outpatient surgery staffing??(long)

[outptsurgeryrn]

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!!!