I really need advice on how to advocate for change.
I work in the SICU of a 350ish bed hospital that does cardiac surgery. We got a new CNO two years ago during a nursing shortage. She gave us a slight pay raise and blocked off rooms on the med surg floors when we did not have staff so that they would only have a 6:1 patient ratio at the most and swore that she would keep us from unsafe staffing.
Two years later, the med surg floors are back to 1:8 and there's a plan to make the ICU patient staff ratio 4:1 with no 1:1 patients (our normal 1:1 patients are fresh, still intubated open hearts, therapeutic hypothermias, CRRT patients, balloon pumps, and Imepellas). We are currently at 3:1 with charge nurses back into staffing and we are feeling a major strain. This is mostly due to staff illness at the moment, but our CNO has been very open about the fact that this is her goal. I can already tell that patient care is suffering. It's manageable when we have less sick patients, but I'm afraid patient acuity will greatly increase as we get further into flu season and we will start having adverse patient outcomes because we've missed something.
There is no law to prevent this from being made our standard of care. Is there anything we can do to start making changes?
