Only one nurse on a psych unit

Specialties Psychiatric

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My hospital ( in a large city in Alabama) sometimes staffs their smaller psych units with only an RN and two techs. I feel this is extremely dangerous and should be illegal. I was just curious if other psych facilities staff like this.

How many beds do the "smaller" psych units have? I've worked for years in settings in which I was the only nurse on a psych unit with techs. Although it could be awkward to arrange coverage for my breaks, I didn't feel it was "dangerous."

14 to 16 patients, intermediate care patients, are on these units with only one nurse. I feel it's dangerous for the patients and puts my RN license in danger.

Specializes in Outpatient Psychiatry.

Must be a UHS organization!

Specializes in Oncology/StemCell Transplant; Psychiatry.
Must be a UHS organization!

I currently work per diem for a UHS facility, and I can tell you that's how our working conditions are, except we usually have closer to 20-25 patients.

Specializes in Forensic Psychiatry.

Yup, this is very common. I work in a state forensic psych facility in maximum security admissions. We are sometimes staffed one nurse and four to five techs per 20 patients depending on the day. It can get crazy but I've never felt, "unsafe." It just tends to get very busy when you have two admissions, a couple of seclusion going on, meds to give, doctors calling and orders coming at you left and right, along with all the charting that goes with that.

Specializes in Psych (25 years), Medical (15 years).

On MNs, it's not uncommon for there to be one RN per unit.

Saving graces are excellent coworkers, security, code greens, rapid responses, and the house supervisor.

14 to 16 patients, intermediate care patients, are on these units with only one nurse. I feel it's dangerous for the patients and puts my RN license in danger.

Are you a relatively new, inexperienced RN? In that case, I can understand your feeling that it's "dangerous," and it might be in that situation. I would question the wisdom or values of an employer that would put a newer grad in that position, and the wisdom and judgment of the newer nurse who would take a position like that. But that doesn't mean that the situation is intrinsically unsafe.

I work on an acute unit (our pt's come from ED) and then we "downgrade" them to RTC after awhile. I'm saying this because our staffing is based on how many acute pt's we have (which is ridiculous). Our unit is 18 beds. 5yrs-12yr olds. We always have at least 3 staff...usually 1 RN and 2 techs. I don't feel unsafe because 1st, we have excellent staff which makes the biggest difference. We also can call a Code if needed. Plus we have a seriously awesome Dr, so when I call to tell him exactly what I need I get it. What's hard is when your dealing with a crisis in the unit and have admits coming. Ugh. It's just very busy. I rely on my techs to run the miliue, without good techs then ya, I would be pretty stressed.

As a new RN I would not feel comfortable with this at all. And no new RN should feel comfortable with that. The more experience I have plus great co-workers that I TRUST I feel comfortable. With psych you all have to be on the same page and have excellent teamwork. I've been in psych now for 7 years.

Where is this UHS organization located? What kid of patients do they treat? Has the issue been brought up toa nursing safety committee before? It is kinda unsafe depending on the acuity of the patients.

Specializes in Forensic Psychiatry.
Where is this UHS organization located? What kid of patients do they treat? Has the issue been brought up toa nursing safety committee before? It is kinda unsafe depending on the acuity of the patients.

I think this is pretty standard across the board in psych units, at least in my state and in the state run facilities. This is mostly due to lack of nurses who want to work in these facilities and lack of funding. Is it safe? Well, I think that depends on the acuity of the unit and the amount of unlicensed staff that there are. About a little more than half the time, I work by myself on my unit with anywhere from four to six PCTs. I work in a forensic facility with adult males in max security admissions so we are very busy. I don't think that it is necessarily, "unsafe," although I wish I had time to sit down and take a break sometimes. I will admit, there are days when we do need an extra nurse and there just isn't an extra. I just do what I can, delegate, and make it work...

Specializes in Psychiatry, Forensics, Addictions.

I work forensic psychiatry with anywhere from 14 to 22 patients to a unit. Frequently, only one nurse is assigned to a unit. We often have restraints, admissions, seclusion, & other crises to deal with. My current unit has five continuous observations. I don't feel like my license is in danger or that the unit is inherently unsafe, except for the violent nature of the patients of course!

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