Staffing a unit

[GM1928]

Hello everyone. I work on a med/surg/ortho floor at a large hospital. One day recently, we started the shift with 3 RN's. Shift supervisor pulled one of us to another floor, which left us with two RN's for 12 patients. Granted, the census was low on our unit, but is it safe to have just two nurses working? If a patient codes, don't you need two nurses to handle the code and a third nurse to cover all of the other patients? I've expressed concern to our unit supervisor about this. Hospitals typically don't back nurses if a lawsuit is brought, and I have told her that I'm really uncomfortable jeopardizing my license. Thoughts? I know it's not my place to tell the facility how to staff, but it IS my business to protect my license. (The shift which followed us also had 2 RN's for 12 patients, and those two nurses were very upset. The facility has never staffed our floor with just 2 RN's) Anyone have input? Thanks.

[HouTx, BSN, MSN, EdD]

Unless you're working in a very odd sort of hospital, calling a code will summon a group of qualified code team very quickly. In fact, most RRT programs will do the same thing if a patient seems to be having a downturn or serious change in condition. Granted, it's not an ideal situation, but 6 patients is a pretty average workload these days.

I would be more concerned about staffing coverage for breaks & mealtime. Make sure that the House Sup or other qualified RN provides relief coverage at those times. Under no circumstances should there only be one RN present. If you are not provided with relief staff, make sure that you are paid for your meal break (which you were unable to take).

[Dogen]

My unit staffing matrix stops at two RNs and a CNA, from 10 down to whatever the census would have to be to close the unit (never happens). At 12 we'd have 3 RNs, no CNA. I don't pretend to understand staffing matrices, though.