styx876

Per SEIU, California Mandated Ratio for Telemetry Unit is 1:4. Our unit is considered Med-Surg Unit with 1:5 ratio but they mix telemetry patients in our assignment. They're saying that our Stepdown Unit is the true telemetry unit. But how come we are getting patients with irregular heart problems (e.g. a-fib, heart block, with pvc's, bradycardic patients, etc). On top of this, we are always short of CNA's forcing the nurses to be interrupted to help patients going to the bathroom, feeding, ADL's, etc. I'm very grateful to have this job. Many of my co nurses think that there's something wrong with this picture but no one wants to speak up. I really appreciate all your comments!

[ATTACH=CONFIG]27181[/ATTACH] Per SEIU, California Mandated Ratio for Telemetry Unit is 1:4. Our unit is considered Med-Surg Unit with 1:5 ratio but they mix telemetry patients in our assignment. They're saying that our Stepdown Unit is the true telemetry unit. But how come we are getting patients with irregular heart problems (e.g. a-fib, heart block, with pvc's, bradycardic patients, etc). On top of this, we are always short of CNA's forcing the nurses to be interrupted to help patients going to the bathroom, feeding, ADL's, etc. I'm very grateful to have this job. Many of my co nurses think that there's something wrong with this picture but no one wants to speak up. I really appreciate all your comments!

Hi Nurse Beth, I came here to get some enlightenment. I'm currently working at a Med surg unit here in Cali. Our nurse-patient ratio is 5:1. We have patients with combination of stroke patients, cardiac monitoring, ETOH withdrawal, dialysis patients, post-op patients, complicated wounds with wound vac maintenance, and other high acuity comorbidities. On my previous job, the hospital was very strict with the ratio of 4:1 if you are assigned even with 1 patient on telemetry monitoring. Is there a law that describes telemetry nurse-patient ratio in California? On my current job, we can get assigned up to 3 telemetry patients out of 5 patients. The rationale that I hear from the higher ups is that the telemetry patients are not real telemetry patients and that we are not pushing meds that control blood pressure or heart rate. Thus, when a telemetry patient assigned to us gets a heart rate of over 130, we have to transfer them to Stepdown ICU for cardiac management. I would really appreciate your inputs on this topic. I am very concerned about this type of workplace environment. Thank you!

Hello dgrando, I have some questions about NRSE 4600. Would you mind sending me an email [email protected]? I will be taking the class in 2 weeks. I already have an approved topic but wanted to ask you some questions about the clinical portion of it. Thank you!

Hello dgrando, I have some questions about NRSE 4600. Would you mind sending me an email at [email protected]? I will be taking the class in 2 weeks. I already have an approved topic but wanted to ask you some questions about the clinical portion of it. Thank you!

The Commuter, thanks for your feedback. WOW! I would take 12 patients any day! Since you have background in SNF/ Rehab setting, you must know how all of us feels about this situation. I also read threads about this topic way back almost more than 8yrs ago. So it's been going on. Honestly, I'm currently looking for another job. I wanted to learn more about SNF but the working condition is getting ridiculous. It's only a matter of time before the mgt will try to talk to me abt the recurring OT. Some other nurses there don't want to say anything for fear of losing their jobs. So they just continue being exploited. This is my first job as a new grad and I'm pretty much stuck at this job because hospital jobs require to have at least 6mos acute experience.

In our rehab facility we have abt 24-26 Nurse-Patient ratio. During the day there is a treatment nurse but not on PM shift. The Pt load is so high that all nurses stay at least 2hrs up to 4hrs just to finish up carrying out orders and charting. Almost every nurse there clocks out for their 30min break then just go back to work. That means we are not only getting paid OT for 30mins, we are working for free for 30mins. We are always taught, Safety first. But what can be done so nurses are not abused like this?

I'm a new grad RN and started working in a SNF. I have witnessed nurses not taking their 30min breaks. They just clock out for lunch, then go back to what they were doing (medpass, charting, checking the MAR, etc) then checks in after half hour. When I was orienting, I asked the nurses, what time do you take your lunch. I was told, most of the nurses just take like 5mins to eat their food then go back to work. On day 1 of me being on the floor on my own, I didn't get to sit down for 8hrs. I did medpass all through out, I punched out, then worked, then punched back in after half hour. This is the norm, they said. If you don't do this, you will be staying for hours. Nurses are always behind with their medpass because of the very high nurse-patient ratio, which is very unsafe, and gets interrupted with family members and patients asking for assistance, etc. There's no way the work being imposed to the nurses in my facility can finish the work on a reasonable time. Mostly finish at least 2hrs past their time. How can we make a change? I hate to see that loving and care nurses are being exploited just like this. I care for the patients and the nurses. Any solid suggestions that we may take in order to turn things around?

