the change in staffing ratio side effects
on the first day of january, california staffing ratio changed. for a telemetry unit like ours, it was changed from 1:5 to 1:4. our hospital however, anal about safety, always go one patient less. so that last year, when all of california has a 1:5 ratio, we had 1:4.
i guess you easily figured that out. yes. on the first day of january, we changed to 1:3.
when you have been so used to working your butt off with 4 patients, you can only imagine what the change means. we used to imagine it, because we knew since last year that there will be a change. well, actually, we used to dream about it.
now, we’re living the dream.
what is nice about it is that we actually have more time with the patients. for example, before the change, i can’t recall the last time i have given any of my patients a bath even when they requested it. i simply had no time and had to tell them they had to wait till day shift because that’s when there were more PCAs to do it. now, just on the third week, i have given two patients full baths, and two sponge baths to two others!
you have no idea how good it felt…you know, to say, “oh, you want a bath? i’ll be back!” needless to say, we have more time to listen too. i have gathered so many interesting stories in my head about patients who obviously just want to talk to someone, and i know it is a small thing, but they openly appreciate it. it feels good to be appreciated. i won’t lie about that.
as far as patients are concerned, this change is definitely a good thing.
as for the staff? i think it still remains to be seen.
the thing about it is that we have more time to catch up with what’s going on in everybody’s personal lives. i have been updated on who is about to get a divorce, who is not getting a divorce even though they can’t stand their husband, who is complaining that their husband wants sex everyday, who is starting a business, who hates who, who can’t stand who, who….you get the idea. the topics and the stories are endless, and nobody knows where the gossips start.
don’t get me wrong, i like it that i know what’s going on with my coworkers’ llives. i enjoy interacting with them, sympathizing with them, and sharing my own learnings and mishaps with them. what i am not so comfortable with is the talking about somebody else, which usually starts as an innocent thing, but eventually ends up as something else.
i don’t know if that is a good thing or a bad thing.
sometimes, i just feel that i would rather be spared from too much information about my coworkers’ thoughts, especially things they talk about other staff who are not present. not only that it makes me paranoid, because i end up thinking about what they say about me when i’m not there, but also because i just don’t dig the whole thing sometimes.
the problem is, even when i have my head buried in a book, i can still hear the whispers. it’s hard to sift the truth from the lies. it’s almost impossible not to get involved. even if it’s just in your own head.
as i said, i’m not sure if that will eventually be a good thing or a bad thing.


I sooooo know what you mean about how it’s nearly impossible to stay out of the drama. I’ve about had it with our unit’s drama and I’m actually thinking of finding a new job. There’s a couple positions open at my former hospital, and I think I’d have a really good chance at getting hired.
But, I know there’s politics everywhere you go, so even if I changed jobs, it will still be there, just with different people!
I’m glad you are getting to spend more time with your patients, I’m sure they really appreciate the extra care also!
Comment by CrazyRN (Brooke) — January 17, 2008 @ 1:02 pm
Gosh,1:3!.At my last job they got twitchy at me when I said something about having 6 pt on day shift tele floor. Two being titrated on heparin gtts(not theraputic yet and symptomatic),one going to cath lab,one to endoscopy,one for stress test on nitro gtt for malignant htn and oh,one getting a thoracentesis whose baseline B/P was 90/50.I got fussed at for missing a staff meeting that everybody else missed b/c we were all swamped. I’m glad I’m out of there but I don’t think there are any better jobs out there in this area and I’m not willing to almost kill myself again.
Sorry to vent May,there seems to be no happy medium.And the drama queens? OMG!
Comment by CinderRN — January 17, 2008 @ 2:59 pm
That’s great about the new ratio, May! As for the drama, it’s tough to avoid. I guess there’s only so much that you can do to separate yourself from it. Hang in there…
Comment by unsinkablemb — January 20, 2008 @ 6:10 pm
how i wish that ration was the same here… even 1:10 would be a dream come true
Comment by Rygel — January 22, 2008 @ 4:59 am
I need to move to Ca. I worked the other night, on a med/surg floor. I started with 7 patients, 1 getting blood, 2 on PCA’s, 1 wound vac, all needing stuff. I immediately got a fresh post-op patient. And…. I was supposed to just be working a partial shift. But there was no relief for me. So I had to give all of those patients to the other 3 nurses who were already carrying 8 each.
Congrats to you-it must be wonderful being able to care for your patients!!
Comment by lpnmon — January 25, 2008 @ 11:07 am
may:
That sounds like a real deal! I wish my unit had the same thing.
I gave a patient a shower Thursday before I left because I had an order to do so. I had to do it because I knew the techs nor the RN would have time to do it.
It would be nice to do this whenever I wanted. Getting clean from a shower or bath is totally different from getting a sponge bath.
Comment by RehabRN — January 27, 2008 @ 9:04 am
Oh - if this is true I may return to bedside nursing! How I longed for that. I would strongly encourage you and your peers to consider yourselves guardians of all of OUR fates. If the administration feels, or had data, that the change did not increase patient care time — we all may be doomed. I too recall believing that drama was inevititable. Until I worked with, by a weird chance in life, with my sister. She drove me crazy in our family, avoiding talking about anyone else. I didn’t know how she did it. But while spending several weeks on a unit with her I saw. She listened alot, contributed nothing more than “ok gee that must be tough”, or “how about that?” to any story or complaint no matter how juicy. And it never went on bit further. If asked about another person she said, “I don’t discuss anything that is said to me about personal lives of the people I work with” and changed the subject. When asked how she felt about another coworker etc “Why do you ask?” and then listened and avoided the question or it it returned restated “I don’t discuss my coworkers without their knowledge, if you would like to know, I will be happy to tell you when they are present” or simply “why don’t you ask them?”. The staff got mad at her, just like I did. She didn’t share much of her personal issues at work, but listened to alot of others. After awhile they knew not to ask or expect that she would participate. They didn’t know how she coped. But I did, she kept a varied but trusted circle of friends/professionals who she talked with regularly, she journaled her feelings some times dramatically. I had been one of those she was able to talk to but when we were on the same staff she sought out others. Once our units split again we were able to be of support to each other again. I learned alot from her. I wish that I had the courage and strenght to do what she did. I wish it for us all actually.
Comment by MP — April 5, 2008 @ 3:25 pm
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Comment by rmvoisd jxyl — September 11, 2008 @ 2:25 am