Safety and staffing

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Specializes in psych, home care, Quality Review.

I'm looking for opinions about staffing ratios in regards to safety on the inpt unit. Of course the hospital is always trying to save money plus our unit director has only been there 6 months and doesn't want to look ineffective. He is looking at ways to spread us even thinner, while accepting even sicker psych pts plus medically compromised geriatrics. I have tried to point out that injury and assault rates for staff tend to increase with overwork, overstress, and low staffing levels. He refuses to believe there is any link, even though I have provided government (OSHA) and national nsg journal references.

What is your situation? Did you ever have similar issues and how did you handle it?

BSS

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I swear, I think we must be working at the same hospital! I'm in the same predicament and not liking it at all. Half the time they don't even staff to grid, and you can forget about them actually staffing to acuity. We've got acuity through the roof right now for both psych and medical reasons. Seems like the doctors are sending more and more medically sick patients to us. Everyone is getting a ton of (unwanted) overtime right now because no one even has time to pick up a chart to work on it until the next shift comes in. Seems like they are working their few good RNs until the point where everyone is going to get burnt out quickly. The floor has the capacity to hold 36 patients, yet there are only 3 full time RNs on one certain shift. Everyone is so stressed and frustrated. Whenever we talk to our nurse manager (who has only been there 6-8 months), we hear either "there's no money to hire someone" or "well, we're looking, we just can't find any nurses!" Personally, it just makes me want to look elsewhere.

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Specializes in psych, home care, Quality Review.

I waited a little while before posting so someone else could jump in but I guess it's just the two of us. We've been fed the same line as you about there not being any nurses and no money. Somehow I'm thinking if they are offering new nurses the 'no money' special employment package, they are never going to find any! It's just another blow off to let you know they aren't recruiting hard enough. Psych historically is rated at the bottom of the moneymaker pile (the glorious OB wards and shiny new cath labs are the "important" things). There must be some business model out there somewhere that says, 'don't sink any more money into a unit than it will likely bring in'. Until one of their own is affected......Look at this place I found that sounds like heaven! http://www.southeastmissourihospital.com/nursing/psych.htm

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Specializes in Psychiatric, Med Surg, Onco.

Hmmmmm...yes, I believe we all work at the same place...well in essence we do. The patient/staffing ratio at my facility is...well...a disaster waiting to happen. I work on an admissions unit (11-7am - when the hospital receives 40% of it's admissions) at a state psychiatric hospital. They have been running us 11-7 with 3 mental health workers and 1 nurse...with a cap (which is thrown out the window when beds full...) of 25 patients. Our acuity is downright dangerous...we have several "levels" that we must monitor at all times...checks...admissions...you know the routine. I do believe that we are finally seeing the consequences of funding cuts for drug rehab, MR group homes and jail overpopulation. It appears to me that we are taking a U-turn back toward the turn of the century...warehousing of the mentally ill...and any other "unsavory" populous that the community has no place for...as long as it looks okay from the outside, then it must be...but it isn't.

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