"Unsafe staffing levels"

Today, on a male ICU ward, we woke up to find out that of all the staff working on the ward, only two of them had worked on here for more than a month. Both of these staff were female. We had only one regular male on shift, with today been his second shift on the ward. 

All the other staff on shift were either non-regular or new to the ward. In total, including the male mentioned above, we had between three & four males on shift. The rest of the shift were made up of females.

Other than the fact this is an ICU ward and prone to violence and incidents, we have one patient on arm's length observations, one on eyesight obs' and another on two staff when they get up. This means that the male-to-female staff ratio on the ward was unsafe, with not enough males to be able to do everything that needed doing.

As I write this, we have a staff gender ratio of 4:1 in the dayroom, with three patients up. One of these patient being on eyesight obs'. This mean that if he wishes to go back to his sideroom to use the toilet, he either cannot go, or the only available male staff will have to take him - leaving only females in the dayroom with two male patients. 

While this type of staffing may be acceptable on some wards, i'd remind the reader that this is an ICU ward i'm talking about. A ward with some very challenging patients on it and a ward that has had multiple incidents on it over recent weeks. To use one of the nurse director's, we have a "high level of acuity" at this time. 

We understand that the hospital has an issue with staffing at this time. (In part due to the fact Trust management are trying to stop overtime and force staff to become 'bank' staff). This however cannot be used as an excuse to provide wards with inadequate staffing levels and/or gender balances.

It's all very well saying a ward requires X number of staff to run safely, but this number doesn't seem to take into account the day-to-day needs of the patients. For example, if as  a patient, if I decide to go back to my room for a bit, we'll require two staff to sit on the corridor as one patient is on constant obs' in their sideroom. If another patient requires a shave, that'll also require two staff. If another LTS patient (on two staff) wishes to get up, that'll take up yet more staff. Soon we find ourselves without enough male staff to be able to staff the dayroom or enough staff of any gender to be able to do any of the various tasks that are required of them during the core day. 

I know that (Care Group Nurse Director) is aware of the current issues around staffing levels and that he intends to consult with patients on the issue via the Made Purple platform.  Its good that we can communicate through Care Opinion.  While that MIGHT help provide a fix at some point in the future, it isn't going to help any time soon. We need safe staffing levels to be decided not by management, but by the staff and patients on the individual wards. Such decisions need to be made by people who understand the day-to-day intricacies of a particular ward and it's patients.