Understaffed with a heavy patient load

noelly10 · Feb 28, 2016

Realize that you're only one person. Do all that you can. If you can't get to something, don't let it eat you up. You will have days you don't get to something. All you can do is your best

Pangea Reunited, ASN, RN · Feb 28, 2016

Just the fact that you care puts you ahead of a lot of people. It sounds like you're doing the best you can with what you have to work with. Keep prioritizing and taking care of the most urgent tasks, first.

The only thing you might try (if you don't already) is coordinating with nursing staff when you can so that you both have extra hands available ...maybe bathe during nursing skin assessment or a big dressing change.

kay91 · Feb 28, 2016

I swear that sounds exactly like my floor. Usually we have 4 nurses and 1 or 2 techs for 18 patients (which is fully if we don't have the staff to double up rooms),but lately we have had 3:1:1. It is hard to get to everything done even for myself as a nurse. All you can do is your best.

Grab your nurse when you are ready for to bathe a total too. Set your people up who can bathe themselves and while they are getting washed up, get the totals done, and go back to check on the independent people. Where I work they assign the tech 12 patients and no more, but then expect nurses to do total care for 2 patients if we have 3:1 staffing.

noelly10 · Feb 28, 2016

I swear that sounds exactly like my floor. Usually we have 4 nurses and 1 or 2 techs for 18 patients (which is fully if we don't have the staff to double up rooms),but lately we have had 3:1:1. It is hard to get to everything done even for myself as a nurse. All you can do is your best.
Grab your nurse when you are ready for to bathe a total too. Set your people up who can bathe themselves and while they are getting washed up, get the totals done, and go back to check on the independent people. Where I work they assign the tech 12 patients and no more, but then expect nurses to do total care for 2 patients if we have 3:1 staffing.

I wish our staffing was like this. Sometimes we have 6 nurses and 2 techs to 32 patients. Sometimes we only have 1 tech. Sometimes no tech at all and we have to *gasp* do total care for 5-6 patients...

Penelope_Pitstop, BSN, RN · Feb 28, 2016

Why are all of the baths on YOUR shift?

ashleesini · Feb 28, 2016

We work 12 hour shifts, night shift doesn't do baths.

Everline · Feb 28, 2016

A hospital operates 24 hours a day, generally with two shifts or more. You do what you can in a shift and then the next person who comes on does what she or he can. You will never be able to do everything because the nature of taking care of people in a hospital doesn't really have an end time (needs continue around the clock), but your shift DOES have an end time. You sound like a person who does the best they can and has a strong work ethic despite a difficult, understaffed environment. Keep doing what you can, hand the patients off at the end of your shift and go home knowing you did your best.

LM NY · Feb 28, 2016

You sound like someone that cares. I have no doubt in my mind you will be a great nurse and look at this amazing experience you are getting beforehand. I wish my unit was maxed at six patients to a nurse. Whether you are a tech or a nurse, prioritization is most important. What is more important, vitals or a bath? I suggest you do your morning vitals before anything else and glucose checks especially for those with uncontrolled diabetes.

I am not sure about the nurses you work with, but I love the relationship I have developed with my techs. I always tell the tech to let me know when he/she is going to clean the full care patients, because that is a perfect opportunity for me to assess for pressure ulcers or clean the existing ones. I help them with the turning and cleaning and I get the same assistance so I can fully assess the body.

Also, I suggest when you are taking the vitals, do a quick check to see if that patient is soiled. Then you start with the most soiled and work your way down. I have seen some techs that buddy up and assist one another, because the care gets done quicker. Best of luck in school :)

Penelope_Pitstop, BSN, RN · Feb 28, 2016

We work 12 hour shifts, night shift doesn't do baths.

What? I did midnights for years, and as an RN on a MedSurg floor, tried my darnedest to wash up my completes during last round, and set up some independents or partials.

In the ICU, at least half of the baths were done on nights.

Our problem in medsurg was that evening shift never did baths, just day shift and midnights.

No way should all of the baths be on your shift, especially with those ratios! Your shift includes all of the meals as it is! No way do you have time for bathing everyone.

TheCommuter, BSN, RN · Feb 29, 2016

I try to prioritize and bathe all of my total care patients first. Yesterday I had 18 patients and I bathed 10 total care people and that's all I could get done.

Help bathe/shower the independent 'walky-talky' patients first. Get them out of the way before you start on your total care patients.

If you start with your total care patients, the first part of your shift will be sucked into a black hole. Help the people out who can help themselves out first. The move on to your needier patients.

Good luck to you!

Here.I.Stand, BSN, RN · Feb 29, 2016

We work 12 hour shifts, night shift doesn't do baths.

No reason a bath can't happen between 1900-2200, even 2300 for the night-owl pts, or 0500-0600 for early risers.