In the past year legislation has been introduced nationally regarding nurse patio ratios. This will be a long time coming if it ever happens at all.
Our ER staffs by volumes. We have, for the most part, good staffing. During the day shift it sucks. We desperately need another nurse. Something bad is going to happen.
When we get a critical patient it requires two nurses as a norm. In the early morning hours we have 14 beds open, we have 3 nurses on. Most of the time the 14 beds are full. When that critical patient comes, that leaves 1 nurse to take care of 13 patients. Often times the charge nurse is out in triage helping the one nurse out there because it is so busy.
Later on another nurse comes on the side with 14 beds. So now when we have a critical patient, there are 2 nurses to manage 14 patients. It is not until 3 pm that the staffing becomes adequate.
I work in a hospital that specializes in cardiac care, stroke care. The patients we see in our ER are complex. They are not your in/out laceration, ankle sprain type patient. Add to this an order happy medical staff and you get the picture.
It is commonplace in the ER to have 2 critical patients in the ER at the same time. This ties up 4 nurses in a 35 bed emergency department. Good luck to the rest of the nurses caring for those other patients.
This is a dangerous situation. To think that our management expects 1 nurse to monitor 13 patients when there is a critical patient during a period of the day is crazy. Or to expect 2 nurses to manage 7 patients each during another part of the day, is ridiculous and dangerous. It is an accident waiting to happen. That accident is coming any day now.
Now add this scenario onto the drive for patient satisfaction. How satisfied do you think those other 13 patients are when they have 1 nurse to care for them?