured up, true. They have to be hired, paid appropriately and treated appropriately. Until all those things are happening then no one can really shrug and claim that there are none to be had.

Management is "stuck" because if they can't shovel downhill, they're not interested.

I feel like our managers do actually try. That makes all the difference. We used to have good staffing, so I'm looking for a light at the end of the tunnel.