What are your covid + medical floor/non ICU nurse patient ratios? And other questions..

[justjRN]

 this is the only place I can ask any questions anonymously so I don’t  have to fear being canned for it- 

whats your medical floor covid + ratios (non ICU)? Ours lately is one nurse to 5-6 covids. Ten on the floor today NO TECH for them. And Saturday one poor tech to the ten... 

Also level two mask and shield in the rooms. I’ve asked before if we wanted to wear n95 can we? Repeatedly told same answer “you don’t need it” .  Luckily it is not my home floor but I do get floated there- I have refused to care for them without n95 . I realize n95 per the CDC is the recommended PPE but that level 2’s are acceptable.  I don’t see the problem with wanting the most protection. 

Many nurses have not been fit tested at all or in a very long time on this floor as well- what the heck do they expect to happen if a covid patient codes?????! It’s just wrong and I’m venting and truly curious... maybe it’s the same everywhere or I am being a complete whine bag...

thanks in advance for your input. 

[BeckyESRN]

My husband works the COVID+ and COVID pending floor at his hospital and has since March. Their ratios are unchanged from cardio/pulmonary, so 7a-3p 5 pts, 3p-11p 6 pts, 11p-7a 7 pts. Acuity is never a consideration. PCAs have up to 21 patients depending on the census. Some nights the floor has no CNA and the nurses can have up to 5 with no PCA. There have also been nights where there is only 1 nurse and no PCA on that side of the unit (closed double doors in between), which seems really unsafe. 

N95s can be requested, but the nurses agree that management tries to discourage the use of N95s. On the COVID+ side, nurses were told to re-use their gown for as much of the shift as possible, they are given 2 for 12 hours, but can request more and receive a lecture for doing so. They've switched types of N95s a few times since March and no has been fit tested for the new ones although the emails about the new masks have said that new fit testing was required. 

I think the worst thing that the hospital is doing is pulling COVID unit staff to other areas of the hospital AFTER working 4 hours on the COVID+ unit without providing clean scrubs. So, 4 hours of exposure (even with PPE and especially with the gown situation) and then they move the nurse to oncology or observation or ER holds...

[LibraNurse27, BSN, RN]

Our Stepdown unit ratio is the same whether the pts are covid or not. 3 patients and no CNAs. We get N95s. What kind of masks are you wearing in the rooms if not N95s? Surgical masks? Also floating someone from a covid positive floor to oncology is a terrible idea! wow

[MunoRN, RN]

OSHA requires your employer to provide respirator-level respiratory protection when caring for known or suspected COVID patients (N95, PAPR. N100).  The only exception is when your facility meets the CDC's "Crisis Capacity" criteria, at which point respirators can be prioritized to certain high risk exposures.  Just saying "you don't need it" referring to N95's or other respirators when caring for COVID patients is a workplace safety violation which you can report anonymously to OSHA.

[amoLucia]

Munro - often times,  I too have suggested anonymously reporting workplace violations. However ...... it's not too difficult for the employer to put 2 + 2 together and GUESS the informant. Esp if the informant was specific & persistent.  Yeah, complaints are supposed to be confidential, but if the 'squeaky wheel' makes too much noise, it won't take rocket scientists to GUESS.

On the remote-est possibility might there be a union for OP? Or am I wishing too hard?

 

[DesiDani]

I work on a MS floor. We do have units that are sort of designated COVID units (rule out/positives), but they may still have other patients.  The only thing is the COVID wings are separated by some temporary door. If a patient is rule out or even positive only ONE nurse will take care of that patient, no CNAs. They may have 2 or maybe 3.

On my unit, if we do get a rule out or positive (they are usually transferred to the COVID floor eventually) a RN is pulled and that one RN only has that patient. They cannot go into the rooms of the other patients. Therefore, the other RNs on the unit have to take the rest of their 6 patients (our census at night is 7 max).

[OUxPhys, BSN, RN]

Right now its either 1 to 1 or 2 to 1 but we have had a steady low census for the past few months now. When I say low census I mean 3-5 pts total.

[zoidberg, BSN, RN]

Our med surg nurses get typically 4 patients, 5 if they are short. One tech per about 10 patients, sometimes less patients. We use a new n95, gown, gloves, shoe and hair covers, and eye protection for every covid or covid rule out encounter. Do not risk your health, wearing anything other than an n95 isn’t smart.