oldcurlyrn49

We are currently at odds with management as to how best"staff" our 14 bed pediatric unit.Our patient's ages range anywhere from neonate to 18yrs.Our acuity varies from day to day. On any given day we may be caring for a sickle cell pt. with an "acute chest" who needs a blood transfusion, a severe asthmatic on cont. nebs, surgicals,and a DKA on an insulin drip.Our policy in the past has been to staff with a minimum of 2 RNs at all times.We should also mention we do not have a PCA that regularly works on our unit. That means the 2 RN's are responsible for baths, linen changes, answering all the call lights,passing meds, etc.We also transport our pts to the door at discharge. Some days we are also entering our own orders on the computer, answering the phone, and letting in visitors, because we do not have a secretary all the time.We rarely get breaks, or a lunch,our manager has told us the hospital does not "have " to provide us with these luxuries!(?) Most days it is do-able, however there have been times both RNs have been busy in the treatment room starting an IV, call lights are going off with no one to answer them immediately. We have been fortunate so far that nothing terrible has happened.Management has recently been trying to staff with 1 RN and a PCA, while the other RN stays at home "on call". Not only has staff been losing hours,morale is at an all time low, with many of us looking for other jobs.There are many days one RN has to leave after 8hrs.(we work 12's) on call, replaced by a PCA who may or may not be familiar with our unit, with the expectation we could be "called back" at any time before the shift ends. Some of us are crossed trained to the NICU(our sister unit) but their staff have been losing hours also. All of us work peds because we love it! However we also have car pymts., mortages to pay. The ironey is our unit is part of a brand new beautiful buliding that adjoins the main hospital, it was built specfically for Women& Children", in the community. We continually meet with management to discuss our different views on staffing. It would be interesting to know if other small pediatric units experience some of the same problems.