Staff to Patient Ratio in GI Units

[sadiej]

What is your staff to patient ratio in your GI lab? How many patients do you normally see in one day? Do you have a cut-off of the number of patients that can be scheduled? If so, how is it enforced? How do you manage lunches and breaks?

At my hospital, on a good day, we have 6 RNs and 1 tech (who doubles as a unit sec. too) in the GI lab. We do about 15-20 procedures (EGD,Colonoscopies,Bronchs,ERCPs) a day, both inpatient and outpatient. That comes to about 350 pts./month with about 50 of those being in-patient. We don't have a transport team.

Lately, it's gotten so bad that 4 out of 5 days we don't get a lunch and rarely have a break. When we do get lunch, it may be only for 15min. with constant phone interuptions or a doctor may show up ready to work and we have to get his patient. We've tried staggering lunches, etc. but nothing seems to work and we're getting exhausted. Plus, we work from 6:30am until the work is done which sometimes means 7:00pm. And, we have to take call every 3rd weekend. We've asked for help but so far nothing has been forthcoming. Any of you having the same problem? How do you cope? Thanks

[CrohnieToo]

At our hospital we have volunteers who do the wheelchair discharges, man the family waiting room, bring patients' family down to recovery to sit with the patient and assemble the chart kits. Inpatients are brought to the unit by personnel from their floor or department.

[QueenPenguin]

How many procedure rooms do you have? We have two and when both rooms are being used, I have 9 staff. 7 RN's and two tech's. Two RN's at the desk for admitting/IV's, one RN in each procedure room and two RN's in the recovery area. One tech is in the room, the other is processing scopes. A unit secretary is optional but can be very vital to the process when it comes to making up charts, answering phones, etc and would bring the staffing need up to 10.

It is my goal to have 3 techs when two rooms are running. We have two staff in the procedure rooms. One for sedation, the RN and the other to assist the physician, the tech. Right now because we are down one tech, one room will have two RN's in it, one acting in the tech role.

When we only have one room running, I have 6 staff. 4 RN's and 2 techs. An RN at admit, recovery and in the room plus one RN to float. One tech in the room and the other to process scopes.

If both rooms are going beyond 12 noon, then we need staff on hand to provide lunch relief. If one room is running after 12 noon, then the staff that is no longer working in the other room will provide lunch reliefs.

We also have specific criteria for after hours cases. They need to be urgent or emergent to be added on. We are hospital based but are primarily an out patient department. Are you a free standing facility?

What I have found in Endoscopy is true through out nursing. Staff that does not get their breaks will burn out and move on. We try very hard to make sure that everyone gets a rest period of 30 minutes at some point during the shift, starting at 11am for lunches. Some days this does not work but for the most part it does. Everyone rotates staff out, usually our float nurse facilitates this. Admitting will relieve each other as does the recovery area when both are staffed with two RN's.

www.sgna.org has a standard for staffing in Endoscopy that you might find helpful.