SAFE STAFFING PATIENT RATIO

SAFE STAFFING PATIENT RATIOCarrie Grossi

Fitchburg State University

Abstract

The reason for choosing “Safe Staffing Ratio” as my topic for my final paper because while working alongside my preceptor at Local Community Hospital on the Med/Surg Unit, it has become apparent to me that working short staffed or working with a higher patient to nurse ratio, it is a concern for care and safety of the patient(s). This is an incomplete project that has been ongoing and in negotiations with the hospital contract since August of 2019 and prior to this date.

The nurses on the Med/Surg Unit have been voicing their concern about the patient to nurse ratio and the safety and care of the patient to management and the CEO of the hospital for over a year. The nurses will regularly stand outside in various locations once a week holding signs to advocate for safe staffing. One of the nurses was featured on the Leominster Local Access Television Station discussing this with Representative Natalie Higgins. One thing that I would like to see changed and addressed is patient centered care to allocate appropriate staffing that allows for nurses to spend quality time with patients.

The Med/Surg Unit can hold up to thirty patient(s), and if appropriately staffed the unit would consist of eight Registered Nurses, a Charge Nurse without and assignment, a “STAT” Nurse that floats from unit to unit to assist with whatever may be helpful to them at that time, and six Nurses. The six Nurses would be assigned five patients each. This staffing has only been achieved a few times, but this would allow the charge nurse to assist all the nurses and utilize her as a resource person, for admissions, discharges, and or patient concerns. Currently the Charge Nurse takes a full patient assignment and therefore leaves her unavailable to assist her team.

While performing in my Practicum setting as a student nurse it allowed me to see the dynamics from a different view. I was able to see how all the nurses interact differently. By that I mean how they delegated care, how they made and delegated assignments, and most importantly how each one interacted differently with the patient. Each Nurse had a different approach, style, and way of caring for the patient. My preceptor and I would receive a report at the start of the shift and the first thing that needed to be done was to assess who was a diabetic before breakfast was handed out. Once identified you would go into EMR “Electronic Medical Record” to ensure that the Blood Glucose was tested that morning and to calculate how many units of insulin to give the patient. When drawing up the insulin you always must have it double checked before giving to the patient to ensure the correct dosage is being given. This is a process that should be done in an appropriate time frame as the patients are waiting for their breakfast and I found that some do get very angry if they don’t have their insulin in time.

During the Practicum in the Hospital setting on the Med/Surg unit I’ve learned a lot. The start of the shift reports and requirements, and patient delegation. Focused on patient care, patient need, empathy, drive, and commitment to great patient safety and care. Demonstrated a high level of integrity and ethical judgement. Understanding of the patient(s) privacy laws including HIPAA and similar state laws. I’ve also learned that each patient is different when it comes to caring for them, you can have two come in for a Total Knee Replacement and their wants and needs can vary which is all based on their physical and mental mentality. Then there was the end of shift reporting and the hand off patients to the next shift, you need to make sure that all your EMR “Electronic Medical Record” is up to date, the reports are done and most importantly you communicate with the incoming shift about their patients.

In my setting there were both leaders and management involved in overseeing patient care. The nurse manager was not working on the unit with patients but did walk the floor and make her presence known. From my observation, she was more focused on administrative duties. All the nurses had positive and encouraging things to say about her, she was a good manager and cared for her staff. Leadership on a shift by shift basis on my unit came from all the nurses. Each nurse, when it was their week to be the charge nurse they showed excellent leadership qualities, such as checking in with each nurse and making sure she was available even though she herself had a full patient load. The unit worked as a team. We know that leadership and management are two distinct competencies. (Porter-O’Grady, Malloch, 2016, p. 99). All the nurses on this unit displayed great leadership qualities, showing equality and fairness.

References BIBLIOGRAPHY

Porter-O’Grady, T., Malloch, K (2016). Leadership in Nursing Practice Changing the Landscape of Health Care. Burlington,MA: Jones & Bartlett Learning.