Staffing a unit

[PMHNP10]

If there is a 6 bed unit is it legally ok to staff the unit with 1 RN and 1 tech...no LVN, no charge, just those 2 people? If this isn't supposed to occur, but does because the hospital says the house sup is the other available RN, is that a loophole in the rules (even though we all know house sups are typically not readily available). If you have to have 2 nurses physically on the floor, could someone please direct me to the information where Medicare or some other entity forbid such understaffing.

[Pepperlady]

What kind of unit, what level of care for the patients???

I don't have an answer for you but providing that information may give someone else a better idea of how to answer

[Daytonite, BSN, RN]

What kind of facility are you talking about, hospital or nursing home? I've worked in hospitals where one nurse would have been left alone with 6 patients. I was a supervisor and manager and that is the way it is sometimes done when there isn't enough staff.

Here are the Medicare laws. You can read them for yourself, but I don't think you are going to find the answers you seek because they are very general in scope. You have an internal facility problem. The only staffing laws I know of are the ones passed by the state of California and they pertain to RNs only and apply only to acute hospitals. They are based on patient to nurse ratios and not on unit to nurse ratios.

• Title 42 of the Federal Code (Public Health), Part 482, the "Conditions of Participation for Hospitals" (http://www.access.gpo.gov/nara/cfr/waisidx_05/42cfr482_05.html). - Open up section 482.23.
  
• Title 42 of the Federal Code (Public Health), Part 483, the "Conditions of Participation for Long Term Care" (http://www.access.gpo.gov/nara/cfr/waisidx_05/42cfr483_05.html).
  

[PMHNP10]

medi-psych

[lpnflorida]

Are you speaking of working the nightshift in psych? In which case, yes we use to see that on occasion. dayshift or eves would have called for two Licenses. 1Rn, usually 1 Lpn. Our ratios on acute care pscyh locked unit was no one had more than 3 patients. That was 10 years ago. I do not think the ratio has changed much

[queenjean]

We have a couple of small units in our hospital that do this sometimes, *not* ICU of course. It depends upon the acuity of the pts, but our pediatric floor often has just 1-3 pts, and they may be staffed by a single RN with no assistance at all (as I said, it depends upon the acuity of the pts). We also have a specialty floor for certain scheduled, elective procedures. Many of these are performed on Mon-Wed; by the end of the week there may be 4-6 pts there, but they are not fresh post ops any more and are getting ready to leave. So they usually just have an RN and an aide on nights. I don't know about day shift staffing, as I only work nights.