Safe Harbor situation?

[8jimi8ICURN]

level 1 trauma center, high acuity tele med/surg floor. 6-1 ratio at night with charge nurse taking 3 patients and 2 floor nurses each with 6 patients.

Pt is rule out TIA vs CVA.

Pt is has a left bka and is in 3 point soft limb restraints. L BKA is unrestrained because they didn't figure out a way to restrain it.

Pt kicked charge nurse in the head, shoulder, arm and side. Pt intentionally trying to kick, saying "I got you that time." Pt punched the primary nurse in the crotch.

I entered the room and immobilized the leg and arm so that a new iv could be started so we could push some haldol.

Pt required approximately 4 hours of direct RN interventions. Several times all RNs on the floor were in the room for more than 30 minutes.

I'm afraid tonight is my turn. I will accept the assignment, but when 5 of the other patient's are acutely ill, is this a situation that you all as my peers would deem as a proper safe harbor?

I left late due to charting 2nd to spending a good bit of time defending my two female counterparts. Before I left, day shift primary RN comes into the break room nauseated from a kick to the stomach.

Please post up, i'm going to sleep right now and have to be at work at 1845. I just want to know if i am going to screw myself by calling a safe harbor.

[qpmz]

On our floor in this case, with the patient taking up so much time away from the other patients we would have asked for a transfer to ICU where the patient had more one on one care. Also if we have to chemically restraint anyone it is an automatic trip to ICU.

[8jimi8ICURN]

That was my opinion too. But no one agreed with me. It's fine by me as long as they provide enough nurses to help out cause i DEFINITELY wasn't going to be spending all my time in the room ignoring my other patients. The acuity on our floor is WAY to ridiculous to be spending all night on some guy who's a limited / comfort measures only code status. It is sad tho, my charge elected to take him and one other person and then she just doped him up.

that's not nursing care in my opinion. I was at least ready to draw my line in the sand. I had the short-form safe harbor in my pocket, although, if they had given him to me with the reduced ratio, i would have been ok with it.