Nurse To Patient Ratio Analysis

Challenges related to shortage of competent nurses

The ICU where the writer is working currently is a general ICU which caters from neonates to adults requiring intensive and coronary care. As for now there are total of twenty nine nurses working with her. However, ideally for twelve beds the required number of nurses should be at least thirty three of them. As per Malaysian Society for Quality in Health (MSQH), the required number of post basic staffs in critical care area should be above 40%. However, currently the writer is only having seven nurses with post basic which is only 24%. The remaining seventeen nurses are still incompetent and a few of them are not even suitable to be working in critical care areas. The writer feels it is not

Having incompetent nurses in critical care units is not a safe practice as they can compromise patients’ care and safety. Here the writer would like to share two incidents that took place in her own unit. The first incident was medication error on high alert drug. Doctor B was a newly joined Cardiac surgeon and there was a patient referred to him for Coronary Bypass surgery. Post surgery the patient was taken care by Nurse A, who had been working in the ICU/CCU for more than ten years. Doctor B ordered for intravenous potassium chloride (KCL) 3gms stat to run over one hour and 3gms to add on to the maintenance drip as the potassium level was 3.3mmol and order was carried out by nurse

However, the writer is still struggling to train her nurses to be competent. This is a challenge that yet to be overcome as the turnover for staffing is high. According to Neog & Barua, (2015), the constant staff turnover does give a great impact on the existing employees and it leads to unsafe practices. There are many reasons why the staff decides to leave the organization. The writer believes that one of the reasons is due to generation gap and this is the seconded most challenging factor for