This is making me nervous

Tait, MSN, RN · Jul 2, 2011

As far as our hospital goes an RN can not be alone on a floor. There always has to be two licensed nurses.

miss81, BSN, RN · Jul 2, 2011

So are you there completely by yourself? Is there anyone else with you like a CNA, PCT, PCA?

pers · Jul 2, 2011

I would refuse to staff a unit as the only licensed person. Even if there was only 1 patient on the floor, I wouldn't accept the assignment unless there was a second nurse with me. You never know what will happen with that patient, or on my unit, how many admissions you are going to end up with.

reddellrn · Jul 2, 2011

no cna nobody just me the rn. Im scared to refuse being the only nurse on the floor because i might get fired.

miss81, BSN, RN · Jul 2, 2011

Do any of the pt's need to be turned? I wouldn't be doing that alone! 1 RN with 8-10 patients is about the ratio we have on our surgery unit BUT you are never alone! There are 3 RN's on the unit, 3 LPN's (they are there to help the RN, they do not take there own pt's as such). I would never take 7 pt's BY MYSELF! Our beds are so full, from time to time we have to open an over flow unit with 1-3 pt's and then they will put 1 RN there only. No one likes it, but if any of the pt's are total care they would never leave just one person there. Also, if there were 7 or 8 pt's you wouldn't get another RN, just a "second pair of hands" as they put it.

Mulan · Jul 3, 2011

Do work like that at times. There is an aide that floats around so the aide will be there part of the shift.

I don't like it and I don't feel/think that it is safe.

That's how it is done, won't get another licensed person unless the census is at a certain point.

They can and do staff like that, nothing I can do about it, does no good to call the supervisor and complain.

Illegal? What law would they be breaking?

I think employers can do pretty much what they want.

Mulan · Jul 3, 2011

I would refuse to staff a unit as the only licensed person. Even if there was only 1 patient on the floor, I wouldn't accept the assignment unless there was a second nurse with me. You never know what will happen with that patient, or on my unit, how many admissions you are going to end up with.

Well, I guess then that you are prepared to be fired.

brownbook · Jul 3, 2011

my hospital is trying to cut corners due to low census.

Cut corners? Does it make sense to have an RN and a LVN for ?? 10?? patients, and a RN and a LVN for 4 - 7 patients? What would you do if you were balancing a budget and paying salaries?

So here is what they are doing. I work on a 10 bed rehab unit. our average amt of pts is 4-7. Now they want to pull my lpn to the medsurg floor from 11-7,

How far away is the rest of the hospital staff??? Is the med/surg floor down the end of a hallway or far away? Honestly if you called for help via phone or a code blue button HONESTLY how long would it take for help to arrive?

leaving the rn by theirself. If the census on the medsurg floor is low they wont pull the nurse. Now even with 4 pts im very uncomfortable and nervous all night long by myself. what if some one codes

Codes??? Really is that likely??? Is it a r/o MI unit???? I think your patients have less chance of coding since they have had recent doctor exams, lab work, etc. than if you were walking down the street of your city???? Do you worry some one will code as you walk down your street? And again what would be the response time to you calling on the phone or pushing the code button.

or im giving meds in one room and someone is trying to get out of bed in another room?

Maybe this is valid. Are your patients on bed alarms or do they need a 1:1 sitter? If so someone would need to be there, two staff would be appropriate. Otherwise if a patient isn't on alarms or has orders for a sitter, honestly even with two staff and 4 - 7 patients, wouldn't you just know it the patient still manage to get out of bed when no one is looking!

And we have alot of pts with dementia, alzehimers and stroke pts with impulse issues. What do yall think? Is this safe? Can they do this? Is it legal?

mediatix8 · Jul 3, 2011

Where I work an RN has to work with at least another CNA even if there is only 1 patient. They would never pair up 2 RN's though for only 1-2 patients. But they would never leave the RN by herself even with 1 patient.

chrsaaron · Jul 3, 2011

Wow really, I understand that your nervous, but yes it's legal. And if your not comfortable with the work load, voice your opinion to your boss, but be prepared to walk away from your job. Ultimately it's up to you, and whay you feel is safe and responsible care for yourself and your patients. Now my personal opinion is that as long as there is staff in the building able to respond to a code (in the unlikely event that the rehab unit has one) then you should be fine. As far as unruley patients getting up and impulseing themselves to the floor either set alarms, or get sitters ordered. goodluck and remember THE DECISION IS YOURS. don't let anyone make you do anything you don't want to but prepared to take responsiblity for those decsions. AKA NO JOB

scg08rn · Jul 3, 2011

It may be legal.

I wouldn't agree to doing it.

I would also emphasize quality of care. I'm sure most of the rehab patients don't turn themselves every two hours. It's hard to do cares/ADLs by yourself. How about a boost in bed when it's med time? Can't swallow pills if they are laying by the foot of the bed and can't move themselves..