USAVARN

I am a new manager less than 6 months of a medical/telemetry floor. Even though it is a telemetry floor, we do not handle any type of cardiac drip, insulin drip and it is against hospital protocol for a nurse on my floor to push lopressor....so we are a step, step down medical/telemetry floor. The maximum number of patients on my unit is 23. I am just getting an understanding of the NHPPD rules! I admit my nurses are busy but I also see alot of mis-classified patients because the nurse doing classifications for that shift play with the numbers. I am trying to change that mentality and further educate about a balanced assignment. I am from a very busy level 2 trauma center where I was an ER nurse, then an ICU nurse so I have to admit that alot of the nurses who are complaining to me about not having enough help have time management issues. I admit too that many of our patients are not full care, alot are behavioral issues and a few are 2 person assist and a majority of the patients become placement issues so they hang with us for awhile while our social workers find them a nursing home, etc. Only license (RN/LPN) and assistants are used for my NHPPD. I recently had our unit cap lowered to 18 due to staff vacancies. Despite this I am still getting complaints from nursing that their loads are too high. Tonight when I left we had a census of 12 of which 3 license staff and one nursing assistant were on. I have even calculated the NHPPD according to each shift. I do agree with acuity that looking at staffing is more than looking at numbers. I get so frustrated. I hear complaints from my nurses but I get complaints from my bosses about why my nurses report they can't handle a 1:5 or 1:6 assignment. In some regards reading all these posts I can report to my nurses that other hospitals are having the same issues. Sorry for rambling, just a bit frustrated.