• ICU nurses are taking FOUR patients.
• Telemetry nurses are taking EIGHT patients.
• Medical/Surgical Nurses are taking TEN patients.
• Psychiatric Nurses are taking TWELVE patients

This is not a joke! These are real numbers I am hearing from real nurses, and it has to stop! Nurses know these are unsafe ratios for them to be practicing with, and it is unsafe for the patients! The only way this is ever going to change is with nurses educating the public and standing up to say enough is enough! Nurses are meant to be patient advocates. By advocating for safe nurse to patient staffing ratios, we are advocating for safer patient care!

My Experience

I would like to preface this by saying what I have experienced is happening in all types of facilities, all over the county! Not just the ones I have been in. My experience as a nurse so far has made me passionate about this subject and made me realize that something needs to be done about staffing ratios. In Long Term Care facilities, a nurse can legally take up to 44 patients! The idea of simply passing medication to that many patients is absurd, but we are also responsible for these patients’ lives.

Long term care facilities are not simply the “rest homes” of yester-years. The patients/residents in these facilities are becoming more acute. Hospitals are discharging people sooner. I worked full time (still work float pool) on a Transitional Care Unit in a Skilled Nursing/Long Term Car Facility. The Transitional Care Unit is a 22 bed short stay (up to 100 days) rehabilitation unit that is staffed with one nurse, 2-3 CNAs on first shift, 2 CNAs on second, and one on third. We see a lot of patients post-op from hip and knee replacements and post MI (heart attack) and CVA (stroke) patients as well as other diagnosis. We have patients with tracheotomies, PEG tubes, NG tubes, and wounds vacs. I usually have at least one patient with a PICC or IV line receiving fluids and antibiotics. Add in the possibility of admission and discharges plus the charting and paperwork that is expected of you, and you can easily become overwhelmed. There is discussion of bringing in vent patients as well. And yes, the legal ratio would still be up to 44 patients! Luckily in my facility, no matter what unit, you never have that many patients. But there are a lot of places where nurses do take 44 residents/patients.

With clinical experience in both my LPN and current RN program, I also am seeing the problem occurring in hospitals first hand as well. Nurses are taking more and more patients, and on top of that having to keep up with the admissions, discharges, hourly rounds, pain assessments, constant charting and more! Nurses look exhausted and defeated during report, before they even begin their shift. Older nurses are counting down the years to retirement, and younger nurses are considering leaving the nurse profession all together. I hear it all the time at clinical, “Get out now while you can!” Luckily, nurses are uniting to raise awareness about these unsafe staffing ratios, and working toward fixing this problem. If we don’t we are going to lose some very talented and knowledgeable nurses.

Under Appreciation for Nurses

Nursing services are not billable in the way doctors and other departments are. When a doctor does a procedure, there is a set amount that insurance or the patient is going to pay for that procedure. When a Physical Therapist visits, the hospital knows they are going to be paid a certain fee. When a nurse does the dozens of tasks, assessments, medication administration, and treatments that they do every shift, there is no direct billing for that care. Hospitals are not seeing a direct monetary return for nurses in the way they do other professionals. However, this does not mean our care and skills are any less important or necessary.

Nurses are the ones who are looking after patients at all times. Once a patient is assigned to us, we are responsible for them for the rest of our shift. We keep constant eye on their condition, and if we see the slightest change, we are there to intervene before things can get worse. If a patient codes, we are the first to jump on the bed and start chest compression. We are always doing our very best to keep patients safe and ALIVE! I find the public often still sees nurses as the people in the white dresses who follow around the doctor and take their every order. NOT TRUE! We are well educated in the disease processes, have top notch assessment skills, knowledge of medications, autonomy in our practice, and so much more. We work closely with doctors, but when it comes down to it, we are the health care professionals who will be in your corner if anyone, including a doctor, attempt to do anything unsafe.

The more patients nurses take, the less time we spend with each individual patient. The less time we spend with a patient, the less opportunity we have to assess for what can be life-threatening changes. We also are more rushed with medication and treatment administration, which can lead to med errors. All this can lead to more negative outcomes for patients, and cost the hospitals more money. With better staffing ratios, we can assess and monitor patients the way we need to. We have the time we need to give medications safely. This leads to more positive outcomes for patients, and saving the hospital money

Nurse Burn Out

Nurse burn out is a real thing, and can really weigh a nurse down. I have felt the effects of nurse burn out, and it is no fun at all. As nurses, we love taking care of people. We want to give our patients the best, safest, most competent care possible. That being said, we are still human! We are being spread to thin. In nursing school, you are taught so much about educating your patients on how to better care for themselves and what you can do to help them. You have this beautiful image in your head of the time you will spend with your patients, the thorough assessments you will perform, the comfort you will provide. In the real world, you realize it can be nearly impossible at times to do all these things because you do not have the time!

Nurses are tired. Tired of having “customer satisfaction” come before quality healthcare. Tired of taking more patients than they can safely care for. Better and safer staffing ratios will lead to happier nurses and patients. This will lead to a better hospital experience for everyone and better patient outcomes.

 

#NursesTakeDC

On May 12, Florence Nightingale’s birthday, nurses are taking to the steps of the Nation’s Capital to let America know we are done working with unsafe ratios! Nurses are going to be advocates for our patients, to let everyone know that we want our patients to be safe while under our care. They are supporting a bill that will result in national nurse to patient ratios, much like what is already happening in California. I wish I could join these fantastic nurses in person, but due to school and work, I won’t be able to attend. I will however be with them in spirit, and will continue to raise awareness on safe staffing ratios and why they are important! The current bills are specifically for acute care hospitals, and will not affect long term care facilities at this time.  I plan to work in a hospital after I become an RN, and I care deeply for my fellow hospital nurses and patients, so this bill and movement is so close to my heart and important to me! I also believe a national movement for safer hospital ratios will lead to safer ratios in other facilities! This is a win-win for all nurses and patients.

Proposed Staffing Ratios Include:

• Intensive/Critical Care/CCU/Burn 1:1
• Step Down 1:3
• Telemetry 1:4
• Medical/Surgical 1:4
• Psychiatric 1:6

For a full chart of proposed DC RN Ratios, click here.

Sending My Love

I want to end this with saying I love my career, and I am proud to be furthering my education in the RN program. I am proud to be a nurse! I write this because I want to provide the best patient care possible. Nurses are an amazing workforce, and an amazing group of people! Now that we are united, I have no doubt that we can make things happen! We all need to do our part to start to raise awareness of this unsafe staffing ratio epidemic that is sweeping the nation, and start advocating for a change. I send my love to all the nurses out there who are feeling the tired frustration that this problem brings! Keep pushing through! Together, we will bring safe staffing ratios to all nurses!

Find out more information about this movement at Show Me Your Stethoscope Official and National Nurses United.

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