Working Alone on a unit

[lauron9]

I work on a pediatrics unit and when our census is low, the nurses work alone with up to 3 patients. I've tried to find articles/acts regarding nurse safety when working alone, but the majority of the information available is about nurse patient ratios and having too many patients. Does anyone else have similar working conditions or know of any safe practice acts about nurses working alone?

[AprilRNhere]

I'ts common where I work. 1 Nurse in ICU unless we have more than 2 pts, often 1 nurse in the OB too. I think they can have 2 pairs in OB by themselves.

[TexasPediRN]

Wow.. thats scary.

Anything more than 1 pt at my other job required 2 nurses.

What if they code? You need help? We had to have 2 nurses there..we just shared the pt..

Scary Scary Scary...

[barefootlady, ADN, RN]

Not a good situation . Even a CNA would be a comfort. Besides, there are always "things" that can be done when the census is low to justify at least a CNA.

Check stock for out dates, clean refrig, go through that drawer at the desk with "the junk" and get rid of most of it. Blessings.

[RNperdiem, RN]

I work in ICU and we need to have a minimum of 2 nurses at all times on the unit. If there is low census, this affects lunch times and road trips out of the ICU.

Is there anyone assigned as backup if you run into problems- a charge nurse on another floor or a house supervisor?

[RainDreamer, BSN, RN]

We don't have that problem at the hospital I work, just because the place is huge and we never have fewer than about 30 nurses/shift. But when I did my preceptorship in a level II NICU at a tiny hospital ..... there were 2 nurses on at all times, regardless of the numbers. There were a few nights that they only had 1 baby in the whole unit ..... 1 nurse took care of that baby while the other nurse was available to go on high risk deliveries and was there in case they got an admit.

I don't know, I don't think I would accept a position in which I could potentially be put in a position in which I would be the only nurse. What if something went wrong and you have very limited support, if any at all? Another reason ...... I'd be bored outta my mind!

[RN1989]

I have NEVER worked a facility that left you alone with a pt. The policy always stated that there must be 2 people at all times. Of course if a CNA or tele tech was available for the shift then it was the RN and CNA/tech, to save money on having 2 nurses. But I always had someone with me, even for only one pt.

[santhony44, MSN, RN, NP]

A few years ago, I worked on a small epilepsy monitoring unit. When we didn't have many patients, we would sometimes work with just one nurse and a CNA. We also had a monitor tech in the back.

One night we had, I think, two patients. One of those had electrodes which had been surgically implanted in his brain. While both the CNA and I were away from the monitors, for legitimate reasons, the patient with the implanted electodes sat up and yanked out his electrodes. Fortunately, he suffered no ill effects.

Although the CNA and I heard that the neurosurgeon ranted and raved and demanded our heads on a platter, our nurse manager and the facility DON backed us up. The incident did result in two changes: one, patients with surgically implanted electrodes were restrained. Two, there were two nurses, plus either a CNA or a unit clerk, on the unit at all times.

Personally, I would not work alone with even one patient, unless I was extraordinarily confident of my backup, except in the most unusual of circumstances.

[hikernurse]

We always had to have two nurses, even if there were only two patients--which has happened. What if you're in the bathroom and something happened? Never mind lunch...

[trmr]

I would be scared out of my mind. What happens when you urgently need help? I quit a past job because of this exact thing. A baby coded and I had no one to help. I did a lot of praying and crying later. He lived but it was not a good thing. I will not work alone again.

[jessiern, BSN, RN]

Our policy states we must allows have two nurses on the floor...even if we just have one patient. One is assigned to the patient, and usually the other will man the desk.

The policy was put in place years ago when they staffed one nurse because we discharged down to 2 patients on the floor (scary scary). Well, wouldn't you know the poor nurse and sec. (That was me) got slammed with admits, and the on-call nurse could not be reached.

Now, ICU usually only has one nurse is only one patient, the rationale being they can pull from med-surg staff if they get in a bind.

[pinksugar]

I would never, ever work alone on any unit. I work ICU and there are always at least 2 nurses, even if there is only 1 pt. I can't pull narcs without a witness, let alone what happens if someone codes? I can't do CPR, push meds, hang Levo or Neo, manage airway, record, and be a runner by myself during a code (and Lord knows the residents don't know what they're doing - I need at least 1 other nurse, preferably more).