So, got a new job 8 weeks ago. Was told there was a Tele floor and a med-surg unit and I would be floating between the two. Not a problem, I am comfortable with both. 6 to 1 ratio. Again pretty standard. However here is my last assignment.
1) Guy who was just stepped down from ICU. Came to the med Surg unit with a triple lumen femoral catheter and two peripheral lines. On continuous bipap and tele. Anytime I take him off the bipap to feed him and put him on hiflow at 12lpm it takes about 3 bites before he is in the low 80s. Getting bags of potassium and albumin due to electrolytes still off. Uroseptic and diabetic. Ax0x4.
2) 48 year old with metastatic cancer. Ambulatory and axox4 but having diarrhea. Also on electrolyte replacement.
3) A lady who is demented. Complete care. Has a family paid sitter at bedside who just charts everything I do but does not assist. Bilateral leg wounds with daily dressing changes, coccyx wound, incontinent, urinates but has residual ad us the cathed every 8 hours because family does not want Foley.
4) malnourished man with G-Tube boils feedings and Trach in for Gram + pneumonia. Copious sputum needing suction every 2-4 have hours. Many I V atbx and electrolyte replacement. Axox4
5) New admit from ER of pneumonia after falling a week ago and breaking a rib. Axox4, ambulates.
6) In with CHF and Afib with RVR 160s. Overload is so bad that he is frequently requesting to be placed back on bipap due to SOB on 4-6 liters. MD ordering IV push digoxin. AXOx 4 can’t ambulate due to poor endurance.
So I really feel that 1,4 and 6 do not belong on a med-surg unit. That their conditions warrant a 4 to 1 ratio and closer monitoring. Trying to decide if I am going to be able to cut it in led Surg if this kind of patient load is the norm. Yes I had an aid, but she had 15 patients so I was pretty much 1 to 1 except for vitals. I feel like running but I’ve tried all sorts of nursing, there is no where to go.
No worries, I used it to get into acute care and wanted to see if it was a fit. It was not and I managed to take another opening elsewhere in the same hospital, one that was an "internal" posting. You can do it for a year or so, or maybe your Med-Surg unit will be one of the sane ones. It doesn't hurt to try.
CKPM2RN, ASN, EMT-P
330 Posts
No worries, I used it to get into acute care and wanted to see if it was a fit. It was not and I managed to take another opening elsewhere in the same hospital, one that was an "internal" posting. You can do it for a year or so, or maybe your Med-Surg unit will be one of the sane ones. It doesn't hurt to try.