1 RN no aid

Specialties Psychiatric

Published

Okay I am a new nurse and I am working in a gero-psych unit in Oklahoma. There is only one RN (me) and an aid (if we have more than one patient). At times we have some pretty crazy patients. So, does anyone know the laws regarding staffing a psych facility? I would think that there would have to be at least an RN and an aid at all times. I know it is a gero unit, but we have had patients as young as 25 and alot of our patients are between 40 and 60 and are schiziphrenic. If I only have one patient the administration tells me that we can't show a need for more than one person(the RN). Also, we do telemedicine and I have to go into the room with the DR before the patient does, this leaves the patient alone in the hall. I refuse to do this. At night there is almost always only the RN and no aid. HELP!!

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It seems unsafe to me, especially if there was an emergency...or if you needed to to CPR or if you got assaulted. What do they expect you to do if you need to use the bathroom? I think the laws vary by state. I work on adult psych and have worked alone without an aid on occasion and maybe had 10 patients...but it was very unsafe and thank god nothing happened! Right now on our unit (I generally work nights) the staffing grid only calls for two nurses if we have 12 patients, but there must be an 2 RNs and a aide. Anything under 12, there is one RN and one aid.

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Specializes in Management, Emergency, Psych, Med Surg.

It is common practice to have at least two staff on during each shift, no matter what type of unit you are in. This is important in case an emergency occurs. What if you have to call a code? What if you are attacked by a patient? Who will have your back? I would not work without having at least one person to back me up. Too dangerous.

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Specializes in psych, addictions, hospice, education.

When I first started working psych I worked on a unit that was for the "more functional" patients, and I was usually the only staff person there. Theoretically I could call for help to the nearby "intensive care psych unit". However, there was a locked door and a long hallway between us, and there were no phones in the patients' rooms. I can tell you from experience that it is definitely not a safe situation. I really didn't realize how at risk the patients and I were, with only me there as staff, but now, I would never ever accept such an assignment. Rather than vent about all the terrible things that happened, I'll restrain myself here, but if you would like details, feel free to send me a private message.

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I think that this is absolutely rediculous. If there is not legislation that restricts this, there should be. I have searched the web but am unable to find anything. If you have any suggestions please let me know. I really feel like both the patients and myself are in danger with this situation. I too have been told that if I need to I can call to the med surge unit of the hospital, but there is a long hall between here and there and there are also NO phones in pt rooms. We had a code one day and thank God there was an aid here or I would've been in a world of trouble.

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Specializes in Med-Surg, Psych.

My suggestion - get a new job. Not only is this situation unsafe, but you are also new at nursing which makes it even more unsafe for all.

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Specializes in mental health; hangover remedies.

Another way around this is breaks - depending on your contracted entitlement.

We don't allow less than 2 RNs because of covering breaks.

Do they pay you for breaks or not? If they pay then it's harder - but if they don't then you are entitled to leave the unit. Advise them you wish to avail your break half way through your shift and you need cover.

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I feel your pain. I just started at a psych facility in LA. 54 beds: 24 "high functioning psych and detox patients" with 1 RN and 1-2 techs and a "shared" LPN with the "low functioning-high acuity" unit that has 20 pts with 1 RN and 2 techs. The Adol unit is 10 beds with 1 RN and 1 tech. They are tring to cut staffing more. I can't ever remember such inadequate staffing anywhere. Maybe this is the Louisiana standard?

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Specializes in EMS, ER, GI, PCU/Telemetry.

one person alone on a psych unit is way too dangerous. there needs to atleast be one more person with you in case of emergency. is there atleast a hospital wide security/code system that you can call over head?

the psych hospital i did my clinicals at had locators with emergency buttons on them for all the staff there incase they got in a pt's room and either needed help or got trapped...

i would look for another job, for your safety.

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Specializes in psychiatric, rehab.

Isn't the standard 1 staff member to every 5 patients? I work days, but I usually have at least one MHT and an LVN that we share with the adolescent unit. If there are more then about 15 to 20 pts, I generally have second tech with me. The adolescent unit generally runs about the same for staffing as I do, but we just added children so there might always be two techs assigned to that charge nurse.

We used to have more staff on hand, but we have a new company and CEO, so they changed the staffing ratios. A lot of the nurses that have been there for a while are complaining, but on second thought perhaps things aren't so bad....

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Breaks? Are you kidding me? They take 30 minutes off my time automatically and I can not leave the unit. They say if you get to set at the desk and eat then you had lunch. It's crazy. But they also let the RN's leave the aids by themselves so that they can go grab something from the cafeteria. I will not leave the unit so I just send my CNA

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Nope, we don't even have a security officer. We have to somehow make it to the nurses station at the front of the unit and call the other end of the hospital for help. Sometimes they run down and sometimes they take their sweet time. I don't really know what I would do if I got stuck in a patients room. There would be no way to call for help.

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