Question

You are the house supervisor in an acute care hospital. Most of the units are full. The ED request 2 admissions to the step-down unit. The floor with appropriate and empty beds has only 4 RNs on duty for this 30-bed unit with a census of 20 patients. The charge nurse (one of the 4 nurses present) tells you that they can’t safely admit any more patients. You currently have no more float pool staff and upper administration has already said no to closing the unit for admissions at this time. What should be done? What is the ethical dilemma? How does this impact patient care? What possible solutions are there for this situation?

Answer 1

The patients cannot be admitted on the 30-bed unit due to the scarcity of RNs and float pool staff at that time. They were advised to seek help at a nearby hospital.

The ethical dilemma involved in this case is the unavailability of sufficient and conpetent staff to take proper care of the patient.

Also, poor staffing makes the available nurses feel overwhelmed and exhausted and this negatively impacts the ability of nurses to efficiently care for the patients.

Possible solutions:

• Nursing assistants can be used to overcome the shortage of registered or enrolled nurses.
• There should be change in the scope of RN practice.
• The nurses must communicate effectively with each other, their patients and other care providers to assign proper duties.
• Float pool staffs should always be available.