Upset When Nurses Volunteer To Take On Extra Patients

[Aloe_sky]

I am an ICU nurse and the ratio is usually 2 patients to every 1 nurse. Now it’s not uncommon to have 3 patients and they don’t care about the acuity. They have dropped the bonuses, don’t send out messages that they need help and just pile on more patients. 

I’m finding now more new nurses are volunteering for a 3rd instead of the charge nurse which has NO patients taking a patient. It’s highly upsetting. The charge nurse sleeps at the nursing station or cleans up the mess at the nursing station.

I have been a charge nurse myself at other hospitals and honestly this hospital has it so easy, they are “resources” but as someone that has more experience then the charge nurse, they can’t help me with anything. They don’t even help with baths. 

I'm just more upset that new nurses are volunteering to be overwhelmed while allowing a nurse to just sit there. I can just scream. Maybe I’m just becoming bitter but I’m really tired of being tripled. Just venting.

[JBMmom, MSN, NP]

Wow, that seems like a very wrong use of resources. The last two times I was tripled in my ICU, I was also charge. We haven't had a charge out of assignment count in probably about a year, we were told at the time that it was budgeted for every shift. But we never have the staff. In all honesty some nights charge out of count is so boring I almost always rather have an assignment. Every now and then there's a night with everyone crashing and being a resource is a good use of time. But I wouldn't have people triple with a tough assignment while charge has none. Is it because the charge nurse is semi-refusing a patient or are they just volunteering out of the blue?

[Daisy4RN]

Sounds like you all have 3 pts regardless of the volunteering. The new ones are just trying to make a good impression but will eventually learn it doesn’t do any good anyway (more than likely). You will not be able to fix lazy people but I do understand the frustration, hope it gets better!

[Aloe_sky]

19 minutes ago, Daisy4RN said:

Sounds like you all have 3 pts regardless of the volunteering. The new ones are just trying to make a good impression but will eventually learn it doesn’t do any good anyway (more than likely). You will not be able to fix lazy people but I do understand the frustration, hope it gets better!

Yes unfortunately, it is the norm to have 3 patients here. I know these new nurses will definitely learn eventually, Thanks. 

[Aloe_sky]

22 minutes ago, JBMmom said:

Wow, that seems like a very wrong use of resources. The last two times I was tripled in my ICU, I was also charge. We haven't had a charge out of assignment count in probably about a year, we were told at the time that it was budgeted for every shift. But we never have the staff. In all honesty some nights charge out of count is so boring I almost always rather have an assignment. Every now and then there's a night with everyone crashing and being a resource is a good use of time. But I wouldn't have people triple with a tough assignment while charge has none. Is it because the charge nurse is semi-refusing a patient or are they just volunteering out of the blue?

The charge nurses will literally throw a BIG fit for taking a patient, 1 will threaten to walk out.  I blame management for allowing this behavior, it should be mandatory they take a patient before any staff nurse is tripled. They will sit there on their phones, look up buying new houses etc and won’t help at all.
 

One nurse was tripled with a patient on FIVE pressors, bicarb gtt, blood transfusion and full code! while the charge nurse didn’t even help with medications. I told the charge the assignment wasn’t fair and that patient should be 1:1 or atleast be paired with a very stable patient. Her response…… well he won’t stay with 2 patients he has to be willing on admitting this third patient that’s in the ED. I was floored by that response. 

[JBMmom, MSN, NP]

On 9/10/2022 at 9:35 PM, Aloe_sky said:

The charge nurses will literally throw a BIG fit for taking a patient, 1 will threaten to walk out.  I blame management for allowing this behavior, it should be mandatory they take a patient before any staff nurse is tripled. They will sit there on their phones, look up buying new houses etc and won’t help at all.

Seems like more than a management issue, they seem like pretty crappy people if they're willing to let coworkers and patients suffer because of their lack of work ethic. Is this off shift when management doesn't see the behavior? If not, then management allowing it to continue is definitely a very big problem. 

[hppygr8ful, ASN, RN, EMT-I]

I do 1 double shift per pay period  and quiet frankly I do it for the Money.

[Robmoo, ADN, BSN, RN]

The only time that management listens is when nurses vote with their feet.  This sounds like a situation in which it is time to vote with your feet.  

[Tami707]

Do you have any type of Professional Performance Committee or Staffing Committee that nurses sit on?

At my hospital, the Charge is a, mostly, rotated assignment. Some senior nurses won't do it, and new grads are not allowed. The Charge does not have an assignment, but we are the Code team, Stroke team, Sepsis team, etc. Not only do we resource and manage bed control in the unit, but we also resource the other units in the hospital. Except ED, occasionally, we may get called to a code there, but it depends on their staffing. We do not take an assignment for those reasons. And are to call our manager if the House Supervisor wants us in the count. 

Sounds like it's time to start a petition among nursing staff about the Charge position not being utilized in an appropriate manner, or start a PPC or Staffing Committee to change this to a more resourceful position.