Patient Ratio Concerns

[deie0383]

I am currently working at a very small hospital where they are trying to cut costs by cutting staffing. The 8 bed ICU/CCU/Tele floor I am on rarely gets a true ICU/CCU patient, but in the past month they have come up with this staffing matrix that basically says to make a long story short:

Up to 4 Tele patients = 1 nurse

1 ICU/CCU patient and 1 Tele patient = 1 nurse

2 ICU/CCU patients and no Tele patients = 1 nurse

if there are any more than that then you get 2 nurses, but we aren't staffed with an aid and only from 7am to 11pm is there a secretary to answer the phones. I am a travel nurse, so I have the opportunity so put up more of a fight than the nurses who are employed at the hosptial full time. Does anyone else think this is extremely unsafe and who outside of the hospital should it get reported to?

[deie0383]

Does anyone have any suggestions? Any point of view would be helpful, so far this week there have been 5 nurses to resign making the staffing situation even worse.

[herring_RN, ASN, BSN]

I wouldn't work alone.

There must at minimum be someone who can make a phone call and do CPR in an emergency.

Even with one stable patient.

[deie0383]

I have refused to work alone, but this is a policy that they are implimenting and it is unsafe. The hospital feels that it is just fine, even the unit manager. JACHO is due to be stopping in anyday, but I have a feeling if they due show up then they will make sure there are two nurses on the unit. Do I send a copy of the new staffing guidelines to them so they can review it before they come?

[nightshift82]

Do you work nights and is this your night time ratio? We always have 2 nurses even if there is 1 patient (which never happens). This is mandatory. I work a small community hospital also(300 beds). We have a ten bed unit. We have no secretary at night 11p-7a but recently have an aide position 4-5/7 days. The aide is always up for grabs if the supervisors feel we don't need him. At night the worst would be 4pt/nurse. Usually staffing is 2-3pt/nurse. The only 1:1 pt is if a IABP is in use or an unstable post PCI/MI or really unstable intubated pt. We do have autonomy with our staffing depending on the acuity of the patients. This does go both ways and we cancel staff when they are not needed.

Day staffing:5 nurses, 1 aide and 1 secretary

Eves:4 nurses,1 aide(new position 4-5/7 days) and 1 secretary

The aide and secretary positions can be pulled from us and take to other floor if deemed needed by the supervisior.

I think our staffing is fine of course the management need to listen to the staff and not simply by a paper matrix.

Hope this helps:redbeathe

[Zookeeper3]

you can't lift and turn your average 350 lb vented cardiac patient by yourself. Pneumonia and bedsores are very expensive non reimbursed hospital acquired illnesses.

What about code browns, how are you supposed to do this? Seems as your management has never physically cared for an ICU pt.

[trvlngrn22]

So, you have to call someone to come relieve you if you need to use the restroom or get a drink or eat. and like the others said, patient care goes out the window. When I have 2 ICU patients and am in one room, my other patient frequently needs something..that my coworkers take care of. zookeeper is right, this could lead to very expensive nonreimbursed problems. but that is hospital stuff. it also leads to poor patient care and they are the ones who suffer

[ronsrn]

i think id slip on that banana peal that the non existant cleaning staff could not get to and sue that place silly - they need a wake up-can OSHA do anything for you?

[gilf7243]

I work at an hospital who is cutting costs the same way. The ratio is the same as you have given. In ICU it is 2 patients=1 Nurse, unless they have a doctors order to be 1:1.

On step-down we have 3-4 patients per nurse. Many times without a nurse tech. Our secretary has to cover the whole critical care block so you can't always get his or her help putting in orders. And always, tele patients are 4 patients=1 nurse.

Many nights my back hurts, I am lucky to take my lunch break, and lucky if I can urinate when I need to. It really sucks but such is my chose profession.

No, I don't agree but this is the way it is almost everywhere. Many hospitals are cutting back b/c of not receiving enough medicaid/medicare funding and other economic issues based on the current economy right now.

Plus, all our nurses are taking turns getting called off. Some of our units have closed down for 5 weeks at a time.

Some of our nurses have prn nursing jobs on the side to make up for the lack of hours.

This all after they layed off all our LPN nurses.