I've been on a busy (as if there is any other kind) med surg floor for three months, working nights, and it seems like every week they manage to add another nursing responsibility to the pile (with no more staffing).
When I started, the patient ratio is almost always 7-8, if not more. It can go as high as 10, and many are freshly postoperative - heparin drips, insulin drips, you name it. We almost never work fully staffed. We often work without techs or CNAs because they get pulled to other floors so that means I'm doing q4 vitals, chem sticks, I&Os, etc. Now we're being asked to do IV push meds (we're not a tele unit, so this means taking vitals, pushing over 5 minutes and taking vitals again - a little time consuming given the load and I'm not really comfortable with the idea), blood cultures, and they just announced they're pulling our phlebotomists who draw am labs, which will add at least another hour of work since almost every patient has blood ordered. This, in addition to each nurse have at least 2 admissions a night. The floor manager is someone who is just holding things down in the interim while they look for a new person, so the floor is almost always lacking equipment or supplies. It's a disaster, every single day. Every week, there's another inservice about another thing we're expected to cover. Next week it's wound care - apparently they're getting rid of the wound care nurse.
I know med surg is busy and crazy, but when I hear about this 5:1 and 6:1 ratios it sounds like a vacation. I know I'm a new grad and "time management" is a big thing, but I honestly feel like I'm pretty solid at managing what seems like a regular patient caseload of 6:1. Is the workload par for the course for most med-surg floors?
Give me a break
17 Posts
Good advise