Unsafe work conditions?

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Ok, I have been ano RNC for 6 years in a busy Oncology/Medical unit. Over the time I have been employed as a nurse, I have seen staffing up and down. We do have a large turnover, and most of the time are short handed.

Just a brief background, when I started I had no hands on patient medical experience. I got oriented then thrown into giving extremely potent pain medications (as we take care of a lot of cancer pain). I had 3 deaths in my first 3 months...it was a lot that first year. I got through it and learned a lot. I stuck with this unit, because I enjoy the oncology portion and have mrant a couple wonderful coworkers that have basically got meverything through my days.

The more I learn the art of nursing, the more concerned I get.

I look back and know now that my orientation was not long enough, nor should I have been given the acuity of patients I was right out of orientation.

Lately, the census has been very high in the whole hospital. The nurses are carrying 6 to 7 patients on day shift- and acuity is NEVER looked at when making assignments. We rarely are given more than one nurses aide, which is ridiculous because we are a fast paced unit with very sick patients!

The moral is low, call offs have been frequent and mistakes are being made.

I feel like I have no control. I worked hard for my license and I really do not want something to happen to put it in jeporady. I leave feeling like I accomplished nothing....

There is no way we are able to take care of our patients plus do all the "extras" that administration expects of us.

I'm concerned for the patients and the staff.

Where do I turn? Who do I talk to?

Nurses have talked to our manager, the nursing manager and nothing is done.

The answers they get are absurd.

If no one running the hospital cares, then who COULD I turn to?

Any suggestions would be great.

Thanks,

Stacey

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Specializes in OR, Nursing Professional Development.

Your options are to either find a new job, bring in a union, or move to CA, which is the only state that mandates ratios for all inpatient units. You can also contact your legislators, whose information you should be able to readily find. Unfortunately, expecting nurses to do more and more with less and less is becoming the new norm.

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Specializes in Psych, Addictions, SOL (Student of Life).
Your options are to either find a new job, bring in a union, or move to CA, which is the only state that mandates ratios for all inpatient units. You can also contact your legislators, whose information you should be able to readily find. Unfortunately, expecting nurses to do more and more with less and less is becoming the new norm.

That's right California is the place to be "Swimming Pools, Movie Stars" and mandated nurse patient ratios, except in inpatient psych and LTC where ratios are often close to thirty to one.

Hppy

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That's right California is the place to be "Swimming Pools, Movie Stars" and mandated nurse patient ratios, except in inpatient psych and LTC where ratios are often close to thirty to one.

Hppy

Right now in my state we have no mandates and I have 36:1 with no aide. It's awful. I'm dreaming of Cali. Too bad so many other people love it there too.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

If the hospital is making enough money to pay the big salaries of the CEO et al then, no, they don't care.

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Specializes in GENERAL.

OP: First of all the world should seriously kiss your keister as well as nursing leadership and most state legislatures as well as the ploddingly responsive federal government.

What can you say when too few care? It's not them---yet.

Now while these words are not a remedy for addressing this ongoing problem, know that in my experience (not oncology) acuity sometimes hits a fever pitch only to subside and then rear its ulgy head later on.. For now you have to tough it out.

Try mitigating the problem with the kind advice of your fellow colleagues. While not of immediate help, it's an affirmation of your plight, at least.

The business/political alliance in this country needs a new "business"plan. Especially in light of the fairly recent showing on PBS of the documentary "Cancer, The Emperor of All Maladies" which tells us that one of two people in the U.S.will be diagnosed with some form of cancer at some point in their lives.

So when you consider the stressors of caring for this patient population, and a cancer patient's proclivity for experiencing deep, intractable pain, let me be but one to add my name to the legions of informed nurses who say that while the situation you find yourself in is critical, Nursing's lack of leadership on this issue is criminal.

Call your legislative representatives and find some responsible (not on the payroll) people who, like in Calfornia, can at least start, again, to address this mess.

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Yesterday we had 2 nurses on the unit. Me and another...7 each and they gave him an 8th.

I have been trying to find laws on staffing for nursing in PA. Or at least find who I would talk to....

They are sucking the life out of me.

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Specializes in Oncology (OCN).

I worked inpatient oncology and those are crazy ratios. Are these patients receiving chemo?

We were a 26-bed unit usually staffed with 5 RNs plus a charge. The charge did not take patients. NOC was staffed with 3 RNs plus a charge who took patients. About 3/4 of the time we had 1 CNA but there were times we provided total care. We were usually staffed according to an acuity matrix that took into account things like patients who were receiving complex chemo regimes, patients receiving multiple blood products each shift (we had a lot of leukemia patients), patients on reverse isolation due to neutropenic fever, etc. If acuity was especially high we would receive 6 RNs on days/4 on NOCs. It didn't happen often but there were times when our acuity definitely called for it. There were times we were short staffed but that was also rare.

Does your state have safe harbor laws? In my state, if you truly feel you are being put into a position where you are expected to accept an unsafe assignment you can declare "safe harbor" BEFORE you accept the assignment. This protects your license in the event something happens. Usually just the mention of this will get administrations attention. It will probably also cost you your job (because my state is also an "at will" state and while they cannot fire you for declaring safe harbor, be assured they will find another reason if you do!)

I'm sorry I don't have any answers for you beyond what others have already mentioned. I feel for you. There were days we were stretched beyond our limits at 5 patients. I can't imagine taking 7 or 8. Hugs!

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Specializes in Complex pedi to LTC/SA & now a manager.
Yesterday we had 2 nurses on the unit. Me and another...7 each and they gave him an 8th.

I have been trying to find laws on staffing for nursing in PA. Or at least find who I would talk to....

They are sucking the life out of me.

There is only one state with staffing regulations--California and it only applies to acute care inpatient hospitals. PA does not have laws regarding staffing but if you have a union there may be rules per contract.

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I unfortunately don't have much to offer in terms of WHO to talk too, I have tried to explore similar avenues and have found myself going in circles. I am only able to commiserate and also hope for an eventual answer. I work on a large telemetry/cardiac interventional unit, night shift, and we typically start the shift with 5 or 6 patients, discharge one same day patient from cath lab, and then get 2 - 3 admissions. So we typically end up charting on 8+ patients, and are lucky if we have two nursing assistants (god bless them, I was one, but a handful of them move so slow). It's terrible, but there does not seem to be a light at the end of the tunnel unless the entire face of our healthcare system changes. In a world centered around patient satisfaction, my patients are increasingly dissatisfied, because guess what, their nurses are dead tired and have no time to give truly attentive care, I for one am looking to specialize and possibly move into outpatient, and I'm only a few years into this gig after dreaming of being a bedside nurse for life. I am praying I find somewhere that makes me feel like this back breaking work is worth it again.

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Specializes in PICU, Pediatrics, Trauma.
Your options are to either find a new job, bring in a union, or move to CA, which is the only state that mandates ratios for all inpatient units. You can also contact your legislators, whose information you should be able to readily find. Unfortunately, expecting nurses to do more and more with less and less is becoming the new norm.

Senator Barbara Boxer (CA Democrat) introduced an act (s.864) "National Nursing Shortage Reform and Patient Advocacy Act" on March 15 2015 which is pending consideration by the Senate committee on Health, Education, Labor and Pensions. I received this information from Senator Diane Fienstein and is urging nurses to contact her office in Washinton DC. (202) 224-3841

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