B927

ativan and either morphine or dilaudid is our inpt normal seems to work ok. we tinker with the amounts of each based on the pt

each shift has unique challenges to face and anyone who says pts sleep all night has never worked a night shift what we really need is to stop the in-fighting and team up together to fight for what REALLY matters- the safety and well-being of our pts when working always try to be good to all your coworkers, remember you do pick up after them! Be thoughtful and do to them as you would want done to you, even when they do not.

you'd think I would have all that ratios memorized by now! But there is only so much info my poor little brain will absorb our numbers are based nothing on acuity (the charge is suppose to break up the hard pts between the nurses evenly) for a 29 bed unit each day nurse has about 5 pts (charge has 2) and there are 2 techs. At night we have 6 pts (charge has 4) and have 1 pct. Only if we get to about 27-29 pts does days get a 3rd pct and noc get a 2nd pct. Our unit is HUGE. Like walking the lap of it is at least 1/8 a mile. You can not heard a bed alarm on the other side of the unit. Also because of all this junk alot of our own staff has left. This means we are staffed with many floats. Which is ok, but they are not chemo trained and can not take care of anyone 72-hr post chemo either. This means all the staff is running lots of chemo, usually blood too. they treat us like we're gen med..heck several gen med floors have better numbers!

Cancer is rarely the only medical problem in the pts I see. So all that other stuff they throw at you is very useful! Plus chemo can do some very nasty things to a variety of organ systems so knowing the signs of heart failure, DIC, kidney failure, septic shock in immunocomprised pts, etc... are all very important too. Congrats on being a survivor!!! Good luck in your last year

The other nurses are pitching in, but many are rather scared for their jobs. I am too, but I'd rather loose my job fighting for the right thing then keep my job and let my patients suffer. We do have a union and I am getting everything I do pre-approved by them. They are going to be at the meeting. We are being stalled by our temp manager (who is a puppet for the upper management) because she has not put out our next working schedule. We can't exactly pick a meeting date without knowing when we are working! Our 'master pattern' is a joke because we are moved all the time to fill gaps in staffing- which is being worked on (by who- the floor nurses who are sick of never knowing when they will be working). So anyways we're stuck in a stall at the moment and rather annoyed about it all.

Hello I work on an inpt medical oncology floor. We recently moved from a crappy old 44 bed unit (compleate with 4 bed wards and mold in the ceiling) to a spiffy new 29-bed unit that is all private rooms and very much better for our pts! the problem is we were forced to keep our old numbers (and the old floor stayed open and kept the old numbers, even though they are now all medical and not running chemo). The 44 bed unit NEVER went below 30 so we didn't fight for good numbers below that- so now we are in a heap of trouble. Many good nurses and aides have left because of the poor staffing. Many floats request to not come to our floor because they can not handle the patient load on our floor. We will be soon having a meeting with the powers-that-be about all this. I am being the rather vocal advocate for getting our numbers back to a safe level. I do feel like there is a big target on my backside, but how can I not speak up? At this point I have checklists for our nurses and aides to documents what they are doing in a typical 12 hr shift. They are also writing narritive notes of all the delay in treatment troubles (because the bean counting powers that be care more about the bottom line so this might get to them). I also have done a survey of our floor staff and the float nurses about the staffing on our floor. I have printed study after study about how better nurse to pt ratios save money in the long term. I have been trying to think what more can I do to proove that we need the improved ratios. Has anyone else ever fought the man? what did you do? any ideas from anyone on what more I can do to try and proove our case for better staffing? There are a lot of nurses who are going to leave if we can't get the ratios up and I fear more everyday for my pts safety.