Understaffed

[Kaye22]

I need some opinions. I have just completed my first year as a RN. For the last 6 months we have been tripled in the unit (1nurse:3patients). If we aren't tripled we have a 1:1 combined with another patient. I feel like I should be learning the right ways on how to provide care to patients. Instead, I just got scolded on asking for help from the shift leader or otherwise when drowning in my own work, of which I am overbooked on. I was also told that if I couldn't handle the work, I should consider another place to work. In the beginning I absolutely was a team player and kept telling myself if was going to get better. Now, we are still working mandatory overtime, including bailers! A couple "seasoned nurses" were written up for unprofessionalism. I am a hard worker. I am and have been patient but at what point do you say enough is enough? I never thought I'd be so scared of losing my license of possibly ending up on a "do not rehire list" for ending my shift and not coming back. Has anyone been in a "do not rehire" list and explained themselves out of it at their next job? Can anyone recommend a place that will insure my license? I wouldn't want to lose my assets due to management's lack of staffing. Also, 1 CNA to 30 patients?

[ProgressiveActivist, BSN, RN]

The ratios that you described are unacceptable. With your one year of experience you should be able to find another icu position. Consider a move to california Minnesota washington state because you won't have to triple. You have paid your dues and it is healthy and ok to say to yourself I don't need this. If a prospective employer asks why you left say it wasn't for me and leave it at that. Start looking now.

[JeanOfAllTraits]

A 1:1 is a 1:1, simple as that. Having you out of a the room of a 1:1 for any real length of time, especially the time it takes to care for another (even 'stable') ICU patient, is totally unsafe. Unfortunately that's not as simple to management sometimes.

But yes, you have a year of experience, you could try looking around. Are you in a position in life where you could relocate?

[Kaye22]

I do have another interview. I have also been accepted into a Bsn Program. Thank you. I guess I needed a little affirmation.

[Kaye22]

I am and have considered relocating. I have two major cities to chose from at this point. I'm try to be vague for all around reasons.

[ProgressiveActivist, BSN, RN]

A do not rehire on your personnel file is no big deal if it's a place you never want to work for again. It means you did not give notice equal to your vacation or that you were fired. It wont matter if you have three solid professional references from people in a managment position such as charge nurse or house supervisors.

Not sure what you meant by a place that will insure your license. Get marsh insurance through aacn.

If management is harassing the experienced nurses and trying to brainwash new nurses to accept unsafe ratios then vote with your feet. If I hear one more management official say that the standard in the industry is 3 to 1, I am going to hurl. I want to know where to look up these standards.

[Sugarcoma, RN]

I am in a similar circumstance with being tripled and I am very tired of it as well. My boss has made the same noise about finding another job. I have told her bluntly that I am looking. When a Dr. orders one to one care you are going against a Dr.s order if you do not honor it. Can you imagine trying to explain to a lawyer that you were short-staffed and that is why you ignored the Dr.'s order. Ugh.

I agree with libby a do not rehire means nothing if it is a facility you do not want to work for. As far as finding a safer facility, ask other nurses!!! They are your best source for truthful information.

[Nalon1 RN/EMT-P, BSN, RN]

Wow, our ICU triples on occasion, but 1:1 means 1:1 (one of the reasons we may triple, one nurse takes 3 while the other is 1:1).

It is scary seeing the trend of many ICU's starting to think 1:3 is the norm.

I personally am against unions in general, but this is one area that they can help in (too bad their is a bunch of other stuff the stick their nose into, but that is another topic).

[ProgressiveActivist, BSN, RN]

In my shop pts who are on ecmo ECMO IABP TH are 1:1 and I would not hesitate to call the attending and say that I want to make you aware that the administration is not

following the 1:1 nursing care required by hospital policy and procedure for your patient and I am not going to be held solely accountable if there is a bad outcome.