Safe staffing levels - page 2

What do you consider to be safe staffing levels for an inpatient psych facility? We have 1 nurse for 16 patients and then two techs (our techs help with meals, smoke breaks and personal care). ... Read More

  1. by   ackiepieRN
    We have a 16 bed unit, and if we are "full" (12-16 patients) we can have the following staff:

    Days: 3 nurses, two techs, 1 secretary, + ancillary staff (case managers, OT, SW)
    Eves: 3 nurses, two techs, 1 secretary
    Nights: 2 nurses, two techs

    That is ideal staffing of course. Due to many, many, many reasons ... we often find ourselves with two nurses and one tech.

    As for admissions, the emergency room is always pushing too (sometimes pushing to go OVER census if we have scheduled discharges the next day). We have a policy that there has to be AT LEAST 45 minutes between admissions. And NO change of shift admissions - since techs and RNs are in report during that time, usually nobody is around to see the patient. Which is not a good thing!
  2. by   sleepdeprived1
    Census on adult/gero unit "full" is 18-22 and if we have 16 or less patients only get 1 tech with myself. Sometimes its a busy week with high acuity patients and census over 18+ and supposed to get 2 techs but it doesn't always happen. Mgmt. doesn't lose any sleep over me running around like chicken little like the sky is falling they don't seem too bothered if there are high acuity patients, falls, agitated patients, 1:1 monitoring orders, gero's confused, fragile, admissions with just me and 1 cna...well maybe they do care but they don't show it or show appreciation to their employees.
  3. by   chelleanne
    I've decided to take another position due to staffing levels. I'm excited and sad all at the same time. Psych nursing is my love...but I can't put safety by the wayside. I've taken a position at a health department, so I'm excited as this is something totally new!
  4. by   macfar28
    Congrats! My advice to you was going to be if it feels unsafe, get out of there! I think it is hard to compare across the board state to state and hospital to hospital however your gut knows when something isn't right and it's your license. Good luck with your new opportunity
  5. by   chelleanne
    Thank you macfar28! I have learned to trust my gut while working in psych. And it was telling me that something bad could very well happen. I hope that nothing happens to the staff or patients, but I feel it's only a matter of time. I just want everyone to be safe and for the patients to feel safe. The patients would make comments all the time about the low staffing.
  6. by   adnrnstudent
    We're 1:8 with RN's & 1:6 with B.H. Specialists.
  7. by   NurseSheGirl
    Working night shift, we are constantly understaffed. 1 unit has up to 20 patients with 1 nurse, 1 med nurse, and 2 techs. The med nurse leaves early though. That leaves me 20 patients to complete paper charting on including detox patients that need Q4 assessments, tons of needy patients that need prns, not to mention having to complete 2 sets of q15 rounds and at least 1 set of environmental rounds. Plus no med nurse for 6am meds so I have to do those and the morning accu-checks. That on top of physician orders, new admits and 24 hour chart audits, not to mention codes called and sending patients out to the er (when necessary)..some nights are better than others! But no...I don't always feel its safe.
  8. by   HeartOfGlass
    Geez. After reading this thread I realize how unsafe my unit is. Ive had up to 38 patients on my child & adol unit.. with me as the only nurse. I am the only nurse at all times. No med nurse to assist. 2 techs only unless we get a 1:1.
  9. by   dopdop
    Can anyone provide any national or regional staffing "benchmarks" for psychiatric units?
  10. by   Abug
    Heart of Glass, get out of there. That is some scary staffing. I work 3rd shift at the state hospital. The staffing level here is better than a lot of the levels mentioned in other posts. Still, we have very acute patients that wouldn't be kept for long in private facilities. We have a very large forensics population as well as civic pts, geriatrics and adolescents. I happen to work in a dual dx unit; substance abuse/MI. We have 20 pts with 1 RN & 1 LPT on at night. We frequently get pulled to other units to cover. Some of the other units are really understaffed in my opinion. You worked hard for that license. Don't lose it to admin's bottom line. If something goes bad on your shift, they won't hesitate to hang you out to dry. Their main goal is to look good and make the big bucks; this is diametrically opposed to what our goal as RNs is. Be careful and be safe.