Statement from Cameron Adams, Registered Nurse and NUHW Member:
My name is Cameron Adams and I’m a registered nurse at Sacramento Behavioral Healthcare Hospital. I’m also a proud member of the National Union of Healthcare Workers.
Unlike my counterparts on psychiatric units in general acute care hospitals, my patient assignments at Sacramento Behavioral are not regulated by nurse-to-patient ratios. They are at the discretion of my employer.
Typically, we split about 20 patients between two nurses. This means I’m often responsible for ten patients at a time. When I’m working as a medication nurse, I can be responsible for med passes for all 20 patients.
These numbers don't always reflect the complexity of psychiatric care, especially when you factor in patients who are suicidal, psychotic, or behaviorally aggressive. With such large assignments, it’s nearly impossible to complete everything we’re expected to do each shift in a timely, safe, and patient-centered way. Assessments and medication passes sometimes run late. We have to rush through education for patients and their families. We often don’t have time to return calls from worried family members. And we’re expected to safely manage combative or agitated patients without the proper staff backup.
On more than one occasion, I’ve had to choose between documenting a patient incident and responding in real time to a behavioral crisis on the unit. That’s not safe for anyone.
This is why my colleagues and I are asking the Department of Public Health to step in and enforce clear, safe nurse-to-patient ratios of one nurse to six adult patients, and one nurse to four adolescent patients. We also urgently need regulation of the staffing levels for our unlicensed support staff, who are critical to maintaining safe and equal care on the units.