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Discussion

One RN alone on Unit

At the hospital I currently work for, it is common to have one RN alone on a unit when the census is low. This RN would have 6-7 med-surg/tele patients. There is one CNA on the unit with her. Sometimes there is a secretary but not always. The nurse and tech have to call another unit in the hospital to request one of their staff to come cover breaks or to come do narcotic wastes etc. This is a burden on that unit to have one of their nurses be off the unit for 30 minutes to cover a meal break.

I am an experienced nurse and am capable of caring for my patients. However, when I am in a patient's room, there is no one watching the telemetry monitors, I am the only one who can respond to a telemetry alarm. If I am in the middle of a dressing change or doing an IV, or if I am gowned up in a precaution room, I can't get out to check the monitors immediately. If both the tech and I are toileting or bathing a total care patient together, we can't respond immediately to a bed alarm or call bells. I have to rely on the secretary to stop fall risk patients from climbing out of bed. If we even have a secretary.

I feel like this a dangerous situation. However, it has been going on for a long time and no managers seem to think there is anything wrong with it.

Does anyone else have a similar situation where they work? Its this normal?

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    Wow! I'm sorry that I don't have any answers for you but that is really scary for you and the patients. I hope that management realizes that this is unacceptable before something tragic happens. It doesn't matter how much experience or how great a nurse you are, you cannot be in multiple places at once.

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    Supposedly, my unit is required to have two ACLS-certified RNs on the floor at all times - regardless of census. However, I have yet to see the census so low that this would become a question...

    I can't believe anyone would think your situation is remotely safe.

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    I would flip out if I were routinely left on a unit with more than a few patients (of a med-surg/tele acuity) without at least an LPN to back me up. Briefly while someone transports a patient or takes a break? Yeah, OK. For an entire shift? Ah heck no. The odds of something going very awry are just way too high.

    If you're going to keep working in those conditions you better make sure your malpractice coverage is paid up!

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    Okay...what kind of freaking hospital is this!!!! NO TELE TECH?????I would report this annonomously RIGHT AWAY to your ethics hotline ( mandated nationwide...call HR...dial star 67 first so they can't know it's you.....and ASK FOR THE PHONE NuMBER!!!)......report this. I would also annonomously report this to the board of nursing, Jacho, and anyone else who will act. The patient load is ok, the fact that you have to find other RNs on other units to waste is BORDERLiNE.....and the fact that there is no tele tech SOUNDS ILLEGAL TO ME!!!! I would report and start interviewing for new jobs asap as this is going to end up trouble for someone.....usually US. The hospital does not back up RNs when stuff goes south. Yes, get your own insurance. I can tell you are a Hell of a NURSE!!! To work under these conditions. The no-tele-tech thing is freaking me out. How are you supposed to know when someone has had an MI?????Is this hospital in Arkansaws or somwhere I may know how to spell??!!! Because I DO think telemetry needs a monitor legally. I feel for you baby. You must be a Hell of a Nurse.

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    • Expert

    The 2 places I've worked have not had tele techs. Not illegal.OP, this doesn't seem right to me. Our unit requires 3 nurses at all times be present, even if there is only 1 patient. It's just the safe way to do it. I would bring your concerns to upper management. I feel like this is just a sentinel event waiting to happen...it's sad that it sometimes takes one of these events for change to be made.

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    thanks, Sapphire18. Didn't know not illegal...yet...so unethical. I need to research about this now. Coulda, shoulda, been a nursing lawyer for a union. I can't believe anyone could excpect to have safe care without a tele tech. Thanks.

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    We are exeriencing low census now and have similar situation but not tele patients. I still think it is unsafe practice for only one nurse on a unit no matter the census.

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