Why are we so complacent with high patient loads

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I am a newer nurse, only completing 1 year on the floor. However, this is really bothering me. I am looking for another job because the hospital I work for is completely ok with overloading their nurses. They claim we are in the middle of a nursing shortage, but I'm beginning to wonder if it isn't just a shortage for this company in particular. It is not uncommon for floor nurses to carry 9-10 patients when short staffed. It is a great shift if you carry 7 patients and less than that is such a rarity, almost no one talks about it anymore.

I am not sure why we are ok with this? How is taking care of 10 patients, or 14 if teamed with an LPN, considered safe? Understanding that their will inevitably be discharges, but what about night shift and they still carry that same 9-10 pt load?

Now, I work with some amazing nurses who can handle this many patients, myself included, but you cannot be a fantastic nurse when you carry that many patients. You can be a good nurse, but a great one I'm not sure.

And to make matters worse, several nurses were told they can no longer complain about the load, as it created a bad atmosphere. "It is not your place to question why you have 8-9 patients and someone else has 7" (Extreme case, but still) . "Nursing shortage is a reall thing and just something you are going to have to deal with."

How can management, nurses in their own right, be ok with this? Morale as down all over the hospital and nurses are leaving left and right? (Myself included hopefully)

Unfortunately, I don't know what else to do. We are not unionized and we have no effective voice over what happens there. No one is willing to say anything because saying something leads to discipline in this company. What do you think?

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My hypothesis is that part of the problem lies with nursing being a female dominated profession, and many women are afraid of confrontation and standing up for themselves. They will accept abusive/substandard/dangerous situations at work out of a sense of duty/obligation or the feeling that they can't do any better. Women, in my opinion, are conditioned to behave like that through socialization, and that translates into the workplace as well.

Anyway, again, just my opinion.

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Specializes in PCCN.

nursing shortage .lol also known as this is your new staffing pattern

there is no nursing shortage.saves the company money

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Specializes in Hospice.

Understaffing has been an issue for over 20 years.

When I left hospital bedside nursing in the mid 90s, nurse : patient ratios on the MedSurg floor where I worked were 7-8 on day shift.

People are even sicker now on general units, and staffing is the same or worse.

I've said it before, and I'll say it again; I plan on staying as healthy as I can and out of the hospital.

P. S. There is no nursing shortage. There probably never was.

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Specializes in Neuroscience.

I can't even fathom that kind of patient load.

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I'm not sure what changes are in the works, if any. I received a verbal reprimand when I complained about having 8 pts while another nurse carried 6. I was told it was not my place to question the patient load or why I would receive 2 admits in 1 hour while others did not. I was told I needed to change my attitude and being vocal about my disapproval was not the way to go about it. I am anxiously waiting to leaving pending something better because I feel like my license is in jeopardy if I continue to practice with that many patients...

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I second your sentiments

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I'm not complacent, my kids need to eat and I need to build a positive reputation and portfolio.

It sucks, and hospitals are on auto-digest, but that's the reason I stay.

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Specializes in Critical Care, Float Pool Nursing.
My hypothesis is that part of the problem lies with nursing being a female dominated profession, and many women are afraid of confrontation and standing up for themselves. They will accept abusive/substandard/dangerous situations at work out of a sense of duty/obligation or the feeling that they can't do any better. Women, in my opinion, are conditioned to behave like that through socialization, and that translates into the workplace as well.

Anyway, again, just my opinion.

Yup, simple as that.

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Just my 2 cents, but another problem is the huge number of foreign born nurses who have come here from countries where women do not speak up to complain. SOOO, who benefits when no one complains, obviously nothing gets better. When I graduated school foreign nurses were not available and there was no shortage of nurses. Hospital propaganda to keep salaries low and working conditions horrendous. Unions help now but only to a certain degree if nurses themselves do not speak up and demand what they need.

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Specializes in Critical Care, Education.

In a very large and well-known study (Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction) published in JAMA (October 23/30, 2002 - Vol 288, No. 16) Linda Aiken analyzed health care in the state of Pennsylvania and found incontrovertible evidence linking RN staffing to patient outcomes in acute care. Aiken et al stated ". . the odds of patient mortality increased by 7% for every additional patient in the average nurse's workload in the hospital and that the difference from 4 to 6 and from 4 to 8 patients per nurse would be accompanied by a 14% and 31% increases in mortality, respectively." That's HUGE!!! and this study only examined the number of RNs per patient... did not take into account LPNs, CNAs, techs, etc.

They go on to say "all else being equal, substantial decreases in mortality rates could result from increasing registered nurse staffing, especially for patients who develop complications. ... If the staffing ratio in all hospitals was 6 patients per nurse rather than 4 patients per nurse, we would expect 2.3 additional deaths per 1000 patients with complications. ... Staffing hospitals uniformly at 8 vs 4 patients per nurse would be expected to entail 5.0 excess deaths per 1000 complicated patients"

This was published in 2002. Fourteen years ago. This study has been replicated in many countries - with the same outcomes. It was a major factor in the establishment of nurse-patient ratios in California. The question is - why hasn't it created more outcry & influenced more legislation?

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Yes you are right and these studies are from years ago. Again, it is all about the mighty dollar and the squeaky wheel. The general public does not see these studies and outcries from working nurses apparently most are too afraid of losing their jobs to complain, so the terrible cycle repeats itself on and on. I am so glad I have retired now as these fights have been going on for so long with no results. I would not recommend nursing to my own children at this point.

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