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  1. lag413

    Is this fair to ask of a new RN?

    I work on a similar floor - and you're lucky they're only giving you four. On our floor, once nurses are off orientation, they are treated the same as everyone else and can have 6 or 7 patients their first shifts alone. Many nurses have tried to request longer orientations but unfortunately it hasn't worked. What I have told our new nurses/orientees is a) try to remember the basics about prioritizing. This is a 24 hour job, so maybe you won't get to do all your dressing changes, and it sucks to pass something on but the next nurse will have to do it. b) you're not expected to know what to do in every situation; what you are expected to know is what is normal and what is not. You can always talk to your co-workers and bounce things off of them before paging the MD. It took almost a year for me to start to feel comfortable in the hospital. There are a lot of things you don't get to see on orientation unfortunately, so there will be times when you have to rely on your coworkers/educators to help you through. Best of luck. Stick it out -- it's worth it :)
  2. lag413

    Question about staff ratios?

    Wow thanks for all the replies. I have worked here for a little over a year and was shocked to see that our ratios are the same as when I was on med-surg, and our patients SO much more acute. But as I said, our manager and nursing supervisors blow off our concerns. It's also infinitely more frustrating that for some reason, we only hire new nurses (probably so they can be molded as our management would like and no one knows any better) so on top of having such bad staffing, there's very little support from experienced nurses. I have been growing more and more concerned for my license and the safety of our patients which is making me consider leaving--and when these concerns get voiced, we are labeled as having "bad attitudes". I just am also concerned how it will look on my resume that I worked my first job for only 1 year and had to relocate here, and now I've been here 14 months and am considering leaving. I don't want to seem flaky or unreliable but I had to move for family reasons before and here am looking to go elsewhere for the reasons I've already explained!
  3. lag413

    Question about staff ratios?

    I work on a telemetry unit primarily dedicated to post-op cardiothoracic surgery patients (hearts can come out to the floor as soon as POD #1, and lungs get recovered and then come to the floor a few hours after OR). If we have beds available, we can get surgical tele or regular tele admits. Most of our patients have chest tubes and pacing wires, and frequently have JP drains,epidurals and foleys. We are often giving blood, and can have cardizem gtts and renal dose dopa. We also have the highest rate of falls in the hospital and the highest acuity of all tele units. The generally accepted ratio has been 1:7 max on days and 1:8 max on nights. Even with ratios as they are, we are stretched to the bone, dealing with all the complications and trying to get our general nursing obligations completed. Lately staffing has been worse (many days we have 2-3 nurses scheduled for our 26 bed unit). We were told today by our manager "You don't know what short-staffing is until you've had 14 patients". I realize my generation can be a tad entitled at times. Having only been a nurse 2 years, I don't know if this is the standard elsewhere or if this is unacceptable. To me it seems highly unsafe, considering the acuity of our patients. But I am wondering if my manager is right and we are just spoiled, or if the higher acuity of many patients, combined with the added liability nurses have now as opposed to 20 years ago makes our frustration justified. Any advice please?? Thanks!