staffing at night

[rashan1053]

I am an RN an neuro/ortho floor at nights. Since being off orientation I have had anywhere from 6-8 patients. Things go ok until about 5am. We have only one aid for the floor (16-22pts) and 5am is when line draws are due, we have to get I&O's, patients start waking up and need to go to the bathroom, and report needs to be taped. I find myself falling behind and getting out 1/2hr-1hr late. So far my director has not said anything, but I know the time is going to come when she will. I guess I am just venting, but also wondering how other places are staffed at night.

[yellow finch, BSN, RN]

Back on my old floor, we would have 8-10 pts at night typically with a tech per nurse. They've recently dropped that down to 7-8 pts per nurse with one less tech. This is on nights. Another floor I worked on would have around 6 pts with 2 techs on at night.

My current ICU doesn't have techs (or secretaries at times) and each nurse has 2 pts. We're required to do our jobs plus turn, bathe, clean stool, and do all accuchecks (sometimes q1h while on insulin drips), I&Os, and whatever other stuff we do... I find this job harder than the ones I had on the floors b/c it's more intense (thus, intensive care, heh) and difficult. But I love it.

[MoopleRN]

My floor is either feast or famine as far as census goes. I guess on average I'll have 4-5 patients a night, no tech. Seven patients is the limit on my floor without a tech and those are busy nights... and not the norm, fortunately.

I totally agree with you how the pace can pick up around 5. I used to get out late, too and then I started to be more aware of that 0500 rush. I started taping report earlier, especially on stable patients/patients I knew well. If I need to add something later on, at least the gist of my report is already done. 0500 I&O? If I'm called in or go in earlier, I'll dump the foley then/record intake. It doesn't have to be on the dot of 5. Meds at 0700? I'll give that synthroid when they call for the commode at 0615. Those are just some examples and it took me a while to figure out how I can combine some tasks or work around the routine safely/accurately. There are some nights, however, when you just can't get it all done in time and you have to stay late.

[JRD2002]

Totally understand the 5 o'clock rush. Fortunately we do face-to-face report so I don't have to take time to tape a report. Is there anyway that you could tape report earlier in the night like at 3-4AM?

[locolorenzo22, BSN, RN]

Staffing on my floor is supposed to be based on a acuity model....however..it does not impact techs, and it does not factor in admits....sure, we might have 14 patients with 1 tech and 3 nurses....but we might get 7 admits from the ER, and nobody cares about extra staffing.....

and as a tech, nobody cares if 7 out of the 8 total cares on my floor are feeders, incontinent, etc....you just do what you can....so go figure....