Staffing

Lacie, BSN, RN · Feb 4, 2008

I am curious as to what area staffing ratios are. Apparently this is a secret in my area. I work in a 10 chair unit and have 2 charge nurses and 29 pts. plus 5 techs. I try to schedule 3 techs and one RN for the floor. We run a very tight schedule. The RN's work 12's and the techs work 10 hour shifts. I am tired of fighting with the "we are short" attitude when a tech calls in. I know this adds extra work for the RN but I am always willing to come out and help at turn around. Admin. meds/ sign off txs. The EMR seems to be some of the hang up. I would like to know what responsibilities the charge nurses have in other units and what is considered a safe ratio as well as how many pt do you assign per person on the floor. I want the nurses to be able to take care of the patients safely and not overwhelm them with too many extras like access mgt, anemia mgt, immunizations, careplans. Thanks in advance for all your input.

Wow and they are complaining it's short? I just left Davita where we had 14 chairs and I was the only licensed in the building much less being the charge nurse and taking on pt load as well as only 2 techs maybe 3 if I was lucky! We ran 3 full shifts open to close. By 4:00 in the afternoon staff was sent home leaving myself and 1 tech to finish up the pt care and cleaning of the unit. This meant I usually had 8 pts and the closing for me to do also with one tech. No wonder I was there till 8-9 pm at night. I left primarily due to the staffing and lack of professionalism in the unit as a whole. I am now in a clinic (non-Davita) where the charge takes on no pts, have 2-3 nurses taking pts and no less than 2 techs (usually 3). This is in an 18 chair unit. Jmo, staffing should be based not on body numbers but on the specific role in the unit and then pt #. My understanding according to medicare regulations it shouldnt be any less then 1:4 ratio. But this doesnt consider job descriptions etc. Therefore I am in significant disagreement with the recommended ratio.

CocoaGirl · Feb 5, 2008

4:1 ratio is too much given the acuity of many of our patients. I currently work in

in a state with 4:1 ratio, 12 chairs. We have 3 techs & I am the only licensed

staff in the building. Our ratio used to be 3:1 until we were bought out by FMC

& the patients will tell you they received better care with the 3:1 ratio. Our

unit is very close to two other states, one of which mandates a 3:1 ratio.

They have better patient outcomes because of the adequate staffing. I don't

think many non-nursing managers realize just how much work there is to do &

how sick our patients really are. Many think you put the shift on, sit around &

wait to take them off & put on another shift etc. I wish, we literally have no

down time to even sit with our patients to review meds or issues that may be

going on in their lives. (let alone take lunch or a potty break) It is very sad

that the large dialysis corps worry about $$$$$ & not the safety of the care

the patients receive. I just keep hoping that when CMS does our facility

survey that things will change for the better in reguards to staffing ratios.

But then again, when the surveyer is there, we usually have "extra" staff.

**nurse** · Feb 17, 2008

17 chairs, 4 techs, 1 or 2 nurses. Getting to be 1 nurse more and more often. I told them I'd leave if this became the norm, I was told on hire that 6-8 patients would be the usual. 12 is ok. 17 is not good. So I'm starting a new job on wednesday!

Throne Logic · Feb 20, 2008

18 chairs, 3 Licenses, plus an unassigned charge. Connecticut may be a pain in the tush for many things, but the staffing ratio requirements require that there be a 50/50 ratio minimum of licensed to unlicensed staff. It makes our budget tight, however the staffing conditions are much better. By the way, this is a DaVita unit.