Orientee's now being counted as staff!!

[GiGiRNICU]

Two weeks ago one of the local hospital's has decided now that all orientee's will be counted in the staff numbers including CNA and HUCS. This is all over the hospital including ICU where there is CRRT and Fresh hearts which now are no longer one on ones by the way. If you have 8 patients the matrix would call for a Charge nurse and 4 nurses and a HUC and the other day they had a huc training and shorted them a nurse because they had too much staff. So the staff had to take 3 patients a piece. I walked into work last night to get report on a CABG that had come to ICU at 14:30 still on drips and vent, issues with blood loss got 2 U of PC and issues with HTN, this nurse who was giving me report who has not even been out of school a year had that patient plus two more. Very unsafe. The policies have not been changed but we were all notified by email of the new changes. It is all about budget cuts. We were told the hearts and CRRT's, Balloon pumps are no longer going to be one on one. Resignations are starting to come in this week. Very unsafe and putting our nursing license on the line. We have been told if you feel it is unsafe not to accept report but now that is no longer the phrase...you have to accept or it is pt abandoment. If you can't take care of the patient load what are we suppose to do. Are any of you all have this happening at your hospital.

[lindarn]

Excellent responses, all of them.

I would like to add, that in a court of law, (unfortunately) if something happens to that patient under your care, an incident report is not going to prevent your license from having action taken against it.

One must always do what a prudent nurse would do, and a prudent nurse would not accept an unsafe assignment.

It seems rather harsh, especially since the nurse is only trying to do the best that can be done under the circumstances.

The incident report does not a license save.

I would also like to add, that make sure that you keep any and all any paper communications from management/administration that discusses the staffing changes being made. These will carry alot of weight in court, as the hospital is admitting that they are deliberately changing the previous staffing patters, and deliberately understaffing.

It might also be a good idea to contact an Employment Attorney, discuss with him/her what is going on, and get some professional advice to protect your license. Also, do you have malpractice insurance? This would be a good time to get it, if you don't already have it, before the you know what hits the fan with the hospital and you get fired. Or before some sentinal event occurs that you are involved in and makes you a high risk client for malpractice insurance.

This will also give you access to your own defense attorney in case there is litigation involving a patient event. If you have to rely on the hospital's insurance to represent you, and you have made waves about the unsafe staffing, they will throw you under the bus to save themselves and blame you for bad outcomes. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington