What I'm looking for is info re: other tele floor RN's and PCT's work load/description for comparison.
I am a telemetry RN. Our floor is transitioning to tele/med surg floor for past year. Our grid has changed from 4 pts with one admission, 1-2 discharges to now: 5 patients with 2 admissions and up to 3 discharges per shift. We went from being an excellent floor clinically to being average and many times, less than adequate. We are burnt out! We've lost 12 RN's (total from all shifts) in last year and 6 PCTs. Our management says that according to their info, we are comparable to other hospitals, even overstaffed. We are MISERABLE and dropping like flies! We can't ever find coverage, we are always short PCTS and RN's, everybody hates to float to our floor, and agency and contract RNs never return.
Are we crazy? Are we pansies? HELLLLLP!
A typical day for our RN:
5 patients
2 to 3 isolation (MRSA, pneumo, flu, TB);
80% are 75-90+ years old;
3-4 are unable to roll/sit up independently,
1-3 iv abx per patient;
3-4 are incontinent of b/b;
all have approx 10-15 pills at 9am, 5-6 pills before 7pm;
3-5 are ACHS diabetics;
3-5 have dementia;
1+ with open wounds and wound care;
2-4 are 250+ pounds, many 300+ (this requires mult RN's and PCT's bedside for one patients care be it boosting, bathing wound care etc); occasionally (1 pt per week) wrist/posey restraints.
Other common duties:
tube feeds
heparin drip,
cardizem drip,
insulin drip
pre/post cath
pre/post pacemaker,
mult tests which require transfer to cart by 2-3 staff
Rn's have to take patients down in WC at discharge to their rides;
hang blood products and of course
dealing with the abusive, high maintenance families (people seem to get worse all the time.)
We don't have an IV team.
Both managers are mostly at meetings. We really don't see the unit manager at all and the asst manager early in am then she is mostly in her office.
Our charting is Meditech.
Our Charge RN is absolutely unavailable to us, only to quickly answer a question. She doesn't have time to assist physically with pt's do to her schedule (bed meetings, covering tele clerks for breaks 3xday etc). She is actually more stressed than us many times.
PCT's: take temps and pulses. They have 10-12 pts/day. Isolations, obesity, incontinent, baths, and many complete patients keep them so busy that we assist them.
I've been invited by VP of nursing to present my concerns to CEOs/Drs/Heads of hospital. I think it's payback to speaking up at that last staff meeting.
I need numbers/facts so I can make an intelligent argument.
Someone posted a link within the last year or so on a study that related increased patinet deaths to poor staffing. They were able to put a number on death increase R/T increasing the RN assignment- optimum was 1:4 I believe.
Your department sounds too management heavy. Two unit managers and one charge nurse, none of which take patient assignments, is a waste of bodies.
We are a 30 bed tele unit that shares a unit manager with another department plus our charge nurses take a full patient assignment.
I doubt your immediate superiors will appreciate a suggestion to decrease number of management and increase pt-care staff but it definetly sounds like your facility could use some restructuring.
canoehead, BSN, RN
6,909 Posts
Someone posted a link within the last year or so on a study that related increased patinet deaths to poor staffing. They were able to put a number on death increase R/T increasing the RN assignment- optimum was 1:4 I believe.