This is 2 yrs old. I was wondering what happened. Did you end up working while the state was there? I have interviewed with a DON one time and I asked her what she thinks about assigning a newly hired nurse on shift during a state visit. She said, "No, I wouldn't do that. It's not fair for the new nurse." The DON knows how nurses can be rattled. Even the ones who have worked there a long time are apprehensive with the state visit. Also she said that it will be bad for the company if the new nurse makes an error. I agree with her. Not having enough training and familiarity with company policy is very risky esp with the state is observing. Risky for the pt safety and for our license.

This is 2 yrs old. I was wondering what happened. Did you end up working while the state was there? I have interviewed with a DON one time and I asked her what she thinks about assigning a newly hired nurse on shift during a state visit. She said, "No, I wouldn't do that. It's not fair for the new nurse." The DON knows how nurses can be rattled. Even the ones who have worked there a long time are apprehensive with the state visit. Also she said that it will be bad for the company if the new nurse makes an error. I agree with her. Not having enough training and familiarity with company policy is very risky esp with the state is observing. Risky for the pt safety and for our license.

The last posted topic that I could find about CA state regulations regarding Nurse-patient ratio in SNF/Rehab/Sub-Acute was about 6yrs old. Anyone has any updates about what's being done by our policymakers to improve a safer nurse-patient ratio in SNF/Rehab/Sub Acute facilities? I'm a new grad RN and have been sending out job applications for the past few months. I have been interviewed probably 4x for SNF/Rehab/ Sub Acute positions in the SF Bay Area. The average nurse-patient ratio range from 1:17 to 1:30. Orientation time range from 7days to 1month. But I've talked to nurses that this does not happen because of short staffing. One DON who interviewed me was very proud that their patients have the same acuity as the hospitals nearby. Although this may sound very enticing (because I would learn a lot from different disease process), I don't think handling 20 + patients with high acuity is safe at all. I have worked in a different career for over 10yrs and I don't normally complain about work. But now that I'm a nurse, and we're talking about risking my license and the health of the patients, I couldn't help but speak up. Isn't it ironic? They give you overwhelmingly number of patients to pass meds, do treatment, and carry out orders in a short period of 8 hours. But, you can get written up if you do Over Time for finishing your work. What happens is you end up staying, UNPAID for up to 1-2hrs. Isn't it ironic? You try your best to finish all your work (medpass, treatment, etc) as much as you can, as safely as you can in a period of 8 hours. But when the State Surveyors come to inspect, they want you to slow down… I'm pretty sure they know that this is not what's happening daily. What do they really expect from the nurses? Provide safe and compassionate care only when the State Surveyors are present? Isn't it ironic? Some nurses out there will probably just say, Just suck it up.”, It will get easier.”, You're lucky to have this job in this economy.”, There's nothing you can do.” But there's something we can do. There's gotta be something. I know this topic has been discussed over and over. But something needs to be done. I don't know what or how. If anything, I would like to be a part of this change. Not only for the hardworking nurses that are constantly being exploited, but also the patients who deserve the best quality care. I would really appreciate all of you sharing your thoughts about this. Thank you

Thanks for your insights johsonmichelle!

I know this is off the topic. But I was wondering what would be the best ways to get an RN hospital position. Should I get my experience in sub-acute/SNF then eventually apply to hospitals. Or should I apply for internships. But some of the hospitals in the SF Bay Area require BSN before you can apply. Thanks!

Hi, there's a SNF in the East Bay where my friend works at and have new grad RN start pay of $35/hr. To think that East Bay's cost of living is relatively lower than SF/Peninsula. But I agree, gaining experience right now is also important. I will only be working part time because I'm applying to pursue my BSN. I hope I can survive with this salary. Thanks!

Hello everyone: I'm a new grad and successfully passed my RN-NCLEX. After months of job hunting, I was offered a Staff RN position at a Skilled Nursing Facility where they provide nursing and rehab services. I was offered $30/hr, flat. My question: Is this a fair/starting salary for a staff RN position in a skilled nursing and rehab facility in the SF/ Peninsula area? Please leave your comments below. I would greatly appreciate all your inputs. Thanks! Styx876