Nurse/Patient Ratio matters!
Well, I can’t say it has been an overly exciting week. I was in our high observation unit where the nurse/patient ratio is 1:2. I really love being assigned to these patients: mostly because I feel I can do a better job with only two patients–even though they are much sicker.
One of my patients developed a pulmonary embolism–which always scares the crap out of me! However, because I only had two patients, I was able to catch her changing condition early. It was one of those moments where you look over at your patient and think, “something’s not right, I better do some vital signs.”
Her sats were shockingly low and her heart was in a-fib. As a result, we didn’t really know if it was a cardiac issue or a pulmonary issue. But, after a few tests (Spiral CT, P/Q scan etc.) it was, as I mentioned, a pulmonary embolism.
If I had five or six patients instead of two, it isn’t a remote possibility that she could have faired much worse. As it stands now, she’s doing great! She is improving at exponential rates.
More proof that nurse/patient ratio matters.
October 10th, 2007 at 13:27
If only you were in Boston, I’d be begging to shadow you for a shift or two. Your job sounds fascinating, Sean!
October 13th, 2007 at 16:21
i can only agree. sometimes, it gets frustrating that we cannot do things that we can and are supposed to do, only because we only have one body.
October 15th, 2007 at 12:02
i completely agree, ratios do matter. it also helps to have good supportive staff that are able [and willing!] to give a hand when you need it should you find yourself in needy situations.
great job at catching the pt’s changing situation. Nothing makes you feel better than knowing your immediate action results in better outcomes for the patients, in my opinion anyhow.
October 17th, 2007 at 10:33
I’ve been a nurse in San Antonio for 22 years now. In the ER we HAD a ration of 4:1 but now we are told we must take more patients. Sometimes you’re stuck in a room with a critically ill and dying patient with no pressure or is bleeding to death. So much for your other patients who are waiting for the IVF’s, blood draws and pain meds.
The NNOC set up camp in TX and there was a bill in the TX legislature for safe ratios but it failed to pass. The NNOC, instead of working to gain nursing support for the bill jumped on the Micheal Moore bandwagon of lies about cuba’s fantastic health care and the USA’s need for socialized medicine.
We have no one to speak for us and are considered expendable in the eye of the hospitals we for for.
We are doomed in TX.
October 25th, 2007 at 08:47
Sean – excellent post about the patient’s changing condition and great job on the identification! I work in an ICU and all too often we are tripled with patients. This mkaes it very difficult to recognize minor changes that may have a big impact. Nurse to patient ratios are clearly the reasons patient either do well or poorly. There are a number of research articles that address statistical trends relating to poor nurse to patient ratios. Love your blog and have you listed you all as a fav on mine.
October 27th, 2007 at 12:33
Sean, please humor my ignorance as a nursing student: so, when you noticed something was wrong with your patient, you took vitals and immediately told the attending? Then the attending ordered the Spiral CT, P/Q scan etc. tests? So there was TIME for all this? What do you do for the pt. while waiting for the tests? Thinking about PEs make me really nervous so your insight might help. Thanks!
June 1st, 2009 at 06:34
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December 7th, 2010 at 17:43
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