Unsafe Nurse-to-Patient Ratio

[keithjones]

From Lippincott Manual of Nursing Practice 8th edition

"Unsafe Nurse-to-Patient Ratio

• A pattern of unsafe nurse-to-patient ratio can be caused by staffing problems, be they temporary or longer term.
  
  A series of actions to best resolve the problem includes:
  
  • Address this unsafe situation verbally and in writing to the nurse unit charge nurse with copies to the nursing supervisor and director of nursing.
    
  • This will likely prompt action by the hospital, such as creating an as-needed pool of nurses to call for such situations, hiring more staff or, in the interim, securing contracts with outside nursing agencies and utilizing agency nursing personnel.
    

  Tolerance by staff nurses employed under such circumstances will preclude appropriate resolution and will leave the nurse open to unsafe practice and unmet patient needs, potentially increasing the risk of liability.

  [*]Although the employer is liable for the acts of the employee performed within the scope of employment, the nurse will not be exonerated should a patient's care be compromised in a setting of an unsafe nurse-to-patient ratio."

Stood out like a sore thumb while perusing chapter 2

My summary " If you tolerate poor ratios and don't say anything, YOU ARE PART OF THE PROBLEM! :trout:

I noticed it stops far short of suggesting ratios.

[nurseofalltrades]

Complaining and documenting staffing issues doesnt always work.I work in a LTC/skilled facility and currently have 38 patients to myself during a 6am to 6 pm shift. I have been doing med these med passes for 4 years and each one takes me at least 3 1/2 hours and then I am turning around and starting the next one. If I have any kind of incident during the day I am screwed because it puts me majorly behind. I am also responsible for treatments, charting, I&O, mood and behavior, MDS and feeding......What do you suggest to help me????:typing

[enmack]

Complaining and documenting staffing issues doesnt always work.I work in a LTC/skilled facility and currently have 38 patients to myself during a 6am to 6 pm shift. I have been doing med these med passes for 4 years and each one takes me at least 3 1/2 hours and then I am turning around and starting the next one. If I have any kind of incident during the day I am screwed because it puts me majorly behind. I am also responsible for treatments, charting, I&O, mood and behavior, MDS and feeding......What do you suggest to help me????:typing

get a different job, that sounds horrible. or as least call safe harbor and make them hire someone to help you.

[enmack]

I don't think the issue is one of numbers, but instead one of acuity. There should be a system in place that grades the acuity of pts as they walk in the door. Sort of like a braden scale, only quicker. Maybe something with 4 levels. Prn meds, regular meds frequency, family, doctors, and pt condition to be considered. Then each nurse should only have to deal with a certain number total. Ex. Pts 1-6 are level 1 acuity so this nurse can take on a level 3 pt as well. But pts 7and 8 are level 4s so dont give the second nurse more than 2 more level 1s.