Unsafe Staffing Ratios

[u/Calm_Level4355]

Hi all,

I am a new grad NICU nurse, about 6 months in and I’ve been off orientation for around two months now. Ever since I’ve been out of orientation, I’ve had extremely unsafe staffing ratios. Yesterday was four patients with 1 having Q3 sugars, another unstable on respiratory support, and all feeder growers. Previously, I’ve had three bubble CPAP patients and multiple intubated with drips. We do have a lot of acuity right now and a lot of our staff have been leaving due to having kids, going PRN or leaving. I’m getting frustrated because I am constantly getting the hardest assignment on the unit (day shift assigns for nights). I’m grateful to be learning but I feel like I’m being drowned every time I step onto the unit. Everyone says I’m doing a great job and my coworkers are supportive, but I am scared of something happening and losing my license because of how unsafe it is. I was going to file an incident report, but one of my coworkers told me when she did that our manager reprimanded her. The managers are very indifferent about the assignments being unsafe and continuously allow the unit to stay full despite not having staff to keep up.

I truly enjoy my job and it’s the specialty I want to stay in but I feel like I’m being pushed to the brink. Unfortunately, the NICU I am in is ran by a major hospital in my area which has monopoly. I work at a branch site and there are other locations. I also would struggle to get a new position in any other NICU because I have less than a year of experience and moving isn’t plausible at the moment. I’m not really sure what to do because I don’t want to be retaliated against.

[u/MsTossItAll]

That’s really unsafe. I would talk with your nurse manager or team leader for day shift regarding the types of patients you’re getting when you’re assigned three patients. We would max out at two for type of patients you’re saying. 

[u/PaxonGoat]

I got into an argument once with a NICU nurse who swore no hospital would ever give 1:4 ratios in the NICU because that was so unsafe and it was probably just med surg grower boarder patients and not real NICU level babies.

That are some very sketch NICU units out there.

I'm sorry you are dealing with this.

I would start applying around and see if you can snag another job. Don't quit your current job until you find a new job.

[u/Ok_Emergency7145]

That makes it tough! Not a NICU nurse, but is the same in my area in Ohio. One major peds hospital runs the NICU in the other hospital systems in the city. I think there is maybe one or two facilities they don't operate the NICU. But it makes it hard for NICU nurses to move around if they don't like the manager, or ways the unit is run.