cmp424

I completely agree with all of the above statements. Our hospital is very "lets do what everyone else is doing". It's nice to see others think this is an awful idea and not everyone is doing it this way. I hate it. Not only do we have normal ICU stuff to do (I.e. Neuro checks Q1H, full assessments Q2H, turning and all that jazz) but as a night shifter we are also responsible for giving everyone baths. I took 3 my three days last week like everyone else and literally was the most exhausted I've been since being a new grad. Hoping it's different this week.

With recent budget cuts we are going to an acuity based staffing matrix. Rather than having the straight 2 patients to 1 nurse ratio we are being asked to take 3-4 ICU patients. I work at a small ICU at a community hospital, and I will admit some of the patients we have are floor patients with overly cautious physicians. How do you all staff the ICU? Common 2:1 ratio? Acuity? For those that do acuity based staffing, how are patients assigned?

Background: I have been a RN for two years. Six months of that was spent in psych (not a huge interest per say, just really needed a nursing job out of school). For the past year and a half I have worked in a 12 bed ICU. I have 2 sons ages 2 and 6 months. Before my first pregnancy I had some issues with my lower back. My two pregnancies have made these issues much worse with me unable to really function after work. There are a couple positions open at a local doctors clinic and a position open in the documentation integrity department. As much as I LOVE critical care, I am thinking about leaving for the following reasons. 1. We have vented patients obviously and I have a lot of trouble lifting them. We have bariatric patients and lots of them up to 400#. There are mornings that I don't think I can make it to my car because I can't walk upright. Asking for a lighter load is not an option as I do not want to be categorized as the weakest link. I am unable to take many prescription drugs because they make me too drowsy. 2. I feel like I am missing my kids childhood. I work nights. When they get home from daycare, I am sleeping. We eat dinner and then I go to work. Yes, I get 4 days off but it seems like at least 2 of those are lost in some kind of sleep deprived fog. 3. We are on call a lot. I know it's feast or famine, but it's been a lot of famine lately. I have had to use 45 hrs if PTO in the past 4 weeks because I have been out on call. 4. I do not foresee me being able to get a day position for at least another year. We go by seniority and although I am only 2nd in line of those wanting to go to day shift, no one on days is leaving. Here are the cons for me leaving. 1. Less money, obviously. We are a 1 income household. 2. One of the positions is PRN with plenty of hours but I carry insurance on the boys and myself. I don't know anything about getting insurance. 3. I will lose my skills! This has me nearly panicked!! If I want to return to hospital nursing in the future, I am concerned I will be an undesirable candidate. No offense to office nurses. If you made it through all that, I applaud you. Any advice is welcome. This decision has made me sleepless for the past few nights so I am hoping for some insight.