Staffing question & your cardiac floor

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Hi everyone,

On Wed. when I went into work for my 12hr. shift I was greeted by the night shift nurses at the elevator (not a good sign). It turns out that we had 1 RN call out which left us with only 2 RNs for 20 patients, so I wound have 10. I had 1 Natrecor and Lasix gtt, 1 patient had to get 1 unit PRBC and 4 units FFP with ER shiley placement for dialysis, 1 patient was dying, 2 were combative and confused, 1 Amiodarone gtt, 1 Cardizem gtt, and 3 were semi-ambulatory. Mind you all were on tele, I/O's, etc. I was so overwhelmed I cannot even describe the state of mind I was in. We can have up to 7 patients with drips, tele (we have to read our own), etc. but 10 is unsafe to say the least. My nurse manager was on the floor and didn't seem to see the problem. Personally I feel she should have taken an assignment. The other nurse and I pulled our manager to the side and told her that we cannot work like this, that it is unsafe, tele alarms are going off, patients are practically being neglected, and she told us we just have to prioritize. I wanted to run when she said that. Prioritize! Was she serious? The answer was to get another nurse. Later on in the morning, a nurse who lives 2 blocks from the hospital dropped in to say hello and had no idea what was happening b/c they never even called her to come in(I come to find out that 4 RN's that I talk to outside of work were never called to come in either so I wonder if they even tried to replace the call out). When she asked if she could stay and take an assignment our nurse manager told her no they are doing fine. I cried the entire way home and even harder when I got home. I have never had such a terrible day in my career (mind you I have only been a nurse for 8 months but still this topps all) We generally have staffing issues but never in the entire 8 months that I have been there has things been that bad. Does anyone else think this is unsafe? Am I overreacting? All we needed was a code and that was it. They would have been doing CPR on me. Any advice on what I can do going forward to help prevent this? (Our chief nursing officer doesn't even know we are short staffed per our head cardiologist) Any advice would be appreciated. Thanks for reading.

Lauren

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Specializes in cardiac med-surg.

wow lauren that was a tough mother of a shift, and you did it

i don't think my worst nightmare has been that bad

too bad your manager doesn't have a clue

good luck in the future

we have 7 pts on nights, rarely one gtt

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wow lauren that was a tough mother of a shift, and you did it

Thanks for the reply. I found myself checking and rechecking things 5, 6, 7X b/c I was so afarid of making a mistake with so many patients. I could barely keep track of their names and had to refer to them as 20 bed 1, 25 bed 2 and so on. I was just trying to be as safe as possible, ya know, even if I went slower than usual.
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Specializes in SICU.

People higher up than the manager need to know what is happening on your floor. Write a letter with just factual information and send a copy to the chief nursing officer and risk management. If nothing changes, then start looking for a new job. Once you have "proven" that you can cope with 10 pt's and the floor only needs 2 nurses, well, you can do it again, can't you.

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People higher up than the manager need to know what is happening on your floor. Write a letter with just factual information and send a copy to the chief nursing officer and risk management.

Thank you for the info. I was not sure since I am a new to this who should receive a letter about this.

Once you have "proven" that you can cope with 10 pt's and the floor only needs 2 nurses, well, you can do it again, can't you.

That is what I am afarid of. Since Wed. went off with out a hitch according to our nurse manager (meaning no med errors, codes, etc.) I think they will try this again. When I looked at the schedule for May and June there are many days with 2 RN's and I am thinking she will leave it that way.

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Specializes in Utilization Management.

10 patients on a day shift???? :uhoh21:

Run, Forrest, RUUUUUUUUUUUUUUUUUUUUUUUNNNNNN!!!

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Specializes in cardiac/critical care/ informatics.

OH MY GOSH!!! that is ridiuclus and should never happen. Cardiac floor should not have a ratio higher than 5-1 and that is pushing it! I would be looking for another job. I would also do what the op said write letters, do you have a corporate integrity officer? they would most definetly get a letter, director, CNO, CEO anyone that would listen.

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Specializes in Cardiac Telemetry/PCU, SNF.

Listen and repeat..."Run. Run. Run far away!"

That is far too an unsafe situation to put yourself or your patients in, in my mind it is nearly criminal. Here I was whining about a night of 5:1 and I read this. Sorry you had to deal with this, it ain't right. Like others have said above, get info to anyone higher then your NM and pray this situation gets fixed.

Good luck!

Tom

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Specializes in ED, ICU, PACU.

I have to say that you did one great job with a load like that and no incidents. You should have rec'd an award or bonus. I have been there and have felt the same way as you. Don't you just love it when the manager's answer to your concern about pt. safety is to prioritize? After repeated complaints like yours, only to hear that I have to prioritize better, I finally said something like-well, if I am so bad at it, please show me how its done. Of course, that didn't work and I did what you are doing now, posting here for advise. I did take that advise and start looking for a new job. In fact, I start Monday.

You are right when you foresee this high pt load becoming more frequent and the only thing that may stop it is an incident. If you haven't already done so, think about getting ASAP-you can sign up online. Start to document things like this in a journal type of fashion and include quotes for the replies to your concerns. You have to start protecting yourself right now. Then, start looking for a new job and tell those you interview with exactly why you are looking to leave after 8 months. When a good manager hears about the load you successfully handled, they will outright tell you that it is unsafe-that's the manager you would want to work for and who will appreciate you also.

Good luck to you. You have done well in a very tough situation.

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Specializes in cardiac med-surg.

i missed the boat

that was a day shift !!!!

holy crap

we have 4 pts on days

good luck

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Specializes in Telemetry, Nursery, Post-Partum.

Wow, I would be crying still. That's an impossible shift. I think the most adult patients I have taken has been 8 (maybe, or maybe 7) with at most heparin and cardizem drips, nothing more than that. I would write a letter and send it to everyone above your manger...at my hospital we have directors and then I think above the directors is the CNO, and of course the CEO,etc. Make it known to as many people as possible what happened. And maybe look for a new job too! Good luck.

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I'm am so sorry for you I know what that prabably felt like, with my first nursing job in Florida. Except I was floated to a telemetry floor without any telemetry background we had 20 patients (1RN with 1LPN). Get out before it causes permanent damage, take it from me. You just have to beleave there's something better out there. Any hospital that puts a care provider in that kind of situation should be fined and held accountable for suffering they caused you and your patients. Putting you and your patients in danger. Our representatives in Government should also be paying more attention to how "the people" are being treated. Sound's like the hospital had no excuse as to why they didn't get help for you. I guess it would have cost too much. I hope things get better than that. What city and State are You in? Good luck. I wish you well.

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