Can You Take a 3rd Patient?

I work in an ICU and for the most part we are understaffed.  There have been several times when the staff is asked to take a 3rd patient.  The problem is when taking that 3rd patient makes your patient load unsafe to all of your patients.  Published studies show that appropriate staff helps to decrease medical and medication errors, patient mortality, hospital readmissions, and length of stay. The number of preventable events such as patient falls, pressure ulcers,central line infections, healthcare-associated infections (HAIs), and other complications related to hospitalizations are also reduced. It decreases nurse fatigue, thus promoting nursing safety, nurse retention, and job satisfaction, which all contribute to safer patient care. 

Most ICU's have a 1:1 or 1:2 Nurse/Patient Ratio depending on the acuity level of the patient.  However, most states don't have any laws in place to make this mandatory.  CA is the only state that stipulates in law and regulations a required minimum nurse to patient ratios to be maintained at all times by unit. MA passed a law specific to ICU requiring a 1:1 or 1:2 nurse to patient ratio depending on stability of the patient. Federal guidelines require hospitals who participate in Medicare to have adequate licensed  registered nurses to all patients as needed.  What does this mean for the Professional nurse if you are understaffed?  A higher workload?  Remember you do have the right to refuse any unsafe assignment.  However, isn't it so much easier to have a law in place so you don't even have to refuse?

Some states are taking action to ensure the nurse staffing is appropriate to take care of the patient needs.  Visit The Registered Nurse Staffing Act and write your Congressman today!

All comments are appreciated!