reporting unsafe patient ratios?

TriciaJ, RN · Sep 25, 2017

14 what vs 4 what? When I worked corrections I was often the only nurse in the building with 550 inmates. In fact, we only had 7 nursing positions to cover the place 24/7 and usually at least 2 were unfilled. Of course, we had no actual infirmary and if anyone needed ATC nursing care, they were sent to hospital.

It's really hard to have an opinion on ratios when you don't provide the actual ratios. Please fill in the missing info.

As a registry employee I don't think there is much you can do. You can agree to accept assignments in this facility as is, or not.

txbornnurse · Sep 26, 2017

Try 1 to 2300 inmates. I don't think I have ever worked any prison or jail where the ratio of nurses to inmates ever exceeded 4 to a 1000. And that 4 to 1000 was only on the days the docs were there to conduct clinics. Otherwise the max per shift regardless of inmate population size was 2. About 75% of my many years in corrections it was me, myself and I.

wtpsych · Sep 29, 2017

14 what vs 4 what? When I worked corrections I was often the only nurse in the building with 550 inmates. In fact, we only had 7 nursing positions to cover the place 24/7 and usually at least 2 were unfilled. Of course, we had no actual infirmary and if anyone needed ATC nursing care, they were sent to hospital.
It's really hard to have an opinion on ratios when you don't provide the actual ratios. Please fill in the missing info.
As a registry employee I don't think there is much you can do. You can agree to accept assignments in this facility as is, or not.

we have about 80 patients and each of them is on q15 minute observation due to some unknown regulation i am unaware of. total staffing includes a mixture of psych personnel, rns, lvns, cnas, etc... don't know if that helps any. it's more of a team nursing environment. there's no REAL ratio split. i guess i could've illustrated this better.

last week myself and another RN was on the floor. we split the inmates 1:40. including triaging, admitting, discharging, daily activities, and q15 minutes suicide precaution, etc... an 1 LVN was the med nurse and 1 psych person doing their "psych" duties.

unfortunately, 1 inmate on my coworkers split decide to commit suicide while she was triaging another inmate. we did not know until 1 hour later. i was not able to cover their observation roundings because i was admitting somebody. they asked us why we didn't ask for help? we've always asked, but nothing was documented. we didn't protest because we both want to work at this facility as state employees not registry employees.

i haven't seen the RN since. i hope she didn't lose her licenses.

TriciaJ, RN · Sep 30, 2017

we have about 80 patients and each of them is on q15 minute observation due to some unknown regulation i am unaware of. total staffing includes a mixture of psych personnel, rns, lvns, cnas, etc... don't know if that helps any. it's more of a team nursing environment. there's no REAL ratio split. i guess i could've illustrated this better.
last week myself and another RN was on the floor. we split the inmates 1:40. including triaging, admitting, discharging, daily activities, and q15 minutes suicide precaution, etc... an 1 LVN was the med nurse and 1 psych person doing their "psych" duties.
unfortunately, 1 inmate on my coworkers split decide to commit suicide while she was triaging another inmate. we did not know until 1 hour later. i was not able to cover their observation roundings because i was admitting somebody. they asked us why we didn't ask for help? we've always asked, but nothing was documented. we didn't protest because we both want to work at this facility as state employees not registry employees.
i haven't seen the RN since. i hope she didn't lose her licenses.

Do the regular nurses at this prison have a union? If so, there should be some sort of form for documenting an unsafe staffing situation and a request for help. If there is no form, you can use a blank sheet of paper and write your own.

If you report for work and the staffing level in your opinion is unsafe, then you ask the powers that be for additional help. Then you document that you did so. You add whether you got the help you needed and what was the outcome for that shift. The original goes to management. One copy goes to the union (if there is one) and another copy you keep for your records.

When you use the form, prepare for your employer to be in an uproar. They hate when you do this. But you've seen what happens when you don't. You're on the hook for a bad outcome and they pretend like they never heard you asking for help. Good luck with this. Being a registry person you may not be assigned to that facility again.