I've Got the Floor

Floor nurses have the largest nurse-to-patient ratio of any area of the hospital.  Depending on the hospital, floor nurses can have four, five, six, seven or even eight patients. 

When I first became a nurse, I started on a 22 bed unit, and at night I split it with another nurse. 

That was not a typo.  Me and one other nurse split a 22 bed unit. 

Things like giving baths, helping with meals, explaining medications, treatments and goals of care were like dreams from another reality.  We ran in the patient's room, did the most cursory of assessments, threw their meds at them and ran out.  A patient who wasn't on the call light and had no frequent medications usually didn't get seen more than once.  Medical students, family members and respiratory therapists found patients cold and dead in their beds in those days.

It was all paper charting back then.  The night shift had to do the 24 hour chart checks, the MAR reconciliations, put in all our own orders and start the next day's flow sheets.  Just managing that avalanche of paperwork alone was a full time job.

In theory, floor patients are supposed to be very stable.  But they can also be very sick and getting chemotherapy, blood transfusions, heparin or insulin drips. 

Floor nursing is like  rehearsing Shakespeare in a mall parking lot.  The constant chaos and distractions makes progress difficult.