Staffing based on # of pts, not amount of care!

TigerGalLE, BSN, RN · May 22, 2008

We have this problem on my floor.. My stupid charge nurse never takes acuity into account. It is a problem constantly and it makes me furious.

Tiger

litbitblack, ASN, RN · May 22, 2008

with your charge nurse helping that really doesn't seem like bad staffing. We have 20 beds right now due to remodel and we get 1 charge 4 nurses and 2 pca's. five pts a piece. some can be busy though thats when the charge should jump in

megananne7 · May 22, 2008

Whoops, I meant 24 bed unit, not 22.

Duckyaryj · May 22, 2008

Im on a 12 bed Skilled Unit. We often have the same problem. We will have 2 Nurses and 1-2 techs if we have over 10 patients were lucky if we get 2 at 12 pts. Less than than we will be SOL with just us two nurses. Usually these pts are very high acuity for us to have on our own. We are trying team nursing but without a tech Its almost impossible to do everything. At least 3 times a week we will have 2-3 discharges and at least that many admits with most of the admits showing up around 5 (like today we had 2 discharges which were mine and 4 admits all after 1730 with 1 tech and 2 nurses). I might soon be finding a new job after my honeymoon.

Riseupandnurse · May 22, 2008

We don't actually have charge nurses. It's an RN who is supposed to do all the LPN's pushes, admission assessments, blood transfusions, take the admits + start with as many patients as everyone else. We are drowning, all of us, and always have been. I don't know anyone who gets out anywhere close to on time. And of course, being nurses, we think the answer is to turn on each other and complain that the misery is unequally divided, instead of working together to improve things for ourselves and our patients. The shame of it is that we COULD do the nursing, if we didn't have a rule and a protocol about every little thing that goes on, "safety" measures that slow us down and make things unsafe, and machinery and equipment that can do everything flashy that doesn't need to be done and require more attention and work than the patients. It is so depressing; I don't know if I can do this much longer.

saphyre · May 22, 2008

Our hospital never takes acuity into consideration. I could be doing charge with EIGHT patients to care for, one other nurse (with seven patients of her own to care for) and one CNA. On a recent hectic night when I called management for help, the Nursing Sup said "Well, if I had another nurse to send you, I would have already done so"...!

It's pathetic that most complaints from the patients are in relation to slow response to call lights.... I wonder why....

locolorenzo22, BSN, RN · May 22, 2008

yep,

back on jan 1st, my hospital said that they were going to a acuity based model of staffing.....NOPE....what they meant was "we're going to give you x number of staff for x number of patients...taking into account the acuity ONLY when your department is not into overtime that week OR Joint commission is in the building....AND hoping that the supervisor on duty when your manager isn't there is smart enough to know when you need the extra hands....."

sounds good in theory, but the practice doesn't work......

suzy253, RN · May 22, 2008

I hear you. My hospital does this and we've run into some real close calls with patients going downhill and not enough staff.

gt4everpn, BSN, RN · May 23, 2008

try that same scearion with 40 patients 1 nurse and 2-4 cna's it truly is nuts

RNsRWe, ASN, RN · May 23, 2008

It's not just LTC. I work in an acute care hospital, and while administration SAYS acuity is accounted for, I can't believe it is. IF that were the case, we wouldn't see the same sad understaffing when the census hits a certain number....some days, that number is perfectly fine with the ratio of nurses called for. And sometimes, that ratio could make you CRY (I have).

They staff by the head, not by the care needed, period. And with patients being sicker and sicker in med surg (ok, everywhere!), it's no joke how fast nurses are leaving the bedside!