Working in crisis mode all the time!

margin261 · Jul 15, 2016

Freckles- you have my utmost sympathy! Your OP is why I left bedside nursing! Our ratios were 6:1, however we (the RNs) were responsible for admission assessments, IV pushes, PICC/CL lab draws, hanging TPN, etc for the LPNs, so the actual ratios were higher.

I hated that I was always rushing from pt to pt- or rather, task to task- usually charting! I've been a nurse long enough to remember when nursing included actually spending time with the pts, and I missed it terribly. So I left.

Your manager has already told you ratios aren't going to change, so it's not going to get any better. And it may get worse! If you like spending time interacting with pts, you might want to give hospice or home health a try. There's still a lot of charting- more in HH than hospice- but the actual work is very fulfilling, IMHO.

Remember that your health & sanity are important, and that pace will lead to burnout! Good luck with whatever path you choose

NurseGirl525, ASN, RN · Jul 15, 2016

9:1 on a medsurg floor? In a hospital? That's crazy.

AutumnApple · Jul 15, 2016

Your manager is both honest and correct. The ratios are not likely to change.

Situations like yours are what gives M/s a bad name. Not all M/s units are like that but the myth that patients on this unit are independent lives on and becomes the justification for cutting staff at a lot of them these days.

Unfortunately, you are going to have to tweak your expectations a bit. With your situation, just keeping people safe will be the goal a lot of days. Its not fair to your patients or you but, given what you have to work with, its reality.

Best advice I can give you is: Don't get into taking shortcuts. They always come back to haunt you.

Learn what you can from the experience, but move on when you can. In situations like yours, voting with your feet is the best policy. Just remain professional all the way through the process, before and after casting your vote.

freckles23 · Jul 15, 2016

Thank you all for your comments. I mean I get very overwhelmed and stressed which makes me into one of those snippy nurses, most of the time rather than not, which I absolutely hate. But the clinical experience is good and I am learning a ton. The staff is super supportive too so I dont have too many issues there. I work at a community hospital and I am currently getting my BSN so I need to be at this facility for 6 months after I get my degree which is doable I guess. I have hopes of attempting ED but I know it wont be any better. Not sure whether to transfer to ED at this community hospital or get my Bsn, stay on the med surg floor and then do ED once I have a good foundation since I have 8 months acute care under my belt. And my main goal through the shift is definitely to keep a safe practice with the high patient ratios but sometimes you get lost in your own head and things happen.

NurseGirl525, ASN, RN · Jul 16, 2016

9:1 is still crazy. I'm still a brand new nurse, and not on medsurg, but how on earth do you get all the charting done on 9 patients and meds passed? There's no way you can get any kind of assessing done so what happens to patient care?

I feel like medsurg nurses need to be on top of it because these are the patients that can go down quickly when you least expect it and so your critical thinking skills need to be too notch.

I'd rather pay for my BSN than compromise the lives of patients. I'm not saying anything negative to you at all. This falls on your manager to fight for better ratios and better staffing. Not tell you it's not going to change. What happened to patient advocacy?

That's a disaster waiting to happen.

Pangea Reunited, ASN, RN · Jul 16, 2016

I worked like that as a new grad and could only keep everyone alive and "OK" by cutting corners in a big way. Often, patients with a blood sugar between 150-200 didn't get covered, for example ...even though there were orders, the priority wasn't high enough. I also ignored repetitive (but "required") charting, didn't label IV tubing, etc. I even skipped "mandatory" staff meetings that existed to scold staff and only cut into my valuable sleep time between shifts.

There were certain things that I always made time for, however ....no matter how busy it was, I always did a complete assessment on every patient. Then, I prioritized as necessary. Some nurses spent all their time doing "required" tasks and never looked at their patients.

Everline · Jul 16, 2016

My first several months as a nurse were on a busy m/s floor with a 6:1 ratio and I left because I realized I could not even come close to being the nurse or person I wanted to be if I stayed. There were too many situations that did not sit right with me. I was constantly stressed out, rushing from patient to patient and suffering both physically and emotionally in and out of work. I cannot imagine being in your situation with more than 6 patients, especially if you don't have good techs to help you. I can only urge you to take care of yourself and carefully consider a plan to get where you want to be in the future.

littlemissbookworm · Jul 20, 2016

We've recently had staff cuts as well and on nights we have 8 patients each. I found that I had to find a new system since the staff cuts. Short cuts are tempting, but can add to your work load. I work surgery and I find that going through a five minute pain management educations session with new post ops pays off long term. I've taken over newer post ops who hadn't received that education and their pain was out of control and I had to spend a lot of time trying to get it back under control. Whereas if they do get that education, it can help them keep it under control and they have shorter stays, are happier, sleep during the night etc. Staffing cuts are hard. I'm still trying to figure it out myself. Team work has helped. It really sucks, I'm sorry you have to deal with staffing cuts as well .

Lev, MSN, RN, NP · Jul 20, 2016

In cases like these, your priority should be making sure that your patient's meds are passed safely, their vital signs are stable, and that abnormal labs are addressed.