Unsafe ICU staffing/ patient ratios! Please help!

[sophiern1]

I currently work in the ICU for a hospital in Arizona. In the last year, things have gotten very bad for the nursing staff. We go with out lunches, bathroom breaks, and RN/ Pt ratios have increased. We used to take one to two patients. Now, this has increased to 3 to 4 patients per nurse. Due to this unfortunate change, patients have self extubated themselves and medications errors have been made. We have lost very experienced RN's to other hospitals as well. However, management does not seem to care and uses registry or travel nurses to fill the gaps. Nonetheless, the new hires do not decrease the burden and workload on the staff. I just don't understand why the hospital is not hiring more RN's. Why is management making this environment so unsafe for patients? I am at a loss as to what to do. Please help!

[sophiern1]

No, we do not have a step down unit.

[martymoose, BSN, RN]

Does your facility have step-down as well? What is their ratio?

ours is becoming 5-6 on eves and seven on nites

and the pts are what used to stay in icu.so sick now.

i'm looking for an out.

tptb dont care- its your license , not theirs.with colleges pumping out Rns, they always can hire a new nurse if old one leaves, flubs up, etc.

[Horseshoe, BSN, RN]

I would find a new job, put in my notice, and then let the patient families know that 1-2 patients is a standard ICU nurse to patient ratio. Until the "clients" start raising hell, nothing will be done.

Your admins need to be sued.

[Thought, BSN, RN]

If hospitals could have their way, they'd have one nurse running the whole hospital. Reason? Money. Hospitals would rather sign one nursing check opposed to more. It's to save money. Hospitals do not care about the nurse to patient ratio. Their license is not the line. Yours is. Guess who will be thrown under the bus if something were to happen to one of those patients? I advise checking your malpractice insurance is still active (and if not, get it). The hospital won't protect you. I'm sorry they're putting you through this. Run for the hills, and don't look back. Good luck.

[kiszi, RN]

I work in a small ICU where I have usually one, sometimes two truly critical patients on my assignment. Still I raise all kinds of hell if asked to take a 4th patient, which is rare. Take your ICU experience to a place that staffs safely. They are out there.

[RescueNinjaKy]

Put in a safety report every time ratios are stupid

[TheCommuter, BSN, RN]

Thread has been moved to our Critical Care forum.

[offlabel]

"Why is management making this environment so unsafe for patients? " The answer is..

To make money for the corporate masters.

Gonna guess it isn't that simple. This statement and the 'likes' are one reason why nursing and nurses will be powerless to effect their future unless they stop following anyone channeling Karl Marx carrying a corporate head on a stick like lemmings.

Uninsured, unreimbursed care, unfunded federal mandates and Medicaid/care reductions in reimbursement (among other regional specific problems) are far bigger reasons for "unsafe" staffing than some contrived nebulous claim of "corporate masters".

Please... what is this, 1917? Educate yourselves as to the actual problems facing hospitals, and leave the adolescent slogans to early 20th century tyrants.

[canigraduate]

Hmmm... it sounds like you work for the same people I do. All I hear is "productivity."

The only thing that will bring about change is national exposure or lawsuits.

[Hoosier_RN, MSN]

Gonna guess it isn't that simple. This statement and the 'likes' are one reason why nursing and nurses will be powerless to effect their future unless they stop following anyone channeling Karl Marx carrying a corporate head on a stick like lemmings.

Uninsured, unreimbursed care, unfunded federal mandates and Medicaid/care reductions in reimbursement (among other regional specific problems) are far bigger reasons for "unsafe" staffing than some contrived nebulous claim of "corporate masters".

Please... what is this, 1917? Educate yourselves as to the actual problems facing hospitals, and leave the adolescent slogans to early 20th century tyrants.

Partially true. But TPTB want and need to turn a profit to stay viable. Greed has made bigger profit better. Some of the profits could go to extra staff. But you'll never see a CEO decline their bonus

[sugar12]

You don't owe your loyalty to any place that doesn't make sure your work place is fair and safe. Just follow your other coworkers and leave. When I started to get 7 on med surg and no CNA plus other issues I decided it was time to leave. I was told all hospitals are the same but now I'm at a place where I am much more happier with good staffing. Yeah you can stay there and try to fight but why waste your time and risk your license?

[Wile E Coyote, ASN, RN]

Having no stepdown between icu and regular floors is likely contributing to your icu staffing issue.

I started my icu career in such a unit and was there for over a decade before moving on to an icu that was only 2 beds larger but had a large stepdown next door. In almost 8 years, I've tripled (took a 3rd pt) about once a year, and it was only part of a shift.

What's happening to you may have everything to do with hospital politics or another issue, but i can't help but think the above scenario isnt a significant factor.