Safe, Dangerous, or Irrelevant?

I don't mean to sound dumb, but what is a CNR?

Not sure what CNR stands for, but if you don't feel safe with your assignment, that's a problem.

How long was your orientation? Is it possible to ask for additional time?

What is it that you don't feel safe about? Is it a time-management thing where you would feel more confident with 5-6 patients, but you're not yet up to speed for a full load?

What do you think it would take to equip you to handle a full assignment?

If you can sort this out in your own mind, it might help you to do a better job of explaining it to someone else.

Also, keep the focus on what you need rather than making it sound like your facility is asking you to do something unsafe or unwise. I'm not saying you did that, only that it's easy to do when you feel like you're under the gun.

I hope you can find your way.

cnr = clinical nurse resident....a newbie!:wink2:

Not sure what a CNR is either (just saw your explanation) I assume however you are a new graduate. Having been assigned that number of patients in the school I was at as "team nursing" I can assume you aren't used to the number and also had no or very little orientation? Perhaps it would be best to talk to the nurse manager, let her/him know your concerns ask for a little more time orienting?

It depends on the shift but in general I say no.

It really depends on the acuity of the patients and the comfort level of the nurse, and the support staff available (nsg asst., unit secratary, resp therapist, lab tech...). That is the problem with "minimal staffing" laws. For some assignments 3-4 patients would be a heavy load, or with quieter patients with few needs I could handle up to 8-9 without too much trouble when I was a new grad. I urge anyone looking into a new job to explore the normal licenced staff to patient ratio on the floor before accepting. I can think of no question move important. All in all, 8 patients is on the high side of normal but if the patients were stable with no unusual meds, blood administration, or frequent labs , it is within what most places I've worked would consider a safe assignment.

If a CNR is someone who is not a licensed RN then they should not receive ANY patient assignments. Our NPA states that all unlicensed personnel, no matter the title or whether or not they are in school, must be considered the same. So basically it sounds like you are not clear about your job description. You might look at the Nurse Practice Act for your state or get the Educator or HR to assist you. If you are doing nursing tasks then you could be practicing outside your scope of practice and that could cause big problems. Most BON will not accept ignorance of the law as an excuse.

:redbeathe:saint:At most hospitals when you are a new grad, they put you with a preceptor for about 6 weeks. Between you and your preceptor they usually assign less pts so you can learn and get the routine down.

I have been an ortho/neuro nurse for many years, and also a charge nurse. On our floors i felt 8 pts were too much. They are heavy and fresh post ops have to be watched carefully. I was also a charge nurse on that unit. We started out with 5 pts each, which was good because we had time for teachi ng and assisting them in adl's. Of course over time one day we are short and them admin sees that we can do the work with less staff and there you go. From all the nurse's I have worked with we do the work in the best manner we can no matter how many pts we have. We do it because they are people just like our families and we truely care about them. If we left work undone maybe admin would realize we need more staff, but we care so we keep on.

is it safe and/or wise to assign a new cnr 8 patients?

hi,

the salient issue is not how well the patients are, but that they are patients, in a hospital, and presumably, are there for a good reasons. things can, and will, go bad.

the goalof any responsible unit is not to staff as if all will go according to plan, but to staff with the expectation that all will not.

the best and safest unit staff with the expectation that things will go wrong. as a new nurse, when they do go south(and they will) you will feel out of control and your license and the safety of your patients will be put at risk.

having said that, it also depends upon the staffing of your support personnel and the resonsiveness of your mangers.

What shift are you on?

Do you have nursing assistants?

Is this primary care nursing or functional nursing or.....?

On my unit, 8 patients to one nurse would be unthinkable. It's not unheard of for noc shift to get six patients apiece, but we have nursing assistants.

CNR? you are a student?

greetings guys n gals,

i'm a 48 yr old, semi-retired aircraft mechanic turned rn. i just graduated this past may. i am currently employed by a well known healthcare organization. i am currently working as a cnr on a med-surge floor that focuses on ortho and neuro. i'm looking for feedback and rationals for one simple question:

is it safe and/or wise to assign a new cnr 8 patients?

thanks for your input:yeah:

gomer

whether or not an assignment is safe depends on a lot of factors, imo. how much orientation have you gotten? are you working with a preceptor? do you feel comfortable with the assignment? after all, it's your license.

also, i think typical load varies from place to place, so it's hard to judge. your floor sounds like you probably get fresh post-ops and the like.

i work on a transitional care unit (rehab/subacute) within a skilled nursing facility, and with back up from my preceptor i am handling anywhere from 8-11 patients on my own, but many of them are far less acute. (i'm five weeks in on orienation as a new grad and go on my own starting next thursday).

in short, it's all variable. what would matter most to me if i were in your shoes is whether or not i felt comfortable or ready to handle that load. if not, i'd ask for more orientation