Can a Nurse be Effective with 7 Patients?

I’m seeing a trend in nursing that I don’t like.

The trend is nurses having 7 patients.  Some of my patients have said that that isn’t a lot of patients to have.

When you break down all the things to do for those patients in a 12 hour shift, it becomes a lot of things to do.  I got into nursing to help people.  I like to connect with my patients on a human level and talk to them and hear their stories and struggles.  Not only does that help the patients but it helps me as well.  I can learn life lessons and the patients have someone to talk to.  Some of the patients don’t have anyone to talk to.  When I have 7 patients, I’m not able to do that.  I become task oriented and my patients become more demanding and impatient because I’m being pulled in so many directions.

Also when a nurse has 7 patients, if something goes wrong with one patient, then the other patients unfortunately get ignored for a while.  I’ve seen this too many times.  For example, a few weeks ago, one nurse had to call a code blue for the patient.  In the middle of the code blue another of the nurse’s patients called for some pain medication.  All the other nurses were busy because they all had 7 patients.  The patient ended up waiting about 30 minutes for pain medication.  The charge nurse was busy with the nurse in the code blue.  It was my first day on the floor of this hospital but this was an all too familiar situation.  At the end of the shift, the nurse said she felt bad because she felt like she had ignored some of her patients because of the code blue.

Another example, my preceptor and I went on lunch.  We asked another nurse to look after our patients for our lunch.  When we got back from lunch, one of our patients was screaming.  The patient was mad that the pain medication had not been given when the patient had called 20 minutes ago.  The nurse that was covering for us was very busy and didn’t answer the call light.  I understood that the other nurse was busy.  That nurse was covering 14 patients when we went to lunch break.  It’s hard enough to take care of 7 patients.

This hospital makes the nurses take 7 patients on a regular basis.  To me this is setting up the nurses to fail.  Nursing is more than just doing tasks.  A nurse doesn’t just take care of the patients.  The patient’s family members can sometimes need the nurse to take care of them.  When the patient is dying, the family members need the nurse.

For example, I was teaching my patient about the new diet because the patient had just found out about a new diagnosis.  The patient wanted to have the significant other taught about the diet too.  This is a not a requirement for a nurse but that helps the patient.

Almost every time that I have 7 patients, I leave that shift feeling like I’ve done the best that I could do but I wish I had more help to do all the things that I couldn’t do because it became too much to do in a 12 hour shift.

I was recently talking to a nurse about the 7 patient situation.  The nurse stated that as long as the patients didn’t die then it was a good shift with 7 patients.  He referred to a meme.Sometimes after my 7 patient shift, this is what I feel like telling the patient.  I did the best that I could do.  Yes it may have taken me a few more minutes than the patient liked to get to the patient’s room but I’m only one person.  Yes I have a PCA helping me, but the PCA can’t give the patient pain medication.  The charge nurse is busy because sometimes the charge nurse has patients also.  With all the nurses on the floor having 7 patient the nurses are busy.

At the end of day, a hospital needs to make a safe environment not only for the patients but for the nurses as well.  Giving nurses 7 patients is not making a safe environment.  I’ve seen a lot of nurses take 7 patients and end up complaining about it.  If all the nurses came together and said no then the hospital would have no choice but to hire more nurses.  As long as the nurses keep taking 7 patients then the hospital isn’t going to make a change.

Recently one of my patients read to me the mission statement of the hospital.  The patient stated that not one employee has upheld the mission statement.  I couldn’t say anything to the patient but I agreed with the patient.  Effective care wasn’t being given at all times.

The nurses need to talk to the charge nurse and the director of nursing to let them know how they feel.  Just talking to other nurses isn’t going to be enough to make a change.  I recently had a talk with the charge nurse and the director of nursing at the hospital about this.  This hospital is losing a lot of nurses because of the 7 patient situation.  I let them know how I felt.

A nurse can not be an effective nurse with 7 patients.

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