Posted: 10/9/2006 7:20:20 PM EDT
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I was home for the weekend in Canada listening to my dad's latest health care horror stories. There is a lawsuit against an ER doc who gave a patient with a broken hip some morphine and dilauded and the patient ended up coding and died a few days later. There is definitely disagreement among all parties involved as to the cause of death, but I was surprised to hear about how small the nurse to patient ratio was (or has gotten). There were 21 patients in the ER with 3 ER nurses plus the ER doc the night of the incident. This was apparently an average night. The patient kept asking for more morphine and was eventually made pain-free. No one did vital signs on the patient after she received her last dose until she was found unresponsive 7 hrs later (still in the ER). During those 7 hrs, there were three nurses notes which only said "Patient is sleeping". The patient wasn't admitted by the only orthopedic surgeon for a city of 60,000 people because he told the ER that he would see the patient in the morning. He said he would likely have time to schedule the surgery a few days later. They're actually lucky because they went a few years without an orthopedic surgeon and the nearest one was about 1H10min away. Now my question: Is this nurse/patient ratio reasonable in the ER setting? What is a typical ratio in the U.S.? |
That sounds exaclty like my home town. My parents get their care in the US when they need it. Free health care is far more expensive than that which you pay for. |
Well, then, I guess 7:1 isn't so bad. But no vital signs in 7 hrs? Maybe all the good Canadian nurses came to the U.S. 
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| 7 to 1 would be a shit day, that would also depend on the level of care each patient would require, we are required to get vs's on all pt's each 2 hours, cardiac and any unstable pt will require vs every 15-30 min. In the case you mention I would rechecked the pt after 15 min to ensure the pain medication had worked, then each hour or so afterwards. |
Thats because you are a good nurse. There are others that dont give two shits or are so overworked they are physically unable to take care of all their charges in one shift. |
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I've worked in three level1 trauma centers in my city and they seem to have agood patient to nurse ratio.Atmost 3-1 and on the highest acuity patients it's usually 1-1. Our main trauma center sees high volume pretty much 7 days a week and it is crawling with personell most of it nursing. The care you get is only as good as the people working. |
I don't know how acute the patients were in this situation, but it is easy to see how an overworked nurse with more critical patients would have to cut corners. It's a non-issue for the nurses in this case since they are not named in the lawsuit. Only the hospital, ER doc, internist and my dad (specialist) are named. My dad's lawyer thinks he'll be dropped from the suit shortly since he didn't even take care of the patient until after everything went to shit. |